Justia Health Law Opinion Summaries

At issue in this case was whether the district attorney prosecuting a civil commitment petition under the Sexually Violent Predator Act (SVPA), Cal. Well. & Inst. Code 660-6609.3, may obtain copies of the treatment records supporting updated or replacement evaluators’ opinions about an individual’s suitability for designation as an SVP and whether those records may be shared with a mental health expert retained by the district attorney to assist in the prosecution of the SVP petition.The Orange County District Attorney filed a petition to commit Richard Anthony Smith as an SVP. The SDSH performed updated and replacement evaluations and concluded that Smith no longer qualified as an SVP. Ultimately, the trial court denied the request of the district attorney asking for an order permitting his retained expert to review the SDSH evaluations. The Court of Appeals, however, directed the trial court to vacate its order and enter a new order granting the request. The Supreme Court affirmed, holding that a recent amendment to the SVPA allows the district court to obtain otherwise confidential records, and the district court may then disclose those records to its retained expert, subject to an appropriate protective order, to assist in the cross-examination of the SDSH evaluators or mental health professionals retained by the defense and in prosecuting the SVP petition. View "People v. Superior Court of Orange County" on Justia Law

Defendant struck Plaintiff, a pedestrian with his vehicle. Plaintiff filed a personal injury suit. Defendant filed an answer with an affirmative defense. Defendant answered an interrogatory about his drivers' license by stating that he had diabetes and required medical approval to drive, but refused to answer follow-up questions about his medical condition, stating that the question violates HIPAA, doctor-patient privilege; the Defendant has not placed his medical condition at issue. The court found that Plaintiff had legitimate cause to believe that Defendant had sight problems that could have been related to the accident and held Defendant’s attorney in contempt. The court found the attorney was not entitled to assert the physician-patient privilege, 735 ILCS 5/8-802. The Illinois Supreme Court affirmed the appellate court’s reversal of the contempt order. A plaintiff may not waive a defendant’s privilege by putting the defendant’s medical condition at issue. Neither the plaintiff nor the defendant asserted anything about defendant’s physical or mental condition. If these allegations put a defendant’s medical condition in issue, then it will be at issue in most traffic accident cases. The court urged the legislature to clarify the meaning of “at issue” and noted that, when a patient obtains a physician’s report to maintain his driving privileges, he is not seeking treatment so the privilege does not apply to the record filed with the Secretary of State. View "Palm v. Holocker" on Justia Law

The Supreme Court reversed the judgment of the court of appeals reversing the trial court’s grant of summary judgment in favor of Cora Sue Bell and concluding that Embassy Healthcare could pursue its claim against Cora individually under Ohio Rev. Code 3103.03, Ohio’s necessaries statute, and was not required to present its claim to the estate of her deceased husband, Robert Bell, holding that a creditor’s failure to present its claim for unpaid expenses to a decedent’s estate within the six-month statute of limitations in Ohio Rev. Code 2117.06 bars a later action against the decedent’s surviving spouse under section 3103.03.The court of appeals concluded that Embassy could pursue its claim for Robert’s unpaid nursing-facility expenses against Cora individually under section 3103.03 and was not required to present its claim first to Robert’s estate under section 2117.06. The Supreme Court disagreed, holding that a creditor must present its claim for unpaid necessaries to the decedent’s estate under Ohio Rev. Code 2117.06 before it can pursue a claim individually against the surviving spouse under section 3103.03. View "Embassy Healthcare v. Bell" on Justia Law

