Justia Health Law Opinion Summaries

The Court of Appeal affirmed the trial court's order reappointing the public guardian of the county as conservator of D.P. under the Lanterman-Petris-Short Act, because D.P. was gravely disabled as a result of a mental disorder. In the published portion of the opinion, the court held that the trial court properly instructed the jury using the applicable statutory definition of gravely disabled. View "Conservatorship of D.P." on Justia Law

In this action seeking a declaration that the University of Kentucky is not an agency within the executive branch the Supreme Court affirmed the circuit court's decision that sovereign immunity did not bar this action against the University but reversed the court's holding that the University is not within the executive branch.The University referred Plaintiff's delinquent UK HealthCare accounts to the Commonwealth, Department of Revenue for collection. The Department's collection efforts included imposition of a twenty-five percent collection fee and interest and garnishment of Plaintiff's paychecks, bank accounts, and tax refunds. Plaintiff petitioned for a declaration that the University was not an agency within the executive branch, as required by Ky. Rev. Stat. 45.237(1)(a), and therefore was not authorized to refer its accounts to the Department. The circuit court trial court granted Plaintiff's motion for declaratory judgment. The Supreme Court affirmed, holding (1) the University is within the executive branch of the state government for purposes of Ky. Rev. Stat. 45.237 et seq.; and (2) sovereign immunity did not bar this declaratory judgment action. View "University of Kentucky v. Moore" on Justia Law

Plaintiff filed suit challenging South Carolina's decision to terminate PPSAT's provider agreement because it offers abortion services. At issue was whether, and on what basis, the Medicaid Act's free-choice-of-provider provision affords a private right of action to challenge a state’s exclusion of a healthcare provider from its Medicaid roster.The Fourth Circuit affirmed the district court's grant of a preliminary injunction in favor of plaintiff and held that Congress's intent to create an individual right enforceable under 42 U.S.C. 1983 in the free-choice-provider provision is unambiguous. The court also held that a plain-language reading of the provision's mandate—that states "must" furnish Medicaid recipients the right to choose among providers "qualified to perform the service or services required"—bars states from excluding providers for reasons unrelated to professional competency. Because the individual plaintiff in this case has a private right of action to challenge South Carolina's denial of her right to the qualified and willing family-planning provider of her choice, the court agreed with the district court that she has demonstrated a substantial likelihood of success on her free-choice-of-provider claim. Furthermore, the district court did not abuse its discretion in enjoining South Carolina from terminating PPSAT's provider agreement; it was clear that plaintiff would suffer irreparable harm in the absence of a preliminary injunction; and the remaining preliminary injunction factors were satisfied. View "Planned Parenthood South Atlantic v. Baker" on Justia Law

Forest Laboratories, LLC ("Forest"), filed a permissive appeal pursuant to Rule 5, Ala. R. App. P., of an Alabama circuit court's order denying it summary judgment. Forest manufactured and marketed Lexapro, a drug prescribed for depression, and Forest Pharmaceuticals, Inc. ("FPI") sold and distributed Lexapro. In 2015, Elias Joubran's physician prescribed Lexapro for Elias's depression. Elias's prescription was filled with generic escitalopram that was manufactured and sold by a company other than Forest. On December 30, 2015, Elias entered the house belonging to him and his wife, Sheila Joubran; he shot and killed Sheila, then shot and killed himself. Kevin Feheley, Sr., serving as personal representative of Shiela's estate, sued Mary Jourbran in her capacity as the personal representative of Elias's estate. Forest, FPI and several fictitiously named defendants were included in the suit. The complaint alleged that, at the time of the murder/suicide, Elias was under prescription for pharmaceuticals manufactured by defendants, including Forest and FPI, and that "Forest's Lexapro[] enhanced, enabled and aggravated [Elias's] depression and violent behaviors." The Alabama Legislature enacted section 6-5-530, Ala. Code 1975, "on the heels" of the Alabama Supreme Court's decision in Wyeth, Inc. v. Weeks, 159 So. 3d 649 (2014). In addressing the Weeks decision, section 6-5-530 specifically provided that a plaintiff who is suing based on personal injury, death, or property damage caused by a product "must prove ... that the defendant designed, manufactured, sold, or leased the particular product the use of which is alleged to have caused the injury on which the claim is based" regardless of the type of claims or theory of liability the plaintiff asserts. Because this case was a permissive appeal, the questions before the Supreme Court were limited to whether 6-5-530 effectively overruled Weeks, and whether a manufacturer could be held liable for an injury caused by a product it did not manufacture. The Court determined Section 6-5-530 abrogated Weeks: a pharmaceutical manufacturer cannot be held liable for injury caused by a product it did not manufacture. Based on the Court's answer to the trial court's certified question in the permissive appeal, it reversed the trial court's order denying Forest's motion for a summary judgment and remanded this case for further proceedings. View "Forest Laboratories, LLC v. Feheley, Sr." on Justia Law

