Justia Health Law Opinion Summaries

Joel Phillip McNinch, Jr., a dementia patient with other serious health issues, was admitted to Brandon Nursing and Rehabilitation Center, LLC in June 2019. He was later admitted to Merit Health Rankin due to combative behaviors related to his dementia. He developed a decubitus ulcer and was admitted to St. Dominic Hospital, where he died the next day. His widow, Cheryl McNinch, requested her husband's medical records from Brandon Nursing and Merit Health soon after his death and received them in mid-December 2019. She filed a complaint in January 2022, alleging negligence, medical malpractice, gross negligence, and reckless disregard, claiming that substandard care had accelerated her husband's health deterioration and led to his death.The defendants moved to dismiss the case, arguing that the action was barred by the two-year statute of limitations. Mrs. McNinch argued that the discovery rule operated to toll the statute of limitations until she received the medical records. The trial court converted the defendant’s motion to dismiss into a motion for summary judgment and granted the motion without holding a hearing.The Supreme Court of Mississippi reversed the trial court's decision, finding that the trial court erred by granting summary judgment to the defendants. The Supreme Court held that there were genuine issues of material fact regarding whether Mrs. McNinch had knowledge of negligent conduct through personal observation or other means prior to or at the time of Mr. McNinch’s death. The court found that the discovery rule could operate to toll the statute of limitations when the medical records are necessary to discover the negligence. The court concluded that Mrs. McNinch exercised reasonable diligence in requesting the medical records promptly, and therefore, the complaint was filed within the statute of limitations. The case was remanded to the circuit court for further proceedings. View "McNINCH v. BRANDON NURSING & REHABILITATION CENTER" on Justia Law

The case involves the United States of America, et al. ex rel. Michael Angelo and MSP WB, LLC (Relators-Appellants) against Allstate Insurance Company, et al. (Defendants-Appellees). The relators alleged that Allstate Insurance violated the False Claims Act by avoiding its obligations under the Medicare Secondary Payer Act. They claimed that Allstate failed to report or inaccurately reported to the Centers for Medicare & Medicaid Services (CMS) information regarding its beneficiaries, which led to Allstate failing to reimburse Medicare for auto-accident-related medical costs incurred by beneficiaries insured by Allstate.The United States District Court for the Eastern District of Michigan dismissed the case with prejudice, deeming the relators' second amended complaint deficient in numerous respects. The relators then moved for reconsideration, which the district court denied. They also filed a motion to amend or correct under Rule 59(e), asking the district court to amend its judgment to dismiss the case without prejudice to allow them to file another amended complaint. The district court denied the motion on all grounds.The United States Court of Appeals for the Sixth Circuit affirmed the district court's decision. The court found that the relators failed to state a claim for a violation of the False Claims Act. The court noted that the relators did not provide sufficient facts demonstrating that Allstate had an "established duty" to pay money or property owed to the government. The court also found that the relators did not demonstrate Allstate's understanding that its conduct violated its obligations under federal law. Furthermore, the court found that the relators' claim for conspiracy also failed as they did not provide any specific details regarding the alleged plan or an agreement to execute the plan. The court also affirmed the district court's decision to deny the relators leave to amend their complaint again. View "United States ex rel. Angelo v. Allstate Insurance Co." on Justia Law

A nurse practitioner, Lisa Hofschulz, and her ex-husband, Robert Hofschulz, were convicted of conspiracy and multiple counts of distributing drugs in an unauthorized manner, including one count resulting in a patient's death. The charges stemmed from their operation of a "pain clinic" that functioned as a front for an opioid mill, dispensing opioid prescriptions for cash-only payments. Robert Hofschulz was also convicted for his role in assisting Lisa Hofschulz in running the opioid mill.The Hofschulzes were initially tried in the United States District Court for the Eastern District of Wisconsin. They were found guilty on all counts, with Lisa Hofschulz receiving a minimum 20-year prison term for the count of unlawful distribution resulting in death, and Robert Hofschulz receiving concurrent terms of 36 months in prison on each of his five convictions. The Hofschulzes appealed their convictions on three grounds: they claimed the jury instructions were inconsistent with a Supreme Court decision, that the judge wrongly permitted the government’s medical expert to testify about the standard of care, and that the evidence was insufficient to support their convictions.The case was then reviewed by the United States Court of Appeals for the Seventh Circuit. The court found no instructional error, stating that the district judge had correctly instructed the jury that the government must prove beyond a reasonable doubt that the Hofschulzes intended to distribute controlled substances and intended to do so in an unauthorized manner. The court also found that the judge had correctly permitted the government’s medical expert to testify about the standard of care in the usual course of professional pain management. Lastly, the court dismissed the Hofschulzes' challenge to the sufficiency of the evidence, deeming it frivolous. The court affirmed the convictions of the Hofschulzes. View "United States v. Hofschulz" on Justia Law