Neighbors is a skilled nursing facility participating in Medicare and Medicaid. The Centers for Medicare and Medicaid Services (CMS) determined that Neighbors inadequately addressed sexual interactions between three cognitively impaired residents and that Neighbors’ failure to act put the residents in “immediate jeopardy,” and issued Neighbors a citation and an $83,800 penalty under 42 U.S.C. 1395i‐3(h)(2)(B)(ii)(I). An ALJ and the Department of Health and Human Services Departmental Appeals Board upheld the decision. The Seventh Circuit affirmed, concluding that substantial evidence supports the Agency’s determinations and rejecting claims that the sexual interactions were consensual. The court noted findings that staff, aware of the sexual interactions, did not talk to the residents about their feelings about these “relationships”; did not document the residents’ capacity for consent (or lack thereof) or communicate with residents’ physicians for medical assessment of how their cognitive deficits impacted that capacity; did not discuss the developments with the residents’ responsible parties; and did not record any monitoring of the behaviors or make any care plans to account for them. Neighbors’ non‐intervention policy prevented any real inquiry into consent, except in the extreme situation where a resident was yelling or physically acting out. View "Neighbors Rehabilitation Center, LLC v. United States Department of Health and Human Services" on Justia Law

Plaintiffs are four parents and their children residing throughout California and a California nonprofit corporation, A Voice for Choice, Inc. This case rose constitutional challenges to Senate Bill No. 277, which repealed the personal belief exemption to California’s immunization requirements for children attending public and private educational and child care facilities. Plaintiffs sued claiming Senate Bill No. 277 violated their rights under California’s Constitution to substantive due process, privacy, and a public education. The trial court sustained the defendants’ demurrer to plaintiffs’ complaint without leave to amend and plaintiffs appealed. On appeal, plaintiffs also raised an additional argument that Senate Bill No. 277 violated their constitutional right to free exercise of religion, although they did not allege a separate cause of action on that basis in their complaint. The Court of Appeal found "[p]laintiffs' arguments are strong on hyperbole and scant on authority." Finding no violation of plaintiffs' constitutional rights, the Court of Appeal affirmed the trial court. View "Love v. California Dept. of Education" on Justia Law

In 2006, the Washington legislature enacted legislation establishing a state health technology assessment program. Part of that legislation formed the Health Technology Clinical Committee ("HTCC") as an independent committee to judge selected medical technology and procedures by their safety, efficacy, cost-effectiveness, and health outcomes. In 2010, the HTCC began its review of a controversial procedure - femoroacetabular impingement (FAI) syndrome hip surgery. Michael Murray sustained a hip injury while at work in August 2009. L&I allowed his claim and provided medical treatment. Murray's physician, Dr. James Bruckner, asked the Washington Department of Labor and Industries ("L&I") to authorize surgery regarding Murray's hip condition, FAI syndrome. L&I denied payment for FAI surgery because the HTCC disallowed coverage for that procedure. Dr. Bruckner performed the surgery on Murray without authorization from L&I. The FAI surgery purportedly successfully rehabilitated Murray's hip injury. Murray appealed L&I's decision denying payment for the surgery to the Board of Industrial Insurance Appeals (Board or BIIA), which affirmed L&I. Murray appealed to the superior court, which affirmed the Board. Murray appealed to the Court of Appeals, which affirmed the superior court. Murray then petitioned the Washington Supreme Court, which reversed. The Supreme Court "harmonized" the HTCC legislation with the Industrial Insurance Act, and in doing so, determined that applying L&I's Medical Aid Rules, HTCC determinations were one of several sources of information L&I used to make medical coverage decisions. "While HTCC determinations are given considerable weight, the Medical Aid Rules do not afford such determinations preclusive effect. Under Medical Aid Rules, L&I, not the HTCC, remains responsible for medical treatment coverage decisions. Accordingly, such Department medical coverage decisions are then subject to review before the BIIA and in superior court, pursuant to chapter 51.52 RCW." Murray's reimbursement claim to L&I was remanded for further proceedings. View "Murray v. Dep't of Labor & Indus." on Justia Law