States may provide certain home-based services through Medicaid's Home and Community Based Waiver program, 42 U.S.C. 1396n(c). Illinois operates a waiver under which it contracts with non-profit organizations (ISCs) to provide case management services for adults with developmental disabilities receiving home- and community-based services as part of Medicaid. Illinois awarded 17 ISC contracts through a non-competitive, annual renewal process. The plaintiffs had received contracts for at least 25 years. In 2018, the state announced a new competitive bidding process to begin on July 1, 2019. The plaintiffs submitted bids but learned in January that their contracts would not be renewed. They sued under 42 U.S.C. 1983, alleging violations of Medicaid’s free-choice-of-provider provision, 42 U.S.C. 1396a(a)(23). On June 5, 2019, with new contracts to go into effect in less than 30 days, they sought a preliminary injunction. The district court denied their motion on June 25, reasoning that ISCs were not “qualified providers” under the statute. The plaintiffs appealed that same day. Four days later, they sought emergency injunctive relief pending appeal, which the Seventh Circuit denied. Months later, at oral argument, plaintiffs’ counsel acknowledged that vacating the new contracts would be too disruptive. The Seventh Circuit dismissed the appeal. With the plaintiffs no longer challenging the denial of their preliminary injunction, it is unnecessary to address the meaning of “qualified providers” or determine what kinds of services the plaintiffs provide. The passage of time has rendered the issue moot. View "Western Illinois Service Coordination v. Illinois Department of Human Services" on Justia Law

Stewart sustained serious injuries upon crashing his car while driving under the influence. Although Stewart does not remember his time at the hospital he signed a form consenting to treatment. An emergency room doctor treated Stewart and in doing so ordered a blood draw, which confirmed that he had been drinking. The police requested and received the blood test results from the hospital’s medical staff. Stewart later sued both officers under 42 U.S.C. 1983 for violating the Fourth Amendment by obtaining his test results without a warrant and the hospital’s medical staff for violating the Health Insurance Portability and Accountability Act by disclosing the results. The Seventh Circuit affirmed summary judgment for the defendants. Indiana law requires medical staff who test a person’s blood “for diagnostic purposes” to “disclose the results of the test to a law enforcement officer who requests the … results as a part of a criminal investigation” regardless of whether the person has “consented to or otherwise authorized their release.” HIPAA does not confer individual enforcement rights—express or implied. The police officers did not violate clearly established statutory or constitutional rights of which a reasonable person would have known. View "Stewart v. Parkview Hospital" on Justia Law