The case involves Amarin Pharma, Inc., Amarin Pharmaceuticals Ireland Limited, and Mochida Pharmaceutical Co., Ltd. (collectively, “Amarin”) and Hikma Pharmaceuticals USA Inc. and Hikma Pharmaceuticals PLC (collectively, “Hikma”). Amarin markets and sells icosapent ethyl, an ethyl ester of an omega-3 fatty acid commonly found in fish oils, under the brand name Vascepa®. In 2012, the U.S. Food and Drug Administration (“FDA”) approved Vascepa for the treatment of severe hypertriglyceridemia. In 2019, following additional research and clinical trials, the FDA approved Vascepa for a second use: as a treatment to reduce cardiovascular risk in patients having blood triglyceride levels of at least 150 mg/dL.In the United States District Court for the District of Delaware, Hikma moved to dismiss Amarin’s complaint for failure to state a claim. The court granted Hikma’s motion, concluding that Amarin’s allegations against Hikma did not plausibly state a claim for induced infringement.The United States Court of Appeals for the Federal Circuit reversed the decision of the district court. The court held that Amarin had plausibly pleaded that Hikma had induced infringement of the asserted patents. The court noted that the case was not a traditional Hatch-Waxman case or a section viii case, but rather a run-of-the-mill induced infringement case arising under 35 U.S.C. § 271(b). The court concluded that the totality of the allegations, taken as true, plausibly plead that Hikma “actively” induced healthcare providers’ direct infringement. View "AMARIN PHARMA, INC. v. HIKMA PHARMACEUTICALS USA INC. " on Justia Law

The case involves United Therapeutics Corporation (UTC), a biotechnology company, and the Commissioner of Internal Revenue. The dispute centers on the interpretation of a tax provision that coordinates two tax credits: the research credit and the orphan drug credit. The Commissioner claimed that UTC disregarded one of the provision’s two commands, improperly reducing its tax liability by over a million dollars. UTC argued that the relevant half of the coordination provision lost effect in 1989 and has been moribund since.The United States Tax Court disagreed with UTC's argument. The court interpreted the statute’s terms by reference to their ordinary meaning, giving effect to the full coordination provision. The court rejected UTC's argument that changes to the tax law since its enactment rendered part of the coordination provision ineffective. The court also disagreed with UTC's interpretation of two regulations it relied on for support.The United States Court of Appeals for the Fourth Circuit affirmed the tax court's decision. The appellate court agreed with the tax court's interpretation of the coordination provision according to its ordinary meaning. The court also found that the tax court correctly rejected UTC's arguments based on the interpretation of predecessor statutes and regulations. The court concluded that the tax court correctly resolved the case in favor of the Commissioner. View "United Therapeutics Corporation v. Commissioner of Internal Revenue" on Justia Law

The case involves Carl Fowler, an employee at Perdue, Inc., who contracted COVID-19 and sought compensation from his employer. Fowler worked at Perdue from January 2020 until late March 2020. In March 2020, Fowler developed COVID-19 symptoms and was later diagnosed with the virus. He was hospitalized for over two months and suffered severe health complications. Fowler claimed that he contracted the virus at work, specifically in the company's cafeteria, which he described as crowded and likened to a "sardine can."The Industrial Accident Board of the State of Delaware initially denied Fowler's claim, finding that he failed to present sufficient evidence that COVID-19 was a compensable occupational disease. The Superior Court affirmed this decision. Fowler then appealed to the Supreme Court of the State of Delaware.The Supreme Court affirmed the lower court's decision. The court found that while Fowler had established that the cafeteria at Perdue presented a hazard greater than that attending employment in general, he failed to show that the cafeteria was a hazard "distinct from" that attending employment in general. The court concluded that Fowler failed to establish the necessary relationship between his work environment at Perdue and COVID-19 as a "natural incident to" that employment. Therefore, the court held that Fowler's COVID-19 infection was not an occupational disease under these circumstances. View "Fowler v. Perdue, Inc." on Justia Law

