Justia Health Law Opinion Summaries

The case involves the Mississippi Division of Medicaid and the Women’s Pavilion of South Mississippi, PLLC. Women's Pavilion, a physician-owned OBGYN clinic, challenged Mississippi Division of Medicaid's calculation of the "encounter rate," a set amount of money per visit by a Medicaid patient. Medicaid set the clinic’s encounter rate at $157.94, which was partially based on the compensation of the five physician owners of the clinic.Women’s Pavilion appealed this decision and requested an administrative hearing. The hearing officer evaluated whether Medicaid’s initial decision was supported by substantial evidence, affirming the reimbursement rate. However, Women’s Pavilion appealed again, arguing that the hearing officer applied the wrong standard of review.The Hinds County Chancery Court agreed with Women’s Pavilion, holding that the hearing officer should have made his own findings of fact and determinations of the issues presented, rather than merely evaluating whether Medicaid’s initial decision was supported by substantial evidence. The court vacated Medicaid’s final decision and remanded the matter back to Medicaid.The Mississippi Division of Medicaid appealed to the Supreme Court of Mississippi. The Supreme Court affirmed the decision of the Hinds County Chancery Court, stating that the hearing officer had erred by applying the standard of review for courts reviewing a final administrative decision, rather than following Medicaid’s own administrative rules governing provider appeals. The case was remanded back to Medicaid for further proceedings under the proper standard of review. View "Mississippi Division of Medicaid v. Women's Pavilion of South Mississippi, PLLC" on Justia Law

This case revolves around a lawsuit filed by Tiffiny Grace, legal guardian of E.G., against Sunrise Hospital and Nurse Cord Olsen for professional negligence. E.G. was born prematurely at Sunrise Hospital and suffered permanent developmental damage following a cardiac arrest in the Neonatal Intensive Care Unit. The hospital's Patient Safety Committee investigated the incident, which Grace sought to examine during discovery. However, Sunrise Hospital objected, asserting that the information was privileged under the Patient Safety and Quality Improvement Act of 2005 (PSQIA) and Nevada law. The district court compelled the testimony, ruling that Sunrise Hospital had waived any privilege by allowing testimony on certain privileged topics.The Supreme Court of the State of Nevada, however, disagreed with the lower court's interpretation. It ruled that the PSQIA provides an absolute privilege for patient safety work products that is not subject to waiver. The court explained that this privilege aims to encourage healthcare providers to identify and learn from errors without fear of legal repercussions. The court concluded that the district court erred by interpreting the PSQIA to allow for waiver of privilege and by failing to determine whether the testimony sought constituted identifiable or non-identifiable patient safety work product. Therefore, the court granted a writ of prohibition, vacated the district court's order, and directed the lower court to reconsider Grace's motion to compel in light of its interpretation of the PSQIA. View "Sunrise Hospital v. Eighth Judicial District Court" on Justia Law

The plaintiff, Yarnell, filed a wrongful death action against Clinton No. 1, Inc., a healthcare and rehabilitation center, alleging that Clinton's negligence led to her mother's death from COVID-19. The Missouri Supreme Court addressed whether Clinton's proposed theories of immunity barred Yarnell's claims, which were based on the Public Readiness and Emergency Preparedness (PREP) Act and two Missouri acts.Yarnell's mother had contracted with Clinton for a private room, but Clinton placed her with a roommate, which Yarnell claimed exposed her mother to COVID-19, violated their agreement, and ultimately led to her mother's death. Clinton argued that Yarnell's claims were barred by the PREP Act, which provides immunity for healthcare providers administering or using covered countermeasures during a public health emergency, and Missouri laws granting immunity to healthcare providers during an emergency declared by the governor and in COVID-19 exposure actions.The court found that Yarnell's petition did not implicate a covered countermeasure under the PREP Act, as it made no reference to the administration or use of a diagnostic test or any other covered countermeasure. The court also found that Clinton failed to demonstrate it agreed to be deployed during the emergency or that the governor or any state agency acted on such agreement and deployed Clinton, which would have entitled it to immunity under Missouri law. Lastly, the court noted that Yarnell had adequately alleged her harm was caused by Clinton's recklessness, and the two COVID-19 statutes would not foreclose relief if Yarnell were able to prove such recklessness. Therefore, the court quashed its preliminary writ of mandamus, allowing Yarnell's case to proceed. View "State ex rel. Clinton No. 1 vs. Baker" on Justia Law