The Ninth Circuit affirmed the district court's grant of a preliminary injunction barring enforcement in several states of final federal agency rules that exempt employers with religious and moral objections from the Affordable Care Act's (ACA) requirement that group health plans cover contraceptive care without cost sharing. As a preliminary matter, the panel held that the plaintiff states had Article III standing to sue and that the appeal was not moot.The panel held that the district court did not abuse its discretion by concluding that the plaintiff states were likely to succeed on the merits of their Administrative Procedure Act (APA) claim or, at the very least, raised serious questions going to the merits. At the preliminary injunction stage, the panel held that the evidence was sufficient to hold that providing free contraceptive services was a core purpose of the Women's Health Amendment and that nothing in the statute permitted the agencies to determine exemptions from the requirement. Therefore, given the text, purpose, and history of the Women's Health Amendment, the district court did not err in concluding that the agencies likely lacked statutory authority under the ACA to issue the final rules.The panel also held that, regardless of the question of the agencies' authority under the Religious Freedom Restoration Act, the accommodation process likely did not substantially burden the exercise of religion. Furthermore, because appellants likely failed to demonstrate a substantial burden on religious exercise, there was no need to address whether the government had shown a compelling interest or whether it has adopted the least restrictive means of advancing that interest. Finally, the panel held that the district court did not abuse its discretion by concluding that the states were likely to suffer irreparable harm absent an injunction, and that the balance of equities tipped sharply in favor of the plaintiff states and that the public interest tipped in favor of granting the preliminary injunction. View "California v. The Little Sisters of the Poor" on Justia Law

Federal law requires that California must pay the counties and their clinics one hundred percent of the cost of a defined list of services for providing Medicare beneficiaries. Furthermore, California's Medi-Cal statute is consistent with the federal requirement. The Clinic filed suit against the State, seeking the full amount the clinic paid to a contractor. The Court of Appeal affirmed the trial court's grant of the Clinic's petition seeking to require the state to pay one hundred percent of the amount the Clinic paid the contractor. View "Tulare Pediatric Health Care Center v. State Department of Health Care Services" on Justia Law

In 2012, Appellee attended a fraternity party and consumed alcohol. Sometime thereafter, he encountered University of Pittsburgh police officers answering a call from dispatch that there was an intoxicated individual attempting to harm himself outside of one of the residence halls of the university. Officers observed though Appellee appeared to be intoxicated, he had sustained superficial cuts to his arm and wrist area, and that other officers found a small knife attached to a money clip on the ground near where Appellee was found. Appellee was transferred to a nearby psychiatric treatment facility wherein Appellee's attending psychiatrist applied to extend Appellee's stay for 20 days. Section 303 of the Mental Health Procedures Act (“MHPA”) required the holding of a hearing on the application before a mental health review officer or a judge at the facility in which the involuntarily committed person was being housed, and also directed that counsel be appointed to represent the person at that hearing. At the 2015 expungement hearing, Appellee averred he was not advised of any hearing prior to involuntary commitment, nor was he appointed counsel. Over two years later, Appellee filed his expungement petition, broadly alleging there was no lawful basis for his commitment." The State Police argued to the Pennsylvania Supreme Court the lower courts ruling on this petition lacked jurisdiction to order expungement. The Supreme Court agreed and reversed a superior court order that reversed a common pleas court's order dismissing Appellee's petition. View "In Re: J.M.Y." on Justia Law

The Ninth Circuit reversed the district court's judgment in favor of Medicare in an action brought by CIGA, seeking declaratory relief after Medicare paid for and demanded reimbursement from CIGA for medical expenses of certain individuals whose workers' compensation benefits CIGA was administering.The panel held that Medicare, as a secondary payer, was entitled to seek reimbursement from a beneficiary's primary payer, typically private insurance. However, CIGA was not a primary plan, and specifically was not a workmen's compensation law or plan. Rather, the panel held that CIGA was an insolvency insurer of last resort. The panel explained that insurance regulation was a field traditionally occupied by the states, and it must presume that the Medicare secondary payer provisions do not preempt state insurance laws unless Congress clearly manifested its intent to do so. Furthermore, nothing in the Medicare statute or its implementing regulations suggested that Congress meant to interfere with state schemes to protect against insurer insolvencies. View "California Insurance Guarantee Assoc. v. Azar" on Justia Law