Justia Health Law Opinion Summaries

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

The Supreme Court dismissed this appeal after the district court administratively dismissed a negligence action for failure to timely submit a proposed scheduling order and then granted a motion to reinstate the case, holding that the district court’s reinstatement order was not a final, appealable order.On appeal, Appellants argued that the district erred when it applied the local rules regarding reinstatement of cases instead of Neb. Rev. Stat. 25-201.01 to decide whether to reinstate the case. The Supreme Court dismissed the appeal, holding that the order vacating dismissal and reinstating the case put the parties back in approximately the same litigation posture as before the action was dismissed, and there was no reason to disrupt the progression of the case by entertaining an interlocutory appeal. View "Fidler v. Life Care Centers of America" on Justia Law

In 2015, the California Governor issued a proclamation convening a special session of the Legislature for certain specified purposes, including to “[i]mprove the efficiency and efficacy of the health care system, reduce the cost of providing health care services, and improve the health of Californians.” Pertinent to this appeal, the Legislature enacted the End of Life Option act, which legalized physician-assisted suicide for the terminally ill. During a special session, the Legislature passed the Act. Plaintiffs were five individual physicians along with a professional organization that promoted ethical standards in the medical profession (collectively the Ahn parties), who asserted causes of action for violations of due process, of equal protection, and of California constitutional limitations on the power of the Legislature to act in special session. In February 2018, the Ahn parties filed a motion for judgment on the pleadings. After hearing argument, the trial court ruled that it would grant the motion, without leave to amend. On May 24, 2018, the trial court entered judgment in favor of the Ahn parties, and enjoined enforcement of the Act. Days later, three nonparties5 (collectively the Fairchild parties) filed an ex parte application to vacate the judgment, which was denied. The State filed a petition for writ of mandate to the Court of Appeal along with a request for an immediate stay. The Court granted a temporary stay, during which the Fairchild parties filed an appeal of the judgment, contending that, as a result of the denial of their ex parte application to vacate the judgment, they had standing to appeal and, in that appeal, to challenge the judgment on the merits. The Ahn parties disputed this. The issue this case presented for the Court of Appeal’s review was not whether the Fairchild parties are parties to the appeal, but only whether they were parties to this writ proceeding. Admittedly, the State’s writ petition did not name the Fairchild parties, nor did the Fairchild parties formally move to intervene. “However, a person can become a party to an action, even if not named in the complaint, by appearing and participating without any objection by the other parties. We see no reason why this principle should not also apply to a writ proceeding. This is not to say that they are necessarily proper parties.” The Court ultimately concluded the Ahn parties lacked standing on any of the theories they asserted in this appeal. The Court was unclear whether, on remand, they would be able to amend their complaint so as to allege standing, whether the trial court will grant them leave to do so, or whether they will be able to prove up their amended allegations. “It is possible (though by no means certain) that we will see this case again; if so, however, at least we will be sure that the constitutional issue is properly presented.” The Court issued a writ of mandate to direct the superior court to vacate its order granting the motion for judgment on the pleadings and to vacate the judgment. View "California v. Superior Court (Ahn)" on Justia Law

The Supreme Court affirmed the findings of fact, conclusions of law, and order entered by the district court committing B.H. to the Montana State Hospital (MSH), holding that the district court did not commit plain error regarding the procedural safeguards in Mont. Code Ann. 53-21-122(2)(a) necessitating appellate review.After the district court committed B.H. to the MSH for a period not to exceed ninety days, B.H. appealed, arguing that the district court erred by failing to advise him of his constitutional and statutory rights during his initial appearance, as required in civil commitment proceedings under section 53-21-122(2)(a). The Supreme Court affirmed, holding that while the district court did not provide a complete advisory of rights to B.H., B.H. failed to establish that the error resulted in a manifest miscarriage of justice, implicated the fundamental fairness of the proceedings, or comprised the dignity of the judicial prejudice. Therefore, any error in the manner in which this proceeding was conduct did not result in substantial prejudice. View "In re B.H." on Justia Law

The Supreme Court denied the defendant hospital’s petition for a writ of mandamus challenging a trial court’s order requiring the hospital to produce information regarding its reimbursement rates from private insurers and public payers for the services provided to the plaintiff, holding that the trial court did not abuse its discretion in compelling production of the information.The plaintiff, who was uninsured, was treated by the hospital, which billed the plaintiff and filed a hospital lien for the cost of its services. The plaintiff sought a declaratory judgment that the hospital’s charges were unreasonable and its lien invalid to the extent it exceeded a reasonable and regular rate for services rendered. The plaintiff served requests for production and interrogatories on the hospital, including information about reimbursement rates from insurers and government payers. The hospital objected to the discovery requests, but the trial court ordered the hospital to produce the information. The hospital then filed a petition for a writ of mandamus, which the court of appeals denied. The Supreme Court affirmed, holding that the requested reimbursement rates were relevant to whether the hospital’s charges to the uninsured plaintiff were reasonable. View "In re North Cypress Medical Center Operating Co., Ltd." on Justia Law

The Supreme Judicial Court affirmed the judgment of the probate court appointing the Department of Health and Human Services as David P.’s limited public guardian pursuant to Me. Rev. Stat. 18-A, 5-601, holding that any error on the part of the probate court was harmless and that there was sufficient competent evidence in the record to support the probate court’s judgment.On appeal, David argued that there was insufficient evidence to support the probate court’s decision and that the court erred in admitting a written report drafted by a psychologist in violation of the rule against hearsay. The Supreme Judicial Court held (1) it was error for the probate court to admit the psychologist’s written report in its entirety, but the error was harmless; and (2) the evidence was sufficient to support the judgment. View "Guardianship of David P." on Justia Law

The Tennessee Hospital Association and three hospitals sued, challenging efforts by the Centers for Medicare and Medicaid Services (CMS) to direct states to recoup certain reimbursements made under the Medicaid program. The hospitals serve a disproportionate share of Medicaid-eligible patients and are thereby entitled to supplemental payments under the Medicaid Act, (DSH payments), 42 U.S.C. 1396a(a)(13)(A)(iv); 1396r-4(b). The Act limits the amount of DSH payments each hospital can receive in a given year. CMS contends that the hospitals miscalculated their DSH payment-adjustments for fiscal year 2012 and received extra payments. Plaintiffs argued, and the district court agreed, that CMS’s approach to calculating DSH payment adjustments is inconsistent with the Act and the regulations that CMS implemented in 2008. The Sixth Circuit affirmed, agreeing that CMS’s policy is inconsistent with its 2008 rule and cannot be enforced unless it is promulgated pursuant to notice-and-comment rulemaking. The court disagreed with the district court’s conclusion that CMS’s policy exceeds the agency’s authority under the Medicaid Act. CMS’s payment-deduction policy is a reasonable interpretation of an ambiguous section of the Act but is not a valid interpretative rule. CMS attempted to exercise its delegated discretion to “determine[]” the “costs incurred” in serving Medicaid-eligible patients—precisely the sort of agency action that requires notice-and-comment rulemaking. View "Tennessee Hospital Association v. Azar" on Justia Law