Justia Health Law Opinion Summaries

The New York City Board of Health’s promulgation of the flu vaccine falls within the powers specifically delegated to the New York City Department of Health and Mental Hygiene in New York City Administrative Code 17-109.At issue was the Board’s amendments to the New York City Health Code mandating that children between the ages of six months and fifty-nine months who attend city-regulated child care or school-based programs receive annual influenza vaccinations. Petitioners - parents of children enrolled in child care programs subject to the flu vaccine rules who objected to their children receiving the vaccination - commenced this hybrid N.Y. C.P.L.R. 78 proceeding and declaratory judgment action to enjoin Respondents from enforcing the flu vaccine rules. Supreme Court granted Petitioners’ motion and permanently enjoined Respondents from enforcing the flu vaccine rules. The Appellate Division affirmed. The Court of Appeals reversed, holding (1) the Board permissibly adopted the flu vaccine rules pursuant to its authority to regulate vaccinations; (2) the Board’s actions did not violate the separation of powers doctrine; and (3) the flu vaccine rules are not preempted by state law. View "Garcia v. New York City Department of Health & Mental Hygiene" on Justia Law

The Court of Appeals held that whether an absolute privilege applies to a communication made in the course of a quasi-judicial proceeding depends on the status of the subject of the communication.New York Downtown Hospital terminated the employment of Plaintiff, a medical scientist, and removed her as chairperson of the hospital’s Institutional Review Board. Dr. Steven Friedman’s statements to the FDA during an investigation of Downtown Hospital’s IRBs about Plaintiff, which discussed the reasons for the removal of Plaintiff from her positions, were published in an Establishment Inspection Report (EIR) released by the FDA. Plaintiff commenced this defamation action against Downtown Hospital, Friedman, and others, asserting that her professional reputation was damaged by the publication of defamatory statements about her made by Friedman to the FDA inspectors. Defendants filed a motion to dismiss. Supreme Court allowed Plaintiff’s defamation claim against Downtown Hospital and Friedman to survive, concluding that the statements were not shielded by an absolute privilege because the FDA’s investigation had none of the indicia of a quasi-judicial proceeding. The Appellate Division reversed, concluding that the complained-of statements were made in a quasi-judicial context in which an absolute privilege protected them. The Court of Appeals reversed, holding that Friedman’s statements, as published in the EIR, were not protected by absolute privilege. View "Stega v. New York Downtown Hospital" on Justia Law

The California Reproductive Freedom, Accountability, Comprehensive Care, and Transparency Act (FACT Act) regulates pro-life centers that offer pregnancy-related services. Licensed clinics must notify women that California provides free or low-cost services, including abortions, and give them a phone number. The stated purpose is to ensure that state residents know their rights and what services are available. Unlicensed clinics must notify women that California has not licensed the clinics to provide medical services. Its stated purpose is to ensure that pregnant women know when they are receiving care from licensed professionals. In a case under the First Amendment, the Ninth Circuit affirmed the denial of a preliminary injunction.The Supreme Court reversed, holding that the licensed notice requirement likely violates the First Amendment. Content-based laws “are presumptively unconstitutional" and may be justified only if narrowly tailored to serve compelling state interests. The notice is a content-based regulation, requiring a particular message. Speech is not unprotected merely because it is uttered by professionals. The notice is not limited to “purely factual and uncontroversial information about" services. Nor is it a regulation of professional conduct that incidentally burdens speech; it applies to all interactions between a covered facility and its clients, regardless of whether a medical procedure is ever sought. Other facilities, including general clinics providing the same services, are not subject to the requirement. If states could choose the protection that speech receives simply by requiring a license, they would have a powerful tool to impose “invidious discrimination of disfavored subjects.” Assuming that California’s interest in providing low-income women with information about state-sponsored service is substantial, the licensed notice is not sufficiently drawn to promote it but is “wildly underinclusive,” applying only to clinics that have a “primary purpose” of “providing family planning or pregnancy-related services” while excluding other types clinics that also serve low-income women and could educate them about the state’s services. California could also inform the women about services “without burdening a speaker with unwanted speech,” most obviously through a public-information campaign.The unlicensed notice also unduly burdens protected speech. A disclosure requirement cannot be “unjustified or unduly burdensome,” must remedy a harm that is “potentially real not purely hypothetical,” and can extend “no broader than reasonably necessary.” California has not demonstrated any justification that is more than “purely hypothetical.” View "National Institute of Family and Life Advocates v. Becerra" on Justia Law

