Justia Health Law Opinion Summaries
Magers v. Alabama Women’s Center Reproductive Alternatives, LLC
Ryan Magers appealed the dismissal of his wrongful-death claim against Alabama Women's Center Reproductive Alternatives, LLC ("the AWC"), for its role in the abortion of Baby Roe. In 2017, Baby Roe was aborted at approximately six weeks of gestation after the AWC provided Baby Roe's mother with an abortifacient pill to end her pregnancy. Magers, Baby Roe's father, then petitioned the Probate Court to be appointed personal representative of Baby Roe's estate. Magers' argument consisted of one conclusory statement followed by a string citation. The brief did not discuss how the cited authority was relevant to his argment. Because Mager's brief failed to conform to Rule 28, Ala. R. App. P., the Alabama Supreme Court determined it had nothing to review on appeal and affirmed dismissal. View "Magers v. Alabama Women's Center Reproductive Alternatives, LLC" on Justia Law
Waskul v. Washtenaw County Community Mental Health
Community Mental Health modified the methodology through which it allocated funding to individuals with disabilities receiving community living support services under a Medicaid waiver received by Michigan. Individuals receiving those services, together Advocacy, challenged that methodology as violating the Medicaid Act, 42 U.S.C. 1396a(a)(8), (a)(10)(A), (a)(10)(B), 1396n(c)(2)(A) and (C); Title II of the Americans with Disabilities Act (ADA), 42 U.S.C. 12132; section 504 of the Rehabilitation Act, 29 U.S.C. 794; the Michigan Mental Health Code; and the terms of Michigan’s Medicaid Habilitation Supports Waiver and the contracts implementing it. The district court dismissed the claims in full.The Sixth Circuit reversed, first holding that the plaintiffs have standing, that the defendants are not entitled to Eleventh Amendment immunity, that the plaintiffs were not required to exhaust their administrative remedies provided by the state under the Medicaid Act, and that the plaintiffs have a private right of action under sections 1396a(a)(8) and (a)(10). The plaintiffs’ allegations suffice to state plausible claims that they are being denied sufficient necessary medical services; that feasible alternatives that provide them a meaningful choice between institutionalized and at-home or community-based care exist and are not being ensured; and that they face a serious risk of institutionalization. View "Waskul v. Washtenaw County Community Mental Health" on Justia Law
In re J.P.
The Supreme Judicial Court affirmed the judgment of the district court judge in this civil commitment matter, holding that sufficient admissible evidence was presented to warrant an order to civilly commit J.P. for a period not to exceed six months pursuant to Mass. Gen. Laws ch. 123, 7, 8.Southcoast Behavioral Health filed a timely petition for J.P.'s involuntary commitment, alleging that, as a result of mental illness, J.P. presented a risk of harm to others and a substantial risk of harm to himself and that civil commitment was the least restrictive alternative in the circumstances. After a hearing, the judge ordered J.P. civilly committed for a period not to exceed six months. The Supreme Judicial Court affirmed, holding (1) the judge improperly considered certain evidence because it was inadmissible hearsay, but J.P. suffered no prejudice from the admission of this evidence; and (2) there was sufficient evidence presented to support the civil commitment order. View "In re J.P." on Justia Law
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Health Law, Massachusetts Supreme Judicial Court
Ardaneh v. Commonwealth
The Supreme Judicial Court affirmed the judgment of the single justice of the Court denying Petitioner's petition pursuant to Mass. Gen. Laws ch. 211, 3, holding that the single justice did not err or abuse his discretion in denying relief.Petitioner was indicted on several counts of rape and one count of strangulation or suffocation. Petitioner was committed for observation to Bridgewater State Hospital for a determination whether he was competent to stand trial. Petitioner was found incompetent to stand trial and committed to the hospital pursuant to Mass. Gen. Laws ch. 123, 16. Petitioner, who remains in the hospital, filed a Mass. Gen. Laws ch. 211, 3 petition claiming, among other things, that his constitutional rights had been violated. The single justice denied the petition without a hearing. The Supreme Judicial Court affirmed, holding that Petitioner had an adequate alternative remedy and that his claims did not present a situation warranting extraordinary superintendence relief pursuant to Mass. Gen. Laws ch. 211, 3. View "Ardaneh v. Commonwealth" on Justia Law
