Justia Health Law Opinion Summaries

In 2016, St. Luke’s Health System, Ltd. accepted an indigent patient suffering from meningitis, seizures, and brain lesions. The patient was ready for transfer to another medical facility by February 18, 2016, but was refused by multiple care providers because they did not want to admit an indigent patient without a payor source. St. Luke’s finally contracted with Life Care, another medical facility, to take the patient on the condition that St. Luke’s would guarantee payment for a thirty day period. The patient was transferred to Life Care on March 9, 2016. St. Luke’s applied for medical indigency benefits covering the period of time from the patient’s initial hospitalization until she was transferred to the Life Care facility. Gem County initially approved the application for benefits through February 3, 2016. St. Luke’s appealed that determination, and after a hearing, the Board approved medical indigency benefits from January 26, 2016, until February 18, 2016. The Board entered a written determination titled “Amended Determination of Approval for County Assistance” which set forth the various bills that were approved for payment, but did not in any way reflect the denial of benefits or the reasoning of the Board. St. Luke’s then sought judicial review of the Amended Determination before the district court, which affirmed the Board’s decision. St. Luke’s appealed. The Idaho Supreme Court vacated the Board’s Amended Determination because it did not reflect the partial denial of benefits and because there were no findings of fact or conclusions of law setting forth the basis for the Board’s denial. View "St. Lukes v. Bd of Commissioners of Gem Co" on Justia Law

In this case concerning arbitration agreements, nursing homes, and wrongful death claims under Massachusetts law, the First Circuit certified questions to the Massachusetts Supreme Judicial Court (SJC) under its Rule 1:03, holding that the dispute in this case turned on the characterization of wrongful death actions by the Commonwealth and presented an unresolved question of Massachusetts law whose answer was unclear.The personal representative of a deceased former nursing home resident brought a state wrongful death action against a set of organizations that oversaw the nursing home (collectively, nursing home). The nursing home sued to compel arbitration. The federal court compelled arbitration and declined to issue a stay of the state wrongful death action. On appeal, the personal representative argued that she was not bound by the decedent’s agreement to arbitrate with the nursing home because her wrongful death right of recovery was independent of the decedent’s wrongful death claim. In asserting that the arbitration agreement was binding, the nursing home argued that Massachusetts beneficiaries’ wrongful death claims are derivative of the decedent’s wrongful death claim. The First Circuit exercised its discretion in favor of certification, holding that Massachusetts law does not clearly decide the independent/derivative or other relevant questions about the status of wrongful death actions in relation to the decedent. View "GGNSC Chestnut Hill LLC v. Schrader" on Justia Law

The Supreme Court reversed the judgment of the circuit court against St. Luke’s Surgicenter-Lee’s Summit LLC on a negligent credentialing claim brought by Thomas and Paula Tharp, holding that the Tharps failed to make a submissible case of negligent credentialing.Thomas Tharp suffered injuries when a surgeon operating out of St. Luke’s damaged his hepatic duct and common bile duct. The Tharps filed suit against the surgeon and St. Luke’s and then settled with the surgeon. The Tharps proceeded to trial against St. Luke’s on the claim that St. Luke’s negligently granted the surgeon staff privileges at its hospital. The jury returned a verdict in favor of the Tharps, and the circuit court entered judgment in favor of the Tharps. The Supreme Court reversed, holding that there was insufficient evidence to support the Tharps’s negligent credentialing claim. View "Tharp v. St. Luke's Surgicenter-Lee's Summit, LLC" on Justia Law

Mathew worked at Parkland Health and Hospital System as a registration specialist and also owned Dallas Home Health Care (DHH). Mathew stole confidential patient information from Parkland and gave it to DHH employees to call the individuals and solicit them as patients. Based on information from a former DHH employee, authorities obtained a search warrant for DHH’s office and determined DHH to be in the possession of approximately 1,300 Parkland patients’ identifying information, including their health insurance claim numbers (HICNs). Mathew pleaded guilty to “knowingly possess[ing] with intent to use unlawfully or transfer unlawfully five or more authentication features, to wit, [HICNs], and the authentication features were or appeared to have been issued by or under the authority of the United States,” 18 U.S.C. 1028(a)(3), (b)(2)(B), (c)(1). The Fifth Circuit vacated his sentence of 30 months’ imprisonment plus $277,957.89 in restitution. The restitution order under the Mandatory Victim Restitution Act, 18 U.S.C. 3663A, was unlawful because it included amounts for Medicare payments that preceded the temporal scope of the offense of conviction. Mathew’s statements at rearraignment cannot serve as the justification for broadening restitution to include conduct not contained in the indictment or factual resume. The court rejected other challenges to the restitution award. View "United States v. Mathew" on Justia Law

The Court of Appeals held that N.Y. Mental Hyg. Law 33.13, which protects the confidentiality of the clinical records of patients and clients as maintained by facilities licensed or operated by the Office of Mental Health or the Office for People with Developmental Disabilities, does not require automatic sealing of the entire court record of all proceedings involving insanity acquittees who have dangerous mental disorders within the meaning of N.Y. Crim. Proc. Law (CPL) 330.20.Defendant, an insanity acquittee, was found to have a dangerous mental disorder as defined by CPL 330.20(1)(c) and was committed to the custody of the Commissioner for the Office for People with Developmental Disabilities. Supreme Court denied Defendant’s motion to seal the entire court record in his case, finding that the documents related to the legal proceedings rather than Defendant’s treatment. The Appellate Division modified. The Court of Appeals affirmed, holding that the legislature provided no automatic sealing requirement of an entire court record in either CPL 330.20 or the Mental Hygiene Law for an insanity acquittee, and Defendant cited no authority for such an obligation. View "In re James Q." on Justia Law