Dr. Paulus, a cardiologist at Ashland, Kentucky’s KDMC, was first in the nation in billing Medicare for angiograms. His annual salary was around $2.5 million, under KDMC’s per-procedure compensation package. In 2008, HHS received an anonymous complaint that Paulus was defrauding Medicare and Medicaid by performing medically unnecessary procedures, 42 U.S.C. 1320c-5(a)(1), 1395y(a)(1), placing stents into arteries that were not blocked, with the encouragement of KDMC. An anti-fraud contractor selected 19 angiograms for an audit and concluded that in seven cases, the blockage was insufficient to warrant a stent. Medicare denied reimbursement for those procedures and continued investigating. A private insurer did its own review and concluded that at least half the stents ordered by Paulus were not medically necessary. The Kentucky Board of Medical Licensure subpoenaed records and concluded that Paulus had diagnosed patients with severe stenosis where none was apparent from the angiograms. Paulus had retired; he voluntarily surrendered his medical license. A jury convicted Paulus on 10 false-statement counts and on the healthcare fraud count. It acquitted him on five false-statement counts. The court set aside the guilty verdicts and granted Paulus a new trial. The Sixth Circuit reversed. The degree of stenosis is a fact capable of proof. A doctor who deliberately inflates the blockage he sees on an angiogram has told a lie; if he does so to bill a more expensive procedure, then he has also committed fraud. View "United States v. Paulus" on Justia Law

The Alaska Supreme Court granted this petition for review to consider how the federal Health Insurance Portability and Accountability Act of 1996 (HIPAA) affected Alaska personal injury case law allowing a defendant ex parte contact with a plaintiff’s doctors as a method of informal discovery. The issue the Court requested the parties specifically brief was whether the federal law preempted Alaska case law, or, if not, whether federal law otherwise required us to overrule or modify our case law. After review, the Court concluded the federal law did not preempt existing Alaska case law. But the Court also concluded it should overrule the case law because its foundations "have been eroded by a cultural shift in views on medical privacy and new federal procedural requirements undermining the use of ex parte contact as an informal discovery measure." The Court therefore held that - absent voluntary agreement - a defendant may not make ex parte contact with a plaintiff’s treating physicians without a court order, which generally should not be issued absent extraordinary circumstances. "We believe that formal discovery methods are more likely to comply with the federal law and promote justice and that such court orders rarely, if ever, will be necessary." View "Jones v. Drury" on Justia Law

On October 8, 2016, Rita Kay filed a complaint against "Brookwood Baptist Health LLC" and fictitiously named defendants pursuant to the Alabama Medical Liability Act, based on injuries she allegedly suffered at the hands of another patient while she was being treated in the Psychiatric and Behavioral Health Inpatient Services Unit at Brookwood Baptist Medical Center from October 8, 2014, until October 12, 2014. She asserted claims of medical negligence, false imprisonment, negligence and wantonness, breach of contract, and negligent and/or wanton hiring, training, and/or supervision. Brookwood Health Services, Inc., filed a petition for a writ of mandamus directing the Circuit Court to dismiss Kay's action against it. Assuming, without deciding, that service on Brookwood Baptist Health LLC, the original defendant, was proper, the materials before the Alabama Supreme Court established that Brookwood Baptist Health LLC did not receive the complaint until February 13, 2017 -- 128 days after the lawsuit was commenced. Therefore, the Court concluded Brookwood established it was added as a defendant after the expiration of the applicable limitations period and that relation-back principles do not apply. Therefore, it has demonstrated that it had a clear legal right to the relief sought. Accordingly, the Supreme Court granted the petition for a writ of mandamus and directed the trial court to vacate its September 7, 2017, order denying the motion to dismiss filed by Brookwood Health Services, Inc., and to dismiss Kay's complaint. View "Ex parte Brookwood Health Services, Inc." on Justia Law

