Justia Health Law Opinion Summaries

by
In a medical malpractice action, Monongahela Valley Hospital (“MVH”) contracted with UPMC Emergency Medicine, Inc. (“ERMI”) to provide staffing and administrative services for its emergency room. Both MVH and ERMI claimed the statutory evidentiary privilege in the Pennsylvania Peer Review Protection Act, 63 P.S. secs. 425.1-425.4 (PRPA) protected from disclosure the performance file of Marcellus Boggs, M.D. (“Dr. Boggs”) that had been prepared and maintained by Brenda Walther, M.D. (“Dr. Walther”), who served as the director of MVH’s emergency department and was Dr. Boggs’ supervisor. Dr. Boggs and Dr. Walther were employees of ERMI. In January 2011, Eleanor Reginelli was transported by ambulance to MVH’s emergency department with what she reported at the time to be gastric discomfort. She was treated by Dr. Boggs. Mrs. Reginelli and her husband, Orlando Reginelli, alleged Dr. Boggs failed to diagnose an emergent, underlying heart problem and discharged her without proper treatment. Several days later, Mrs. Reginelli suffered a heart attack. In 2012, the Reginellis filed an amended complaint containing four counts sounding in negligence. The Reginellis deposed, inter alia, Dr. Boggs and Dr. Walther. At her deposition, Dr. Walther testified that she prepared and maintained a “performance file” on Dr. Boggs as part of her regular practice of reviewing randomly selected charts associated with patients treated by Dr. Boggs (and other ERMI-employed emergency department physicians). In response, the Reginellis filed discovery requests directed to MVH requesting, among other things, “the complete ‘performance file’ for [Dr. Boggs] maintained by [Dr. Walther.]” MVH objected to production of the performance file, asserting that it was privileged by, inter alia, the PRPA. Under the facts presented in this case and the applicable statutory language of the PRPA, the Pennsylvania Supreme Court determined neither ERMI nor MVH could claim the evidentiary privilege: ERMI was not a “professional health care provider” under the PRPA, and the performance file at issue here was not generated or maintained by MVH’s peer review committee. Therefore, the Court affirmed the Superior Court to uphold the trial court’s ruling that PRPA’s evidentiary privilege had no application in this case. View "Reginelli v. Boggs" on Justia Law

by
Pursuant to Mississippi Code Section 27-35-119 (Rev. 2017), Natchez Hospital Company, LLC, (“Hospital”) filed a Complaint and Petition For Reduction of Assessment on Software. This ad valorem assessment was made by the Adams County Board of Supervisors (“Board”). Prior to appealing to the circuit court, the Hospital paid the ad valorem taxes as assessed. The Board filed a motion to dismiss for lack of jurisdiction, arguing that the Hospital had failed to post the necessary appeal bond required by Mississippi Code Section 11-51-77 (Rev. 2012), thus depriving the circuit court of jurisdiction. Following a hearing on the motion, the circuit court determined that the Hospital’s failure to post the bond under Section 11-51-77 deprived the court of jurisdiction to hear the appeal and granted the Board’s motion to dismiss. The Hospital appealed the circuit court’s decision to dismiss the case, asking only whether the bond requirement of Mississippi Code Section 11-51-77 was mandatory to confer jurisdiction on a circuit court to hear an appeal from a decision of a board of supervisors regarding an assessment of taxes. The Mississippi Supreme Court determined the Hospital paid the tax, but that was no excuse for not posting the bond to give the trial court jurisdiction to hear its complaint. Therefore, the Supreme Court affirmed dismissal of the Hospital’s case. View "Natchez Hospital Company, LLC v. Adams County Board of Supervisors" on Justia Law

by
An association representing naturopathic physicians challenged a new Alaska regulation that effectively forbade naturopaths from using and prescribing injectable vitamins and minerals. The association argued the statutory definition of naturopathy included the use of dietetics, that dietetics included injectable vitamins and minerals obtained by pharmaceutical prescription, and that the statutory restrictions on the practice of naturopathy prohibited the use of only prescription drugs, not all prescription medicines. After review, the Alaska Supreme Court concluded the statutory text, the larger statutory context, and the legislative history together suggest that the legislature did not intend to grant prescriptive authority to naturopaths. Therefore, the Court affirmed the superior court’s decision to grant summary judgment against the association on this issue. View "Alaska Association of Naturopathic Physicians v. Alaska Division of Corporations, Business & Professional Licensing" on Justia Law

by
The dismissal of the criminal charge pending against Respondent, an incompetent defendant, did not require his release from commitment to Bridgewater State Hospital, where the charge was dismissed after the period of commitment had expired, and a petition to extend the commitment had yet to be decided.After the criminal charge against Respondent was dismissed, Bridgewater moved to file an amended petition to modify its pending Mass. Gen. Laws ch. 123, 16(c) petition to a petition for civil commitment pursuant to Mass. Gen. Laws ch. 123, 7 and 8. The district court concluded that Bridgewater had no authority to hold Respondent pursuant to Mass. Gen. Laws ch. 123, 16(c), denied Bridgewater’s petition to amend, and ordered Respondent discharged. The Supreme Judicial Court reversed, holding (1) the dismissal of the criminal charges did not require Respondent’s immediate release from commitment, and Bridgewater retained the statutory authority to hold Respondent while the Mass. Gen. Laws ch. 123, 16(c) petition was pending; and (2) the district court abused its discretion in denying Bridgewater’s request to amend its pending petition for an extension under Mass. Gen. Laws ch. 123, 16(c) to a petition for civil commitment under Mass. Gen. Laws ch. 123, 7 and 8. View "In re E.C." on Justia Law