The case pertains to Thomas Ukoshovbera A. Gbenedio, a licensed pharmacist, who was charged with 72 counts of unlawful drug dispensing and one count of refusing an inspection of his pharmacy, essentially operating a "pill mill." The district court sentenced Gbenedio to 188 months of imprisonment and imposed a $200,000 fine.Gbenedio appealed, arguing that the lower court erred in denying his motion to dismiss the indictment due to insufficient notice of the charges against him, and in making certain evidentiary rulings. He also contested the fine imposed, stating he was unable to pay.The United States Court of Appeals for the Eleventh Circuit affirmed the district court's decision. The court found that the indictment provided enough facts for Gbenedio to understand the charges against him. It also deemed the district court's evidentiary rulings as non-abusive and found that Gbenedio failed to prove his inability to pay the fine. View "USA v. Gbenedio" on Justia Law

The case involves Andre Dubois, who was convicted on several federal firearm offenses. These offenses arose when Dubois attempted to ship a box containing firearms from Georgia to Dominica. The United States Court of Appeals for the Eleventh Circuit was asked to address five issues on appeal.Firstly, the court dismissed Dubois's argument that a recent Supreme Court case overturned the precedent upholding a ban on felons possessing firearms. The court held that the Supreme Court case did not abrogate the precedent, and therefore Dubois's argument failed.Secondly, the court affirmed that there was sufficient evidence for a reasonable jury to find that Dubois knew he was in possession of a firearm.Thirdly, the court found that Dubois's prior conviction for possession with intent to distribute marijuana under Georgia law qualified as a "controlled substance offense" under the federal Sentencing Guidelines, triggering a higher base offense level.Fourthly, the court rejected Dubois's argument that the application of a sentencing enhancement for possession of a stolen gun violated his due process rights.Finally, the court held that the district court had not erred in imposing a $25,000 fine on Dubois, as there was sufficient evidence to suggest that he could afford to pay the fine.Therefore, Dubois's convictions and sentence were affirmed. View "USA v. Dubois" on Justia Law

In this case, the plaintiff, Fallon Community Health Plan, Inc., adopted a policy requiring its employees to be vaccinated against COVID-19. The defendant, Shanika Jefferson, a home health aide employed by Fallon, sought a religious exemption from the vaccination requirement. Her request was denied, and her employment was terminated. Jefferson then applied for and was approved for unemployment benefits from the Department of Unemployment Assistance. However, Fallon contended that Jefferson was ineligible for the benefits and sought review of the decision. The board of review of the department, as well as a District Court judge, affirmed the decision.Fallon argued that Jefferson was disqualified from receiving unemployment benefits as per § 25 (e) (2) of General Laws c. 151A because she refused the COVID-19 vaccine in knowing violation of Fallon's reasonable policy and in wilful disregard of Fallon's interest in keeping its vulnerable patient population healthy. However, the Supreme Judicial Court disagreed with Fallon's contention. The court held that Jefferson did not engage in "deliberate misconduct", but rather made a good faith effort to comply with Fallon's policy by applying for a religious exemption. The court also found that Fallon failed to demonstrate that Jefferson should be disqualified on the basis of a "knowing violation" of that policy. The court considered the unique circumstances of the case, including Jefferson's sincere religious beliefs, which did not present her with a meaningful choice regarding vaccination. Therefore, the Supreme Judicial Court affirmed the decision of the lower courts, allowing Jefferson to receive unemployment benefits. View "Fallon Community Health Plan, Inc. v. Acting Director of the Department of Unemployment Assistance" on Justia Law

