Justia Health Law Opinion Summaries
Porretti v. Dzurenda
Porretti, a 62-year-old prisoner, has suffered from serious mental illnesses—Tourette’s syndrome, depression, obsessive-compulsive disorder, personality disorder, and paranoid schizophrenia— throughout his life. Porretti’s mental illnesses have caused him to attempt suicide and to suffer psychotic symptoms, including compulsive ingestion of metal objects like razor blades, paranoid delusions, hallucinations, and verbal tics. Porretti received Wellbutrin and Seroquel for his mental illnesses before he was incarcerated in Nevada and after he entered into the custody of the Nevada Department of Corrections (NDOC). In 2017, without the recommendation of a healthcare provider, NDOC stopped providing his medication because of a new administrative policy.The Ninth Circuit upheld a preliminary injunction requiring prison officials to provide Porretti’s Wellbutrin and Seroquel. The district court carefully applied the preliminary-injunction factors and rendered highly detailed factual findings that rejected opinions from NDOC’s experts for reasons grounded in the record evidence; Porrettif’s Eighth Amendment claim was likely to succeed on the merits and he would suffer irreparable harm in the form of “very serious or extreme damage to his mental health” if injunctive relief were not granted. Porretti’s severe and persistent psychotic symptoms overwhelmingly outweighed NDOC’s financial or logistical burdens in providing Wellbutrin and Seroquel. An injunction was in the public’s interest because prisons must comply with the standard of care mandated by the Eighth Amendment. View "Porretti v. Dzurenda" on Justia Law
Boston Bit Labs, Inc. v. Baker
The First Circuit affirmed the district court's dismissal of this suit challenging Massachusetts Governor Charles Baker's COVID-19 Order No. 43 as unconstitutional, holding that the case was moot.Bit Bar, which owned and ran a restaurant/arcade in the city of Salem, Massachusetts, brought suit under 42 U.S.C. 1983, attacking Governor Baker's order, which temporarily closed the trade part of Bit Bar's business, as unconstitutional. The complaint alleged that the Governor's restriction violated Bit Bar's First and Fourteenth Amendment rights. Just days after Bit Bar filed suit, Governor Baker entered an order allowing arcades to reopen. The Governor then moved to dismiss the complaint as moot. The district court granted the motion to dismiss. The First Circuit affirmed, holding that the case was moot. View "Boston Bit Labs, Inc. v. Baker" on Justia Law
United States v. Moparty
Dr. Narang and Moparty were convicted of Conspiracy to Commit Health Care Fraud, 18 U.S.C. 1349; Health Care Fraud, section 1347, and Engaging in Monetary Transactions in Property Derived from Specified Unlawful Activity, section 1957. Narang is an internist who practiced at his Texas self-owned clinic, North Cypress. Moparty co-owned Red Oak Hospital and served as an administrator for Trinity Health Network, which provided staffing and administrative services to health care entities. Narang ordered unnecessary medical tests for patients and then authorized Moparty to bill for these tests at the higher hospital rate even though these patients were seen and treated at Narang’s North Cypress office. The indictment alleged that this scheme resulted in fraudulent billing of over $20 million to Blue Cross Blue Shield, Aetna, and Cigna. Those companies paid Moparty at least $3.2 million in reimbursement for those claims which he allegedly split with Narang through a series of financial transactions.The court sentenced Moparty to 108 months and Narang to 121 months of imprisonment, with joint and several liability for $2,621,999.04 in restitution. The Fifth Circuit affirmed, rejecting challenges to the sufficiency of the evidence and finding that, although the government made repeated errors, those errors did not warrant reversal. View "United States v. Moparty" on Justia Law
Beshear v. Goodwood Brewing Co.
