Justia Health Law Opinion Summaries

The Supreme Court of Iowa ruled that the State University of Iowa, Iowa State University of Science and Technology, and the University of Northern Iowa were required to be members of the Iowa Individual Health Benefit Reinsurance Association (IIHBRA) and therefore had to pay assessments to the association. The universities had argued that they were not members of IIHBRA and that the statute requiring them to pay assessments violated the Iowa Constitution, which prohibits the state from acting as a surety for another. The court rejected these arguments, finding that the statutory scheme did not violate the constitution and that the universities, as providers of health benefit plans, were indeed members of IIHBRA. The court also ruled that IIHBRA was statutorily authorized to impose late payment fees against its members. However, the court denied IIHBRA's request for attorney fees and costs. The court affirmed in part, reversed in part, and remanded the case for further proceedings. View "Iowa Individual Health Benefit Reinsurance Ass’n v. State University of Iowa" on Justia Law

In the case at hand, the Court of Appeals of the State of Nevada reversed and remanded a district court order that had dismissed a professional negligence action for being time-barred. The case was brought by Gina Engelson, as the special administrator of the estate of Lenore Meyer, against Dignity Health (doing business as St. Rose Dominican Hospital-Siena Campus) and Grape Holdings LLC (doing business as Sage Creek Post-Acute). Lenore Meyer had developed a severe bedsore while being treated at these facilities. Meyer's family alleged that the care provided by the facilities fell below the standard of care in multiple ways, including failing to timely and adequately treat the bedsore. Meyer eventually died, and exactly one year after her death, Engelson filed a professional negligence complaint against the facilities. The district court dismissed the complaint as time-barred, finding that the complaint was filed more than a year after the estate and its special administrator knew or should have known about the relevant legal injury.Upon review, the Court of Appeals found that the district court erred in dismissing the complaint as time-barred. The Court of Appeals clarified that an affidavit of merit, which is required to support a professional negligence-based wrongful death claim, need not opine as to the element of causation. The Court of Appeals concluded that the evidence did not irrefutably demonstrate that the estate or its special administrator discovered or should have discovered the legal injury more than a year before the filing of the complaint. Therefore, the Court of Appeals reversed the district court's order and remanded for further proceedings. View "Engelson v. Dignity Health" on Justia Law

In a case before the United States Court of Appeals For the Eighth Circuit, the plaintiffs, a group of patients, sued BJC Health System (BJC) alleging that BJC had violated their medical privacy rights under Missouri state law. Specifically, the plaintiffs claimed that when they accessed their electronic health records (EHRs) through BJC’s online patient portal, their protected health information was shared with third-party marketing services. BJC removed the case to federal court under the federal officer removal statute, arguing that they acted under the United States Department of Health and Human Services (HHS) when creating and operating the online patient portal. BJC's argument was rejected by the district court which ordered the case to be remanded back to Missouri state court. BJC appealed this decision.The United States Court of Appeals For the Eighth Circuit affirmed the decision of the district court to remand the case to the Missouri state court. The appellate court held that BJC, while receiving federal incentive payments from HHS for creating and operating the online patient portal, was not essentially performing a basic governmental task or duty. Therefore, BJC was not acting under a federal officer in terms of the federal officer removal statute. The court concluded that the creation and operation of an online patient portal was not a basic governmental task, and BJC was not a government contractor or functioning as a federal instrumentality. View "Doe v. BJC Health System" on Justia Law

The United States Court of Appeals for the Ninth Circuit upheld the drug-trafficking and money-laundering convictions of Benjamin Galecki and Charles Burton Ritchie for their distribution of "spice," a synthetic cannabinoid product. The defendants were found guilty of manufacturing and distributing spice through their company, Zencense Incenseworks, LLC. The drug-trafficking charges were based on the premise that the cannabinoid used, XLR-11, was treated as a controlled substance because it was an "analogue" of a listed substance. The court rejected the defendants' arguments that their convictions should be set aside due to Fourth Amendment violations, insufficient evidence, and vagueness of the Controlled Substance Analogue Enforcement Act of 1986. However, the court reversed their mail and wire fraud convictions due to insufficient evidence. The case was remanded for further proceedings. View "USA V. GALECKI" on Justia Law

In this case, Virginia Cora Ward, as the administratrix of the estate of Edmund Edward Ward, brought a case against AlphaCore Pharma, LLC (ACP) and Bruce Auerbach. The decedent, Edmund Ward, was a participant in a clinical trial for a drug known as ACP-501, which was developed by ACP and administered by the National Institutes of Health (NIH). The trial took place in Maryland, where Ward traveled from his home in Massachusetts to receive treatment. Ward later withdrew from the trial due to deteriorating kidney function.In 2016, Ward filed a complaint against ACP, Auerbach, and several others, alleging fraudulent inducement to participate in the clinical trial. ACP and Auerbach moved to dismiss the case for lack of personal jurisdiction, arguing that they lacked sufficient contacts with Massachusetts. The United States District Court for the District of Massachusetts agreed with them and dismissed the case. Ward appealed to the United States Court of Appeals for the First Circuit.The First Circuit affirmed the district court's decision. The court held that neither ACP nor Auerbach had sufficient related and purposeful contacts in and with Massachusetts to establish personal jurisdiction. The court rejected Ward's claims that ACP and Auerbach had contacts with Massachusetts through their interactions with Ward's Massachusetts-based doctor, their alleged shipment of the drug to Massachusetts, their involvement in drafting the clinical trial protocol, and their alleged reimbursement of Ward's travel expenses. The court found that these claims were either unsupported by evidence or were not sufficient to establish personal jurisdiction. As a result, the court affirmed the district court's dismissal of the case against ACP and Auerbach for lack of personal jurisdiction. View "Ward v. Schaefer" on Justia Law

