Justia Health Law Opinion Summaries

Pursuant to the Affordable Care Act, Congress required hospitals to make public "a list" of "standard charges" in accordance with guidelines developed by the Secretary of Health and Human Services. The Hospital and others challenged the Secretary's rule defining "standard charges" as including prices that hospitals charge insurers.The DC Circuit affirmed the district court's grant of summary judgment in favor of the Secretary, holding that the rule does not violate the Affordable Care Act of 2010, the Administrative Procedure Act, or the First Amendment. The court concluded that, viewed in its entirety, 42 U.S.C. 2718(e) is best interpreted as requiring disclosure of more than list prices. The court explained that section 2718(e) permits the Secretary to require disclosure of negotiated rates, and requiring hospitals to display certain datapoints separately falls squarely within the Secretary's authority to develop guidelines for making the list public. Furthermore, contrary to the Association's argument, the best reading of section 2718(e), in its entirety, permits the Secretary to require hospitals to display the information in multiple ways.In regard to the APA claims, the court concluded that the Secretary adequately addressed the feasibility and administrative burdens, as well as the benefits, of complying with the rule. Furthermore, the court rejected the Association's claim that the agency changed its position. Finally, the court concluded that the Association's argument that the rule violates the First Amendment is squarely barred by the Supreme Court's decision in Zauderer v. Office of Disciplinary Counsel of the Supreme Court of Ohio, 471 U.S. 626 (1985), and the court's case law applying that decision. View "American Hospital Ass'n v. Azar" on Justia Law

Due to the rate of positive COVID-19 cases and hospitalizations on O'ahu, the Supreme Court ordered that the August 27, 2020 order regarding temporary extension of the time requirements under Haw. R. Pen. P. 5(c)(3) for first circuit criminal matters is further extended until February 14, 2021.On August 27, because of a surge of COVID-19 cases in community correctional centers and facilities, especially at the O‘ahu Community Correctional Center, the Supreme Court entered its order providing that the first circuit may temporarily extend the time requirements for preliminary hearings to protect public health and safety. Because the rate of positive COVID-19 cases continues to fluctuate and the grand jury was scheduled to be in recess in January, the Supreme Court held that a further extension of the August 27 order was necessary. Thus, the Court ordered that the August 27 order be extended until February 14, 2021 unless otherwise further modified or extended. View "In re Judiciary's Response to the COVID-19 Outbreak" on Justia Law

The Supreme Court reversed the judgment of the court of appeals denying Henderson County Health Care Corporation's (hereinafter, Redbanks) petition for a writ of prohibition prohibiting the enforcement of an order issued by Judge Karen Wilson of the Henderson Circuit Court compelling Redbanks to produce certain consultant reports to the real party of interest, Roland McGuire, holding that the court of appeals erred.Specifically, the Supreme Court held Redbanks was entitled to the issuance of the writ because the consultant reports at issue in this case were protected by the Federal Quality Assurance Privilege, 42 U.S.C. 1396r(b)(1)(B) and 42 U.S.C. 1395i-3(b)(1)(B), because they were used for quality assurance purposes. View "Henderson County Health Care Corp. v. Honorable Karen Lynn Wilson" on Justia Law

Defendants appealed the district court's judgment certifying a plaintiff class and enjoining state defendants from conducting Medicaid fair hearings in a manner that does not result in final determinations of Medicaid eligibility within 90 days of hearing requests. At issue is the phrase "final administrative action" in the context of a federal Medicaid regulation that requires a state agency to take such action within a specified time limit following a Medicaid applicant's request for a fair hearing. 42 C.F.R. 431.244(f).The Second Circuit held that the federal regulatory requirement of "final administrative action" within 90 days requires the state to determine Medicaid eligibility within that time. However, the court explained that such determinations may be made in hearing decisions or on remand to local agencies. Therefore, the regulation mandates that states meet the applicable deadline, but it does not limit states as to the administrative level at which that deadline is met. The court affirmed in part and remanded for further proceedings. View "Lisnitzer v. Zucker" on Justia Law

The First Circuit dismissed this appeal without prejudice for lack of appellate jurisdiction, holding that the appeal was premature.In the early weeks of the COVID-19 pandemic, the Governor of Maine responded to the threat of contagion by issuing executive orders limiting all non-essential activities and gatherings. Plaintiff Calvary Chapel of Bangor brought this action arguing that those orders violated the First Amendment's Free Speech, Free Exercise, Assembly, and Establishment protections. The district court refused Plaintiff's request for a temporary restraining order. Plaintiff appealed. The First Circuit dismissed the appeal, holding that this case did not display the criteria this Court has previously identified as characterizing a de facto denial of injunctive relief and that the remaining requirements for appealability were not satisfied. View "Calvary Chapel of Bangor v. Mills" on Justia Law

In 2012, 41-year-old Karen Hubbard suffered a catastrophic stroke caused by a blood clot to her brain--a venous sinus thrombosis, a type of venous thromboembolism (VTE). She had been taking Beyaz, a birth control pill manufactured by Bayer. While she first received a prescription for Beyaz on December 27, 2011, Karen had been taking similar Bayer birth control products since 2001. The pills are associated with an increased risk of blood clots. The Beyaz warning label in place at the time of Karen’s Beyaz prescription warned of a risk of VTEs and summarized studies.The Eleventh Circuit affirmed summary judgment in favor of Bayer. Georgia’s learned intermediary doctrine controls this diversity jurisdiction case. That doctrine imposes on prescription drug manufacturers a duty to adequately warn physicians, rather than patients, of the risks their products pose. A plaintiff claiming a manufacturer’s warning was inadequate bears the burden of establishing that an improved warning would have caused her doctor not to prescribe her the drug in question. The Hubbards have not met this burden. The prescribing physician testified unambiguously that even with the benefit of the most up-to-date risk information about Beyaz, he considers his decision to prescribe Beyaz to Karen to be sound and appropriate. View "Hubbard v. Bayer Healthcare Pharmaceuticals Inc." on Justia Law