by
Solis alleged that his former employers violated the federal False Claims Act (FCA) by promoting dangerous off-label uses of a cardiovascular drug, Integrilin, and by paying physicians kickbacks to prescribe Integrilin and an antibiotic drug, Avelox. The district court found that Solis’s FCA claims were foreclosed by the public disclosure bar, which deprives federal courts of subject matter jurisdiction over FCA suits when the alleged fraud has already been publicly disclosed unless the relator is deemed an original source. The Ninth Circuit affirmed in part, holding that Solis’s Integrilin claims were substantially similar to those in prior public disclosures, and were close enough in kind and degree to have put the government on notice to investigate the alleged fraud before Solis filed his complaint. The court vacated the dismissal of Solis’s Integrilin claims and remanded for a determination of whether Solis qualified for the “original source” exception, 31 U.S.C. 3730(e)(4). Concerning Solis’s Avelox claims, the court held that the district court clearly erred in finding that the Avelox claims were publicly disclosed based on court complaints that never mentioned Avelox but affirmed the dismissal of Solis’s Avelox claims on the alternative ground of failure to plead with particularity as required by Fed.R.Civ.P. 9(b). View "Solis v. Millenium Pharmaceuticals, Inc." on Justia Law

by
The Second Circuit denied a petition for review of OSHA's final order affirming a citation issued to a construction company for a repeat violation of an excavation standard and assessing a penalty of $25,000. The court held that the Commission did not abuse its discretion by relying on previous violations more than three years old, because neither the Manual nor the Commissionʹs precedent limits OSHA to a three‐year look back period. Furthermore, the Commissionʹs precedents established that ʺthe time between violations does not bear on whether a violation is repeated.ʺ Finally, this was the company's third violation in six years. View "Triumph Construction Corp. v. Secretary of Labor" on Justia Law

by
The Second Circuit denied a petition for review of OSHA's final order affirming a citation issued to a construction company for a repeat violation of an excavation standard and assessing a penalty of $25,000. The court held that the Commission did not abuse its discretion by relying on previous violations more than three years old, because neither the Manual nor the Commissionʹs precedent limits OSHA to a three‐year look back period. Furthermore, the Commissionʹs precedents established that ʺthe time between violations does not bear on whether a violation is repeated.ʺ Finally, this was the company's third violation in six years. View "Triumph Construction Corp. v. Secretary of Labor" on Justia Law

by
The Ninth Circuit affirmed the district court's grant of summary judgment for the Department in an action brought by private ambulance companies challenging the reimbursement rate for their transportation of patients covered by Medi-Cal. The panel held that plaintiffs failed to carry their burden of producing evidence upon which a reasonable jury could return a verdict in their favor and thus the district court did not err in entering judgment in the Department's favor on the Takings Clause claim. The panel reasoned that the ambulance companies lacked a constitutionally protected property interest in a particular reimbursement rate, but the mandatory-care provision of Cal. Health & Safety Code 1317(d) implicated a constitutionally protected property right. The panel held that section 1317(d) did not effect a regulatory taking under the Penn Central test. The panel also held that the ambulance companies did not establish a due process claim regarding DHCS's failure to ensure that Medi-Cal reimbursement rates kept pace with their costs because they lacked a constitutionally protected interest in any particular reimbursement rate. View "Sierra Medical Services Alliance v. Kent" on Justia Law

by
The Ninth Circuit affirmed the district court's grant of summary judgment for the Department in an action brought by private ambulance companies challenging the reimbursement rate for their transportation of patients covered by Medi-Cal. The panel held that plaintiffs failed to carry their burden of producing evidence upon which a reasonable jury could return a verdict in their favor and thus the district court did not err in entering judgment in the Department's favor on the Takings Clause claim. The panel reasoned that the ambulance companies lacked a constitutionally protected property interest in a particular reimbursement rate, but the mandatory-care provision of Cal. Health & Safety Code 1317(d) implicated a constitutionally protected property right. The panel held that section 1317(d) did not effect a regulatory taking under the Penn Central test. The panel also held that the ambulance companies did not establish a due process claim regarding DHCS's failure to ensure that Medi-Cal reimbursement rates kept pace with their costs because they lacked a constitutionally protected interest in any particular reimbursement rate. View "Sierra Medical Services Alliance v. Kent" on Justia Law

by
Armenta worked at Passages as a certified nursing assistant and later as a regional director of certified nursing assistants. Passages billed its services to Medicare. Medicare paid $180 per patient per day for routine services but up to $700 for general inpatient services (GIP). Passages began paying directors based on the number of patients on GIP. The number of patients on GIP significantly increased because directors instructed nurses and nursing assistants to place patients who did not need that level of care on GIP. Passages received an audit request from a Medicare contractor. In response, Armenta and other Passages employees entered false information consistent with GIP care and billing into patient files, then submitted the altered files. Passages employees, including Armenta, were trained on the requirements for placing a patient on GIP. Armenta told the nurses to disregard the training. Armenta and others were charged with health care fraud. Only Armenta proceeded to trial. With a two-level enhancement for obstruction of justice based on lying on the stand and altering records, her Guidelines imprisonment range was 63-78 months.The Seventh Circuit affirmed her conviction and sentence of 20 months’ imprisonment plus $1.67 million in restitution. Although no government witness identified Armenta in court, the defense did not argue that the Armenta in the courtroom was not the same Armenta involved in the fraud. View "United States v. Armenta" on Justia Law