The United States Court of Appeals for the Ninth Circuit, in a case involving physicians who challenged California's Assembly Bill 2098 (AB 2098), which declared it unprofessional conduct for a doctor to provide COVID-19-related disinformation or misinformation to patients, ruled that the case is moot following the repeal of AB 2098. The court found no reasonable expectation that California would reenact AB 2098 or similar legislation. Additionally, evidence from the Executive Director of the Medical Board of California indicated that the board's employees and agents had been instructed not to enforce AB 2098, and that the board would have no legal authority to enforce the law once it was no longer in effect. Therefore, the court vacated the lower court's judgement and instructed it to dismiss the case due to mootness. View "MCDONALD V. LAWSON" on Justia Law

The case involved Rhonda Persiani, a defendant charged with multiple counts of driving under the influence (DUI) in California. Due to doubts about Persiani's mental competence, the criminal proceedings were suspended, and she was found mentally incompetent to stand trial. Persiani was evaluated and found suitable for outpatient treatment through mental health diversion. However, the court and parties believed Persiani was ineligible for such treatment due to a California Vehicle Code section that prohibits diversion in cases where a defendant is charged with DUI. Persiani sought dismissal of her cases, asserting that dismissal was required under the Penal Code because she was ineligible for any of the treatment options. The court denied Persiani’s motion to dismiss and imposed mental health treatment provisions as conditions of her release. In an appeal, the Court of Appeal of the State of California Fourth Appellate District held that a trial court has the authority under the Penal Code to order treatment through mental health diversion for a mentally incompetent misdemeanor defendant charged with DUI. The court concluded that the Vehicle Code section that prohibits diversion for DUI does not prevent a court from ordering a mentally incompetent misdemeanor defendant to receive treatment through mental health diversion after criminal proceedings have been suspended. The matter was remanded back to the lower court to determine whether to order Persiani to receive mental health diversion treatment. View "Persiani v. Superior Court" on Justia Law

A group of individuals filed a lawsuit against Genzyme Corporation, a drug manufacturer, for injuries allegedly caused by the company's mishandling of a prescription drug shortage between 2009 and 2012. The lawsuit was filed several years after the events in question occurred and would typically have been considered too late under the applicable statutory limitations periods. However, the plaintiffs argued that previous class actions, a savings statute, and a tolling agreement between the parties allowed the lawsuit to proceed. The district court partially agreed and rejected Genzyme's argument that the delay in filing required dismissal of the lawsuit. However, it dismissed the claims of all but four plaintiffs for lack of standing, and dismissed the remaining claims on the merits.On appeal, the United States Court of Appeals for the First Circuit found that all plaintiffs have standing and the court has jurisdiction to proceed with the case, at least with respect to the plaintiffs' individual claims. However, it concluded that four plaintiffs waited too long before filing this lawsuit, and their claims are time-barred. For the remaining plaintiffs, the court vacated the judgment dismissing their claims and remanded the case to the district court for further proceedings. View "Wilkins v. Genzyme Corporation" on Justia Law

The case concerns an appeal by Andrew Ocanas Garza against his conviction and a 235-month sentence for drug trafficking and firearm possession. Garza argued that the court incorrectly used his 2016 felony drug offenses for sentencing enhancement, contending that the 2018 amendment to the Agricultural Improvement Act altered marijuana’s definition, potentially excluding the substance he was previously convicted for trafficking. He also claimed that the court erred by not suppressing an unMirandized statement he made about having a gun in his bedroom during the execution of a search warrant.The United States Court of Appeals for the Fifth Circuit affirmed the District Court's ruling. The Appeals Court held that Garza waived his right to challenge the admission of the Bedroom Gun statement by bringing it up during the trial. The Court also rejected Garza's argument concerning the sentencing enhancement based on his 2016 drug convictions. The Court applied the "backward-looking" test, which determines whether the prior convictions were felonies at the time of conviction and were final at the time of sentencing for the current crimes. The Court found that Garza's 2016 convictions met these criteria, making them applicable for sentencing enhancement. The Court also noted that even if the District Court had erred in applying the sentencing enhancement, the error was harmless, as the same sentence would have been imposed. View "United States v. Garza" on Justia Law