The Supreme Court vacated the trial court's order granting a temporary injunction enjoining Defendants from enforcing against only the individual Plaintiffs multiple specifically enumerated executive orders, administrative regulations, and directives, holding that the trial court erred.Plaintiffs, several businesses, filed suit against the Governor, the Secretary of the Cabinet for Health and Family Services, and the Commissioner of the Kentucky Department of Public Health, seeking declaratory relief, a temporary injunctions and a permanent injunction regarding the Governor's orders related to COVID-19. The circuit court granted temporary injunctive relief. The Supreme Court vacated the order, holding that the trial court erred by refusing to allow the Governor to call witnesses and present evidence. View "Beshear v. Goodwood Brewing Co." on Justia Law
Lee Memorial Hospital v. Becerra
Eight years ago, several hospitals challenged the Department of Health and Human Services’ methodology for calculating certain Medicare payments. The hospitals had sought expedited judicial review (EJR) from the Provider Reimbursement Review Board, which is available if a hospital’s claim involves a question that the Board “is without authority to decide,” 42 U.S.C. 1395oo(f)(1). While the Board granted most of the EJR requests, it dismissed the claims of certain hospitals (appellants) for failing to comply with agency filing procedures. The Board declined to grant EJR to those hospitals. In 2018, the D.C. Circuit ruled against the hospitals on the merits.The appellants filed suit, arguing that the Board’s dismissal of their claims was a “final decision” subject to judicial review, and urged the court not to remand their cases but to resolve the merits of their challenge to the rules for Medicare outlier payments. The district court held that the Board had lacked authority to resolve their challenges—the triggering condition for the Board’s granting of EJR—and that the court could proceed to consider the merits. The other hospitals (who had been granted EJR) joined with appellants in seeking vacatur of the challenged Medicare outlier rules. The district court rejected that suit on summary judgment.The D.C. Circuit affirmed. For the hospitals to establish that the now-final judgment against them was void because the district court lacked jurisdiction, they would need to show that there was not even an arguable basis for that court’s conclusion—at the urging of the hospitals themselves—that jurisdiction existed. The hospitals fail to make that showing. View "Lee Memorial Hospital v. Becerra" on Justia Law
Turner v. Costa Crociere S.P.A.
Turner, a Wisconsin resident, filed a putative class action against Costa, an Italian cruise operator, and its American subsidiary, alleging that their negligence contributed to an outbreak of COVID-19 aboard the Costa Luminosa during his transatlantic voyage beginning on March 5, 2020. The Luminosa had evacuated a passenger, who subsequently died of COVID-19, from a cruise immediately preceding Turner’s cruise. Costa told passengers that the ship was safe. It did not hire any experts to verify that the ship had been sufficiently cleaned and allegedly failed to refuse boarding to individuals who had COVID-19 symptoms or had traveled to high-risk areas. On March 8, the Luminosa had docked to transport passengers with COVID-19 symptoms to the hospital but did not inform passengers of those circumstances, When passengers disembarked on March 19, 36 of the 75 passengers tested positive for COVID-19. The Eleventh Circuit affirmed the dismissal of Turner’s complaint on forum non conveniens grounds. Turner's passage ticket contract included a forum selection clause requiring that all claims associated with his cruise be litigated in Genoa, Italy. Forum selection clauses are presumptively valid and enforceable; Turner failed to defeat the presumption by showing that the clause was induced by fraud or overreaching, that he would be deprived of his day in court because of inconvenience or unfairness, the chosen law would deprive him of a remedy or enforcement of the clause would contravene public policy.’ View "Turner v. Costa Crociere S.P.A." on Justia Law
Prose v. Molina Healthcare of Illinois,