A 2014 statute and 2013 regulation re-defined which abortions qualified as “medically necessary” for the purposes of Medicaid funding. The statute defined medically necessary abortions as those that “must be performed to avoid a threat of serious risk to the life or physical health of a woman from continuation of the woman’s pregnancy” as a result of a number of listed medical conditions; the regulation was similarly restrictive. Planned Parenthood of the Great Northwest challenged both the statute and regulation as unconstitutional, and the superior court held that both measures violated the equal protection clause of the Alaska Constitution. The court reasoned that these measures imposed a “high-risk, high- hazard” standard on abortion funding unique among Medicaid services, and held that our 2001 decision striking down an earlier abortion funding restriction on equal protection grounds compelled the same result. The State appealed, arguing that the statute and regulation should be interpreted more leniently and therefore do not violate the Alaska Constitution’s equal protection clause. The Alaska Supreme Court affirmed the superior court’s decision: the statute’s and the regulation’s facially different treatment of pregnant women based upon their exercise of reproductive choice required the Court to apply strict scrutiny, and the proposed justifications for the funding restrictions "did not withstand such exacting examination." View "Alaska v. Planned Parenthood of the Great Northwest" on Justia Law

The Court of Appeals reversed the order of the Appellate Division and dismissed this petition and proceeding, holding that Mental Hygiene Legal Service (MHLS) did not have standing to bring this proceeding in its own name to vindicate its clients’ rights under N.Y. Mental Hyg. Law 9.31(b).MHLS, a government entity charged with providing legal services to patients of mental health facilities and hospitals, brought this proceeding in its own name seeking a writ of mandamus to compel a hospital to comply with section 9.31(b), which sets forth the procedure to be followed after a patient requests an admission or retention hearing. The hospital moved to dismiss the petition on the ground the MHLS lacked standing to bring the claim in its own name. Supreme Court denied the hospital’s motion to dismiss and granted the petition, concluding that MHLS had demonstrated a right to mandamus relief. The Appellate Division affirmed. The Court of Appeals reversed and dismissing both the petition and the proceeding, holding that MHLS did not have standing to bring this petition. View "Mental Hygiene Legal Service v. Daniels" on Justia Law

The Court of Appeals held that assigned Mental Hygiene Legal Services (MHLS) counsel is not entitled to be given an interview and an opportunity to participate in treatment planning meetings for article 10 respondents placed in a sex offender treatment program at a secure treatment facility simply by virtue of an attorney-client relationship with the article 10 respondent.Petitioners - an article 10 respondent called D.J. and his assigned MHLS counsel - requested that counsel be permitted to attend D.J.’s treatment planning meetings either as an “authorized representative” or a “significant individual” under N.Y. Mental Hyg. Law 29.13(b). The requests were denied, after which Petitioners commenced this N.Y. C.P.L.R. 78 proceeding. Supreme Court dismissed the petition, and the Appellate Division affirmed. The Court of Appeals affirmed, holding that MHLS counsel was not intended to be included, as a matter of law, within the terms “authorized representative” or “significant individual.” View "Mental Hygiene Legal Service v. Sullivan" on Justia Law

The Supreme Judicial Court vacated the judgment of the probate court denying the petition filed by Michael Zani and Peter Zani to be appointed co-guardians of Patricia S., their mother and an incapacitated adult, and instead appointing Karin Beaster and Nancy Carter as co-guardians, holding that Beaster and Carter had not fulfilled the pretrial filing requirements of Me. Rev. Stat. 18-A, 5-303(a).The probate court appointed Beaster and Carter as co-guardians of Patricia even though Beaster and Carter had not filed petitions to be appointed. The Supreme Judicial Court vacated the judgment, holding that the superior court erred by appointing Beaster and Carter when they had not complied with the requirements applicable to a guardianship petition under section 5-303(a). View "In re Patricia S." on Justia Law

Reed alleged that she suffered discrimination on the basis of her disabilities while she was a patient at Columbia in March 2012. She contends that the hospital failed to accommodate her disabilities by deliberately withholding from her a device she used to speak and discriminated against her by putting her in a “seclusion” room to punish her, in violation of the Americans with Disabilities Act (ADA), 42 U.S.C. 12181, the Rehabilitation Act, 29 U.S.C. 794, and the Wisconsin Mental Health Act. The district court granted the hospital summary judgment, holding that the hospital did not need to comply with Title III of the ADA because it fell within the Act’s exemption for entities controlled by religious organizations and that the hospital’s alleged mistreatment of Reed was not premised solely on Reed’s disability. The Seventh Circuit reversed. The hospital raised its religious exemption affirmative defense to the ADA claims for the first time after discovery, in its motion for summary judgment; it was an abuse of discretion to excuse the hospital’s failure to raise this affirmative defense earlier. Reed’s Rehabilitation Act claims depend on disputed facts. View "Reed v. Columbia St. Mary's Hospital" on Justia Law