Fisk v. McDonald
David and Margaret Fisk appealed after a district court granted summary judgment in favor of Jeffery D. McDonald, M.D., and the Hospital on their medical malpractice claims. The district court granted summary judgment on the Fisks’ single cause of action after determining the Fisks had failed to provide expert testimony demonstrating actual knowledge of the community standard of care. The Fisks also appealed the district court’s order denying their subsequent motion for reconsideration. The district court granted summary judgment on the basis that the Fisks failed to establish an essential element of their medical malpractice claim. The Idaho Supreme Court concluded the district court's decision was not based on expert testimony submitted by McDonald or the Hospital. As such, the conclusory nature or admissibility of any such testimony was immaterial to the district court’s decision. Therefore, the district court did not err in determining that the burden was on the Fisks to establish the essential elements of their medical malpractice claim. The Court found, however, that the district court erred in denying the Fisks' motions for reconsideration. The district court was asked to reconsider the order granting summary judgment, so the summary judgment standard applied to the district court’s decision on the motion for reconsideration and now applied to the Supreme Court’s review of that decision on appeal. The Fisks supported their motions for reconsideration with additional expert declarations, one of which demonstrated that he had actual knowledge of the community standard of care. Furthermore, the Supreme Court determined the district court erred in determining that the Fisks failed to properly plead that McDonald was liable for the acts or omissions of a nurse practitioner via the agency theory of liability. The case was remanded for further proceedings. View "Fisk v. McDonald" on Justia Law
In re Von Staich
Von Staich is incarcerated at San Quentin State Prison, based on 1986 second-degree murder and attempted murder convictions. In May 2020, he sought habeas corpus relief, citing the COVID-19 pandemic. Shortly thereafter, San Quentin suffered a COVID-19 outbreak that infected approximately 75 percent of the inmate population and dozens of prison staff in just weeks. Von Staich is 64 years old and suffers respiratory problems resulting from bullet fragments lodged in his lung; he claimed that he and a 65-year-old cellmate, both of whom had tested positive for COVID-19 (Van Staich was asymptomatic), were in an extremely small open cell and that there is no opportunity for social distancing.The court directed the Warden to transfer Von Staich to a suitable quarantine location, finding that the Warden and the California Department of Corrections and Rehabilitation (CDCR) have acted with deliberate indifference. There is ongoing federal litigation concerning inadequate medical care due to severe overcrowding in the California correctional system and San Quentin has particular risk factors, caused by the age and architecture of the facility. The court acknowledged that the existing Eighth Amendment violation will continue until the population at San Quentin can be reduced to the 50 percent level. Unless CDCR’s existing expedited release programs are sufficient to promptly achieve this population reduction—which, the sheer numbers indicate they cannot be—CDCR will have to find additional means of releasing or transferring prisoners out of San Quentin. View "In re Von Staich" on Justia Law
Sensory NeuroStimulation, Inc. v. Azar
The Ninth Circuit affirmed the district court's dismissal based on lack of jurisdiction of an action brought by Sensory NueroStimulation, a medical device supplier, seeking Medicare coverage of its product. The panel held that the district court correctly held that 42 U.S.C. 405(h)'s administrative channeling requirement applied and that it therefore had no subject matter jurisdiction to hear Sensory's claims. In this case, the lawsuit is subject to Medicare's administrative channeling requirements; Sensory has not met those requirements; there exists a way to satisfy those requirements; and these conclusions do not completely preclude judicial review so as to trigger a key exception to the channeling requirements. View "Sensory NeuroStimulation, Inc. v. Azar" on Justia Law
Dierlam v. Trump