Russell Foutch and Randall Barrios died while incarcerated in Oklahoma jails: Barrios by his own hand; Foutch from complications related to pneumonia. Their estates sued the respective jails, one sheriff, and various employees and healthcare contractors of those jails. Their claims included: (1) federal civil rights claims under 42 U.S.C. 1983 alleging violations of the Eighth and Fourteenth Amendments of the federal constitution; (2) negligence and wrongful death claims; (3) negligent conduct, training, hiring, and supervision claims; and (4) tort claims alleging violations of rights guaranteed by Sections 7 and 9 of Article II of the Oklahoma Constitution. Two federal courts certified questions of law to the Oklahoma Supreme Court: (1) the Governmental Tort Claims Act renders the State immune from any tort suit arising out of the "[p]rovision, equipping, operation or maintenance of any prison, jail or correctional facility." Do Sections 7 and 9 of Article II of the Oklahoma Constitution nonetheless allow an inmate to bring a tort claim for denial of medical care? and (2) if so, is the private cause of action to be recognized retrospectively? Responding required the Court to determine whether to extend the holding in Bosh v. Cherokee County Governmental Building Authority (305 P.3d 994) to include tort claims brought by inmates alleging violations of their rights to due process and to be free from cruel or unusual punishments. The Oklahoma Legislature responded to Bosh by amending the Governmental Tort Claims Act ("GTCA"), 51 O.S. 151 et seq., to clarify that the State's immunity from suit extended even to so-called "constitutional" torts. The Court, therefore, answered the first certified question "no," and did not reach the second question. View "Barrios v. Haskell County Public Facilities Authority" on Justia Law

The Supreme Court reversed the judgment of the district court upholding the decision of the Department of Health for Medicaid, holding that the Department did not act in accordance with law when it denied Lucile Anderson’s application to have her sons’ payment of her attorney fees treated as a return of assets.The Department found Anderson eligible for nursing home benefits but suspended her eligibility as a penalty for her transfer of assets at below fair market value. Anderson’s sons paid the attorney fees and costs Anderson incurred in her unsuccessful appeal, and Anderson applied to have that payment treated as a return of assets, which would shorten the penalty period. The Department denied the application. The district court affirmed the Department’s decision. The Supreme Court reversed, holding that the Department erred in denying Anderson’s application because the Department’s Medicaid rules did not, as a matter of law, preclude the payment of Anderson’s attorney fees from being treated as a return of assets. View "Anderson v. State ex rel. Department of Health" on Justia Law

Wilkerson mined coal for over 25 years. In 1994, he retired from the Island Creek’s Crescent mine, where he had worked most recently as an electrician. In 2012, Wilkers sought benefits under the Black Lung Benefits Act, which provides compensation to miners disabled by pneumoconiosis, 30 U.S.C. 902(b), 922(a)(1). The Sixth Circuit denied a petition for review, upholding the Benefits Review Board’s award of benefits. The defendant forfeited an argument that the ALJ lacked authority to hear the case under the Appointments Clause by failing to raise it in its opening brief. Appointments Clause challenges arise under the U.S. Constitution, but are “not jurisdictional and thus are subject to ordinary principles of waiver and forfeiture.” Substantial evidence supports the award. An ALJ may presume an applicant suffers from the disease if he worked for 15 years at a qualifying coaling mine and suffers “a totally disabling respiratory or pulmonary impairment.” Wilkerson worked for more than 15 years at a qualifying mine, and substantial evidence showed that he suffered total disability due to a respiratory or pulmonary impairment. Faced with the conflicting medical evidence, the ALJ turned to the four doctors who testified, credited testimony from one doctor, discounted the three others for legitimate reasons, and concluded that Wilkerson suffered from a disability. The doctor’s conclusion about Wilkerson’s disability tracked the newest available data. View "Island Creek Coal Co. v. Wilkerson" on Justia Law

The Supreme Court affirmed the judgment of the district court affirming the position of the Iowa Department of Human Services (DHS) determining that transfers made by Petitioners, nursing home residents, to a pooled special needs trust were for less than fair market value and required a delay in Petitioners’ eligibility for Medicaid benefits, holding that the district court and DHS correctly construed and applied federal law requiring the delay in Medicaid benefits for long-term institutional care.Federal eligibility requirements provide that state ensure that Medicaid benefits are reserved for persons who lack financial means and have not transferred personal asserts that could pay for their care. Petitioners, at age sixty-five, transferred more than one-half million dollars to a pooled special needs trust. The Supreme Court held that the district court and DHS properly interpreted federal law effectively requiring Petitioner’s to tap their pooled trust assets first to pay for their nursing home care. View "Cox v. Iowa Department of Human Services" on Justia Law