The case involves Ryan Owen Frayo, a former employee of A&A Organic Farms Corporation (A&A), who was terminated for refusing to take a COVID-19 test. Frayo sued A&A and its owners, Andrew D. Martin and Aimee M. Raphael-Martin, alleging they violated the Confidentiality of Medical Information Act (CMIA). Frayo claimed that his termination was a result of his refusal to provide a COVID-19 test result, which he argued was equivalent to refusing to sign an authorization for the release of his medical information under the CMIA. He also claimed that A&A used his description of his symptoms, which he considered as medical information, to terminate his employment.The trial court sustained A&A’s demurrer to Frayo’s first amended complaint, finding that Frayo failed to state a claim under the CMIA. The court concluded that Frayo failed to state a claim under section 56.20(b) of the CMIA because the statute prohibits employer discrimination based on an employee’s refusal to sign an authorization to release his medical information, not refusal to take a COVID-19 test. The court also sustained the demurrer to Frayo’s second cause of action under section 56.20(c) because Frayo failed to allege A&A had possession of his medical information, as defined by the statute.The Court of Appeal of the State of California Sixth Appellate District affirmed the trial court's decision. The appellate court agreed with the trial court that Frayo did not state a cognizable CMIA claim under either section 56.20(b) or (c). The court found that Frayo's refusal to take and provide the results of a COVID-19 test was not equivalent to an "employee’s refusal to sign an authorization" under the CMIA. Furthermore, the court concluded that Frayo failed to allege that A&A was in possession of his medical information as defined under the CMIA. Therefore, the court affirmed the judgment of dismissal. View "Frayo v. Martin" on Justia Law

A group of individuals and businesses challenged the Affordable Care Act's requirement for private insurers to cover certain types of preventive care, including contraception, HPV vaccines, and drugs preventing HIV transmission. The plaintiffs argued that the mandates were unlawful because the agencies issuing them violated Article II of the Constitution, as their members were principal officers of the United States who had not been validly appointed under the Appointments Clause. The district court mostly agreed, vacating all agency actions taken to enforce the mandates and issuing both party-specific and universal injunctive relief.The United States Court of Appeals for the Fifth Circuit agreed that the United States Preventive Services Task Force, one of the challenged administrative bodies, was composed of principal officers who had not been validly appointed. However, the court found that the district court erred in vacating all agency actions taken to enforce the preventive-care mandates and in universally enjoining the defendants from enforcing them. The court also held that the Secretary of the Department of Health and Human Services had not validly cured the Task Force’s constitutional problems.The court affirmed in part, reversed in part, and remanded the case for further proceedings. The court did not rule on the plaintiffs' challenges against the other two administrative bodies involved in the case, the Advisory Committee on Immunization Practices and the Health Resources and Services Administration, reserving judgment on whether the Secretary had effectively ratified their recommendations and guidelines. View "Braidwood Mgmt v. Becerra" on Justia Law

The case involves the Iowaska Church of Healing (the "Church"), an organization whose religious practices involve the consumption of Ayahuasca, a tea containing the hallucinogenic drug dimethyltryptamine (DMT), which is regulated under the Controlled Substances Act (CSA). The Church had applied for tax-exempt status under 26 U.S.C. § 501(c)(3) but was denied by the Internal Revenue Service (IRS) on the grounds that the Church's religious use of Ayahuasca was illegal. The Church challenged this decision in the District Court, arguing that the IRS's determination was based on an incorrect assumption of illegality and that the denial of tax-exempt status violated the Religious Freedom Restoration Act of 1993 (RFRA).The District Court denied the Church's motion and granted the Government's motion for summary judgment. The court held that the Church lacked standing to assert its RFRA claim and that the lack of standing also undermined its tax-exemption claim. The court found that the Church's religious use of Ayahuasca was illegal without a CSA exemption, and the IRS had no authority to assess whether the Church's proposed Ayahuasca use warranted a religious exemption from the CSA.On appeal, the United States Court of Appeals for the District of Columbia Circuit affirmed the District Court's judgment. The Court of Appeals held that the Church lacked standing to assert its RFRA claim because the economic injury it claimed was neither an injury-in-fact nor redressable. Without a cognizable RFRA claim, the Church's tax-exemption claim also failed. The Court of Appeals found that the Church could not proffer evidence of a CSA exemption to show it passed the organizational and operational tests for tax-exempt status. View "Iowaska Church of Healing v. Werfel" on Justia Law

This case involves a dispute over the interpretation of a statute that regulates healthcare providers participating in the federal Medicaid program. The State of Texas, acting through the Attorney General, sought to enforce a statute that imposes penalties on a provider who submits a claim for payment and knowingly fails to indicate the type of professional license and the identification number of the person who actually provided the service. The defendant, a dentist, argued that the statute only applies if a claim fails to indicate both the license type and the identification number of the actual provider.Previously, the trial court granted the State's motion for partial summary judgment and denied the defendant's motion. The court rendered a final judgment awarding the State more than $16,500,000. The defendant appealed, and the court of appeals affirmed the trial court's judgment, except for the amount of attorney’s fees and expenses.The Supreme Court of Texas reversed the lower courts' decisions. The court agreed with the defendant's interpretation of the statute. The court held that the statute applies only if a claim fails to indicate both the license type and the identification number of the actual provider. The court found that the 1,842 claims at issue did indicate the actual providers’ license type, so they did not constitute an unlawful act under the statute. The court rendered judgment in the dentist’s favor. View "MALOUF v. THE STATE OF TEXAS EX RELS. ELLIS AND CASTILLO" on Justia Law