Plaintiff filed suit challenging the Affordable Care Act (ACA), seeking retrospective and prospective relief for myriad alleged violations of the United States Constitution and the Religious Freedom Restoration Act. The Fifth Circuit declined to reach the merits of plaintiff's claims. The court held that, given the altered legal landscape and the potential effects of plaintiff's request for prospective relief, a mootness analysis must precede the merits. In this case, a year after plaintiff filed his lawsuit, Congress passed and President Trump signed the Tax Cut and Jobs Act, which reduced the shared responsibility payment (imposed on individuals who fail to purchase health insurance) to $0. In the same year, the Department of Health and Human Services created new exemptions to the contraceptive mandate, including an exemption for individuals like plaintiff. These exemptions were enjoined until the Supreme Court's recent decision in Little Sisters of the Poor Saints Peter and Paul Home v. Pennsylvania. Therefore, the court vacated the district court's dismissal of plaintiff's claims and remanded for the district court to conduct a mootness analysis in the first instance. The court also remanded to allow plaintiff to amend his complaint where the parties agreed that the district court incorrectly dismissed plaintiff's claim for retrospective relief. View "Dierlam v. Trump" on Justia Law
DaVita, Inc. v. Marietta Memorial Hospital Employee Health Benefit Plan
Beginning in 2017, DaVita provided dialysis treatment to Patient A, who was diagnosed with end-stage renal disease (ESRD). Patient A assigned his insurance rights to DaVita. Through August 2018, the costs of Patient A’s dialysis were reimbursed by the Employee Health Benefit Plan, governed by the Employee Retirement Income Security Act (ERISA), at its bottom tier, which applied to providers who are “out-of-network.” All dialysis providers were out-of-network. While most out-of-network providers are reimbursed in the bottom tier based on a “reasonable and customary” fee as understood in the healthcare industry, dialysis providers are subject to an “alternative basis for payment”; the Plan reimburses at 87.5% of the Medicare rate. Patient A was exposed to higher copayments, coinsurance amounts, and deductibles and was allegedly at risk of liability for the balance of what was not reimbursed . The Plan identified dialysis as subject to heightened scrutiny, which allegedly incentivizes dialysis patients to switch to Medicare. Patient A switched to Medicare. DaVita and Patient A sued, alleging that the Plan treats dialysis providers differently from other medical providers in violation of the Medicare Secondary Payer Act (MSPA) and ERISA.
The Sixth Circuit reversed, in part, the dismissal of the claims. A conditional payment by Medicare is required as a precondition to suing under the MSPA’s private cause of action; the complaint sufficiently alleges such a payment. DaVita plausibly alleged that the Plan violates the nondifferentiation provision of the MSPA, resulting in denials of benefits and unlawful discrimination under ERISA. View "DaVita, Inc. v. Marietta Memorial Hospital Employee Health Benefit Plan" on Justia Law
Whole Woman’s Health v. Paxton
Senate Bill 8 -- a statute that requires a woman to undergo an additional and medically unnecessary procedure to cause fetal demise before she may obtain a dilation and evacuation (D&E) abortion, the safest and most common method of second trimester abortions -- imposes an undue burden on a woman's right to obtain an abortion before fetal viability in violation of the Fourteenth Amendment's Due Process clause.The Fifth Circuit affirmed the district court's judgment holding that SB8 is facially unconstitutional and permanently enjoining its enforcement. Applying the undue burden test in Whole Woman's Health v. Hellerstedt, 136 S. Ct. 2292, 2309 (2016), rather than June Medical Services, L.L.C. v. Russo, 140 S. Ct. 2103, 2114 (2020), the court held that SB8's burdens substantially outweigh its benefits and constitutes an undue burden on a woman's right to obtain a previability abortion. Under the statute, the court explained that all women seeking a second trimester abortion starting at 15 weeks LMP would be required to endure a medically unnecessary and invasive additional procedure that provides no health benefit; for most women, the length of the procedure would increase from one day to two, adding to the costs associated with travel, lodging, time away from work, and child care; and SB8 forces abortion providers to act contrary to their medical judgment and the best interest of their patient by conducting a medical procedure that delivers no benefit to the woman. Weighing SB8's significant burdens upon female patients against its nonexistent health benefits and any other limited benefits it may actually confer, the court concluded that it is clear that the law places a "substantial obstacle in the path of a woman seeking" a previability abortion. View "Whole Woman's Health v. Paxton" on Justia Law