At issue in this mandamus proceeding was whether the proportionate-responsbility scheme in Chapter 33 of the Texas Civil Practice and Remedies Code applies to a civil-remedy action under the Texas Medical Fraud Prevention Act (TMFPA).The State sued Xerox Corporation and Xerox State HealthCare, LLC (collectively, Xerox), which administered the Texas Medicaid program, for a civil remedy under the TMFPA. Xerox sought to unite the TMFPA proceedings for purposes of shifting liability to the service providers sued by the State who had directly received disputed Medicaid payments. The trial court granted the State’s motion to strike Xerox’s third-party petition seeking contribution under Chapter 33, holding Chapter 33 inapplicable to the TMFPA action. The court also denied Xerox’s motion to designate responsible third parties under Chapter 33. The Supreme Court denied Xerox’s petition for writ of mandamus, holding that Chapter 33 does not apply to a TMFPA action because (1) the statutory remedy does not constitute “damages” subject to apportionment under Chapter 33; and (2) an irreconcilable conflict exists between the proportionate-responsibility statute and the TMFPA’s mitigation and fault-allocation scheme. View "In re Xerox Corp." on Justia Law

In this interlocutory appeal, the Supreme Court held that sovereign immunity barred the counterclaims filed by Defendants against the State and that it lacked interlocutory jurisdiction to address the trial court’s dismissal of the Defendants’ third-party claims.The State brought this enforcement action under the Texas Medicaid Fraud Prevention Act, alleging that Defendants - several dentists and their professional associations and employees - fraudulently obtained Medicaid payments for providing dental and orthodontic treatments to children. Defendants asserted counterclaims and third-party claims alleging that the State and its contractor mismanaged the payment-approval process and misled Defendants regarding the requirements imposed by the Texas Medical Program. The trial court granted the State’s plea to the jurisdiction against the counterclaims and motion to dismiss the third-party claims. Defendants filed this interlocutory appeal. The court of appeals affirmed the trial court’s order dismissing Defendants’ counterclaims and concluded that it lacked jurisdiction over the order dismissing the third-party claims. The Supreme Court affirmed, holding (1) sovereign immunity barred the counterclaims, and (2) this Court lacked interlocutory jurisdiction to address the order dismissing the third-party claims. View "Nazari v. State" on Justia Law

At issue was the Arkansas Medical Marijuana Commission’s (MMC) process that resulted in a decision awarding five top scoring applicants medical-marijuana-cultivation-facility licenses.Naturalis Health, LLC, one of the applicants that did not obtain a license, brought this complaint asserting that the MMC carried out the application process in a flawed, biased, and arbitrary and capricious manner. The circuit court agreed and went further to conclude that the MMC’s licensing process and decisions violated Amendment 98 of the Arkansas Constitution, were ultra vires, and violated due process. The court declared the MMC’s licensing decisions null and void and enjoined the MMC from issuing the cultivation-facility licenses. The Supreme Court reversed and dismissed the appeal brought by Appellants - MMC and others - holding that the circuit court lacked subject-matter jurisdiction under the Administrative Procedure Act. View "Arkansas Department of Finance & Administration v. Naturalis Health, LLC" on Justia Law

Montana’s Preferred Provider Agreements Act (MPPAA), Mont. Code Ann. 33-22-1701 to -1707, does not violate the Equal Protection Clause of the Montana Constitution.Plaintiff sought and received treatment from St. Peter’s Hospital for various injuries and symptoms. Because Plaintiff did not have health insurance the Hospital billed Plaintiff directly, but almost all of Plaintiff’s treatments costs were either covered by another party’s insurance or significantly discounted by the Hospital’s financial-need discount. Plaintiff brought this lawsuit arguing that the statutes authorizing the Hospital’s billing practices violate the Equal Protection Clause of the Montana Constitution. The district court concluded that the MPPAA creates similarly situated classes but does not violate Plaintiff’s equal protection rights. The Supreme Court affirmed, holding that the MPPAA, which authorizes the Hospital’s billing practices, does not deprive Plaintiff of her right to equal protection. View "Gazelka v. St. Peter's Hospital" on Justia Law