Molina Healthcare contracted with the Illinois Medicaid program to provide multiple tiers of medical-service plans with scaled capitation rates (fixed per-patient fees that cover all services within the plan’s scope). The Nursing Facility plan required Molina to provide Skilled Nursing Facility (SNF) services. Molina subcontracted with GenMed to cover that obligation. Molina received a general capitation payment from the state, out of which it was to pay GenMed for the SNF component. Molina breached its contract with GenMed. GenMed terminated the contract. After GenMed quit, Molina continued to collect money from the state for the SNF services, but it was neither providing those services itself nor making them available through any third party. Molina never revealed this breakdown, nor did it seek a replacement service provider.Prose, the founder of GenMed, brought this qui tam action under both the state and federal False Claims Acts, 31 U.S.C. 3729, alleging that Molina submitted fraudulent claims for payments from government funds. The district court dismissed the case. The Seventh Circuit reversed. The complaint plausibly alleges that as a sophisticated player in the medical-services industry, Molina was aware that these kinds of nursing facility services play a material role in the delivery of Medicaid benefits. View "Prose v. Molina Healthcare of Illinois," on Justia Law
Whole Woman’s Health v. Paxton
The Fifth Circuit, en banc, vacated the district court's permanent injunction declaring Senate Bill 8 (SB8), which prohibits a particular type of dilation and evacuation (D&E) abortion method, facially unconstitutional.The district court held that SB8 imposes an undue burden on a large fraction of women, primarily because it determined that SB8 amounted to a ban on all D&E abortions. However, viewing SB8 through a binary framework—that either D&Es can be done only by live dismemberment or else women cannot receive abortions in the second trimester—is to accept a false dichotomy. Rather, the en banc court concluded that the record shows that doctors can safely perform D&Es and comply with SB8 using methods that are already in widespread use. The en banc court also concluded that the district court, in permanently enjoining SB8, committed numerous, reversible legal and factual errors: applying the wrong test to assess SB8, disregarding and misreading the Supreme Court's precedents in Planned Parenthood of Southeastern Pennsylvania v. Casey and Gonzales v. Carhart, and bungling the large-fraction analysis. Because remanding to the district court would be futile as the record permits only one conclusion, the en banc court concluded that plaintiffs have failed to carry their heavy burden of proving that SB8 would impose an undue burden on a large fraction of women. View "Whole Woman's Health v. Paxton" on Justia Law
Asociacion Hospital del Maestro, Inc. v. Becerra
In this action brought by a group of twenty-five acute-care hospitals in Puerto Rico that received disproportionate share hospital payments (DHS payments) from the government, the First Circuit affirmed the decision of the district court denying relief on Plaintiffs' allegations that the Secretary of the United States Department of Health and Human Services improperly calculated their DSH payments, holding that the district court did not err.When Congress included hospitals in Puerto Rico in providing coverage for the DSH reimbursement program, the DSH payments were often substantially less than the DSH payments provided to similarly-situated hospitals in the states. This disparity was the result of the application to hospitals in Puerto Rico of the existing statutory formula used to calculate DSH payments to hospitals in the states. Plaintiffs brought this action challenging the Secretary's interpretation and application of the statutory formula, arguing that it was inconsistent with the Medicare Act, the Administrative Procedure Act, and the Equal Protection Clause of the United States Constitution. The district court denied relief. The First Circuit affirmed, holding that the Secretary did not err in implementing the statute and that Plaintiffs failed to show that they were the victims of any unconstitutional discrimination by the Secretary. View "Asociacion Hospital del Maestro, Inc. v. Becerra" on Justia Law
Leadbitter v. Keystone, et al.
This discretionary appeal concerned discovery in a medical negligence lawsuit in which the patient suffered complications following surgery at a hospital. The issue was whether certain portions of the hospital’s credentialing file for the doctor who performed the surgery were protected from discovery. The hospital claimed protection under the Peer Review Protection Act and the federal Health Care Quality Improvement Act. The Supreme Court held: (1) a hospital’s credentials committee qualified as a “review committee” for purposes of Section 4 of the Peer Review Protection Act to the extent it undertakes peer review; and (2) the federal Health Care Quality Improvement Act protects from disclosure the responses given by the National Practitioner Data Bank to queries submitted to it – and this protection exists regardless of any contrary aspect of state law. The order of the Superior Court was reversed insofar as it ordered discovery of the NPDB query responses. It was vacated in all other respects and the matter was remanded for further proceedings. View "Leadbitter v. Keystone, et al." on Justia Law