In this dispute in which Plaintiffs sought reimbursement for healthcare costs based upon claims for restraint of trade and monopolization pursuant to N.C. Gen. Stat. Chapter 75 and N.C. Const. art. I, 34, the Supreme Court affirmed in part and reversed in part the order of the trial court deciding issues arising from the Charlotte-Mecklenburg Hospital Authority's motion for judgment on the pleadings, holding that the trial court erred in part.Plaintiffs were a group of current and former North Carolina residents who were covered under the commercial health insurance obtained through the Hospital Authority, a non-profit corporation providing healthcare services with a principal place of business in Charlotte. The trial court granted the Hospital Authority's motion for judgment on the pleadings with respect to Plaintiffs' restraint of trade and monopolization claims but denied the motion with respect to Plaintiffs' monopolization claim. The Supreme Court affirmed in part and reversed in part, holding that the trial court (1) did not err in granting judgment on the pleadings with respect to Plaintiffs' Chapter 75 restraint of trade and monopolization claims; but (2) erred by denying the motion for judgment on the pleadings with respect to Plaintiffs' claim pursuant to article I, section 34. View "DiCesare v. Charlotte-Mecklenburg Hosp. Auth" on Justia Law

The Supreme Court reversed the judgment of the district court granting Defendant's motion to compel arbitration under the "voluntary agreement for arbitration" Rick Miller signed on behalf of his mother, Julia Miller, after she was admitted to Life Care Center of Casper (LCCC), holding that Rick lacked authority to execute the agreement.After Julia died allegedly from injuries sustained during a series of mishaps at LCCC Rick filed this complaint stating claims of negligence and premises liability against Defendant. Defendant filed a motion to compel arbitration. The court granted the motion. The Supreme Court reversed, holding (1) Julia's durable power of attorney for health care did not grant Rick express actual authority to sign the arbitration agreement; (2) Julia did not hold Rick out as having apparent authority to sign the agreement; and (3) Rick was not authorized to execute the arbitration agreement as Julia's "surrogate" under the Wyoming Health Care Decisions Act, Wyo. Stat. Ann. 35-22-401 through 416. View "Miller v. Life Care Centers of America, Inc." on Justia Law

Calvary Chapel challenges Nevada Governor Steve Sisolak's Directive 021, which prohibits certain gatherings because of the COVID-19 pandemic, as a violation of the Free Exercise Clause of the First Amendment. Specifically, Calvary Chapel challenges section 11 of the Directive, which imposes a fifty-person cap on indoor in-person services at houses of worship.The Ninth Circuit reversed the district court's denial of the church's request for a preliminary injunction barring enforcement of the Directive against houses of worship. The panel held that the Supreme Court's recent decision in Roman Catholic Diocese of Brooklyn v. Cuomo, --- S. Ct. ----, 2020 WL 6948354 (2020) (per curiam), arguably represented a seismic shift in Free Exercise law, and compels the result in this case. Similar to the pandemic-related restrictions in Roman Catholic Diocese, the panel explained that the Directive treats numerous secular activities and entities significantly better than religious worship services. The panel explained that the Directive, although not identical to New York's, requires attendance limitations that create the same "disparate treatment" of religion. Because disparate treatment of religion triggers strict scrutiny review, the panel reviewed the restrictions in the Directive under strict scrutiny. Exercising its discretion, the panel concluded that, although slowing the spread of COVID-19 is a compelling interest, the Directive is not narrowly tailored to serve that interest. In this case, the Directive—although less restrictive in some respects than the New York regulations reviewed in Roman Catholic Diocese—is not narrowly tailored because, for example, "maximum attendance at a religious service could be tied to the size of the [house of worship]."Therefore, Calvary Chapel has demonstrated a likelihood of success on the merits of its Free Exercise claim. Calvary Chapel has also established that the occupancy limitations contained in the Directive—if enforced—will cause irreparable harm, and that the issuance of an injunction is in the public interest. The panel reversed the district court, instructed the district court to employ strict scrutiny review to its analysis of the Directive, and preliminarily enjoined the State from imposing attendance limitations on in-person services in houses of worship that are less favorable than 25% of the fire-code capacity. View "Calvary Chapel Dayton Valley v. Sisolak" on Justia Law

In this case involving the interplay between the Health Insurance Portability and accountability Act (HIPPA), the subsequent HIPPA Privacy Rule, and Ohio's common-law cause of action for the unauthorized, unprivileged disclosure by a medical provider to a third party of nonpublic medical information recognized in Biddle v. Warrant General Hospital, 715 N.E.2d 518 (Ohio 1999), the Supreme Court held that the patient in this case failed to state a claim under Biddle.Specifically, the Supreme Court held (1) HIPAA does not preclude a claim under Biddle when the limited disclosure of medical information was part of a court filing made to obtain a past-due payment on an account for medical services; (2) there is an exception to liability under Biddle when a medical provider makes a reasonable effort to limit the disclosure of the patient's medical information to the minimum amount necessary to file a complaint for the recovery of unpaid medical services charges; and (3) the medical provider in this case properly limited its closure of information to the minimum amount necessary to assert a cause of action to recover from the patient payment for unpaid medical bills. View "Menorah Park Center for Senior Living v. Rolston" on Justia Law