In a case before the Supreme Court of the State of Alaska, the court was asked to determine the deadline for filing a claim against a decedent’s estate for reimbursement for Medicaid services provided to the decedent while alive. The probate code of Alaska provides that for claims arising “before the death of the decedent,” the creditor must file within four months after the estate's representative first published notice to creditors. For claims arising “at or after the death of the decedent,” the creditor must file within four months after the claim arose. The court held that Medicaid estate recovery claims arise before death and therefore must be filed within four months after notice to creditors. The court reasoned that although the state may not pursue these claims until after the Medicaid beneficiary has died, these claims arise when Medicaid services are provided, not when the claims become enforceable. The court's decision was based on the interpretation of the probate code, the underlying legislative purpose of the Medicaid estate recovery statute, and the weight of precedent from other jurisdictions. View "In the Matter of the Estate of Fe Perez Abad" on Justia Law

The Supreme Court of Texas handled a case in which a nurse claimed her employer, Scott & White Memorial Hospital, wrongfully terminated her employment in retaliation for reporting potential child abuse or neglect to the Texas Child Protective Services (CPS), which is considered a protected conduct under Section 261.110(b) of the Texas Family Code.The nurse, Dawn Thompson, had previously received two written reprimands for violating the hospital's personal-conduct policy. On the third occasion, she disclosed a child patient's protected health information to a school nurse without the parents' authorization. This was considered by the hospital as a violation of the Health Insurance Portability and Accountability Act (HIPAA) and a breach of the patient's rights. Consequently, Thompson was terminated.Thompson filed a lawsuit against the hospital, asserting that her termination was in violation of Family Code Section 261.110(b), which protects professionals who report child abuse or neglect in good faith from adverse employment actions.The Supreme Court of Texas ruled that Section 261.110 imposes a "but-for causation" requirement, which means that the protected conduct must be such that without it, the adverse employment action would not have occurred when it did. In this case, the court found that Thompson would have been terminated when she was due to her HIPAA violation, regardless of her report to CPS. Therefore, the court rejected Thompson's retaliation claim and reinstated the trial court's summary judgment in favor of the hospital. View "SCOTT & WHITE MEMORIAL HOSPITAL v. THOMPSON" on Justia Law

In this case, the plaintiffs, a minor and her parents, sued their health insurer, Premera Blue Cross, for denying coverage for the minor’s stay in a wilderness therapy program, claiming that the denial violates mental health parity laws. The plaintiffs also alleged breach of contract, insurance bad faith, and violation of the Consumer Protection Act.The Supreme Court of the State of Washington held that the plaintiffs’ breach of contract claim based on alleged violation of federal parity laws does not form a viable common law action. The Court found that the plaintiffs failed to show that a violation of federal parity law would give rise to a viable common law action for breach of contract.Furthermore, the Court held that the breach of contract action based on Premera's alleged violation of state parity laws could not succeed based on the statutory language that was in place at the time.However, the Court did affirm the lower court’s finding that the plaintiffs were not required to produce evidence of objective symptomatology to support their insurance bad faith claim for emotional distress damages. Consequently, the case was remanded to the trial court for further proceedings on the bad faith and Consumer Protection Act claims. View "P.E.L. v. Premera Blue Cross" on Justia Law

The Supreme Court of Missouri reversed a lower court's judgment in a negligence case involving a hospital and an individual who was shot on the hospital's property. The plaintiff, Steven Harner, had sued Mercy Hospital Joplin, alleging the hospital had breached its duty to protect him from the criminal acts of a third person on its property. The case revolved around the "known third person exception" to the general rule that businesses have no duty to protect invitees from the criminal acts of third parties. According to this exception, a duty may arise when a person known to be violent is present on the premises, or an individual is present who has conducted himself so as to indicate danger, and sufficient time exists to prevent injury. The court found that the defendant, Mercy Hospital, could not have reasonably foreseen that the third person in question, who had committed a non-violent theft on the premises prior to the shooting, would suddenly become violent. As such, the court held that Mercy Hospital did not owe a duty of care to Harner under the known third person exception and reversed the lower court's judgment. The case was remanded for further proceedings. View "Harner vs. Mercy Hospital Joplin" on Justia Law

The Supreme Court of Missouri ruled in favor of three employees of a medical facility, Jayla Ruiz Morales, John Kimani, and Valarie Johnson, who were sued for wrongful death by the legal guardian of a patient, Ronald Scheer. Scheer, a resident at the St. Louis Developmental Disabilities Treatment Center-St. Charles Habilitation Center, died after his wheelchair's belt constricted his breathing. The employees were accused of failing to adequately supervise Scheer, failing to ensure that his wheelchair's seatbelt and pelvic harness were properly fastened, among other allegations. The employees argued that they were entitled to official immunity, a doctrine that protects public officials from liability for acts of negligence committed during the course of their official duties. The lower court rejected this argument and the employees sought a writ of prohibition from the Supreme Court of Missouri.The Supreme Court of Missouri held that the employees were entitled to official immunity. The court found that the tasks they were required to perform were not ministerial (routine or mundane tasks) but required discretion. Tasks such as checking on the patient, repositioning him, and using a seat belt and pelvic harness required the employees to use judgment to determine if Scheer needed additional care, and if so, what care to be administered. Therefore, these tasks were not ministerial and the employees were entitled to official immunity. The court made its preliminary writ of prohibition permanent, barring the lower court from taking further action in the case. View "State ex rel. Jayla Ruiz-Morales v. Alessi" on Justia Law