Justia Health Law Opinion Summaries

In this case related to a medical marijuana dispensary license the Supreme Court reversed the ruling of the circuit court denying the State's motion to dismiss a complaint seeking temporary and permanent injunctive relief and an injunction enjoining the State form issuing replacement dispensary-facility licenses, holding that the circuit court did not have subject matter jurisdiction over the complaint.In its complaint, Plaintiff, a corporation, alleged that the Medical Marijuana Commission had violated its own rules, the constitution, and the Administrative Procedure Act (APA). The State moved to dismiss on the grounds of sovereign immunity, lack of subject-matter jurisdiction, mootness, and failure to plead facts indicating a cause of action related to equal protection. The circuit court denied the motion. The Supreme Court reversed, holding that the circuit court lacked subject-matter jurisdiction over the complaint under either section 207 or 212 of the APA. View "Arkansas Department of Finance & Administration v. Carroll County Holdings, Inc." on Justia Law

The Supreme Court reversed the judgment of the district court denying the motion to dismiss this complaint brought by Colectivo Coffee Roasters against Society Insurance, holding that the district court erred.Collective, which experienced substantial monetary losses as a result of the COVID-10 pandemic and related government restrictions on in-person dining, brought this class action complaint against Society seeking declaratory and injunctive relief and damages for breach of contract, alleging that Society was required to compensate it for the business income it lost during the pandemic. Society filed a motion to dismiss, arguing that none of the policy's coverage provisions applied. The circuit court denied the motion. The Supreme Court reversed, holding that Colectivo failed to state a claim for coverage under the Society policy's business income, extra expense, civil authority, or contamination provisions. View "Colectivo Coffee Roasters, Inc. v. Society Insurance" on Justia Law

Defendant-petitioner Lisa Mestas petitioned the Alabama Supreme Court for a writ of mandamus directing the circuit court to vacate its order denying her motion for a summary judgment in this wrongful-death/medical-negligence action brought by David Lee Autrey, as the personal representative of the estate of his wife, Bridgette Ann Moore, and to enter a summary judgment in Mestas's favor on the basis of State-agent immunity. In May 2017, Autrey's wife, Moore, went to the University of South Alabama Medical Center to undergo a surgery required by the prior amputation of her right leg. The surgery was performed without incident, and Moore was transferred to a hospital room for recovery. At approximately 9:30 p.m. that night, nurses found Moore unresponsive. Attempts to revive her were unsuccessful, and Moore was pronounced deceased. It was later determined that Moore died as a result of opioid-induced respiratory depression ("OIRD"). Mestas argued that, at all times relevant to Autrey's lawsuit, she was an employee of the University of South Alabama ("USA") and served as the Chief Nursing Officer ("CNO") for USA Health System, which included USA Medical Center, various clinics, and a children's hospital. According to Mestas, as the CNO, her primary responsibilities were administrative in nature and she had not provided any direct patient care since 2010. Mestas argued that because Autrey's claims against her arose from the line and scope of her employment with a State agency,2 and because she did not treat Moore, she was entitled to, among other things, State-agent immunity. The Supreme Court concluded Mestas demonstrated she was entitled to state-agent immunity, and that she had a clear right to the relief sought. The Court therefore granted her petition and issued the writ, directing the trial court to grant her summary judgment. View "Ex parte Lisa Mestas." on Justia Law

Plaintiff filed a lawsuit alleging state law claims arising from SelectHealth’s administration of her deceased husband’s MA plan and his death. Under Part C of the Medicare Act, beneficiaries can enroll in an MA plan and receive Medicare benefits through private MA organizations instead of the government. SelectHealth removed the action to federal court on the basis of diversity jurisdiction.   The Ninth Circuit affirmed the district court’s summary judgment in favor of SelectHealth, Inc. because the Medicare Act’s express preemption provision, 42 U.S.C. Section 1395w-26(b)(3), barred Plaintiff’s state law claims.   The court held that Section 1872 of Title XVIII of the SSA provides that Section 205(h) is applicable to cases under the Medicare Act to the same extent as in cases under Title II. The court concluded that enrollees in an MA plan must likewise first exhaust their administrative remedies before seeking judicial review of a claim for benefits.   Next, the court concluded that Plaintiff’s claims were not subject to the SSA’s exhaustion requirement because the dispute was not whether Plaintiff’s husband received a favorable outcome from the internal benefits determination process but rather whether he should have received the services earlier.   Further, the court held that Plaintiff’s claim that SelectHealth breached a duty to process timely her husband’s October 7, 2016, appeal was expressly preempted. Because the standards established under Part C supersede any state law duty that would impose obligations of MA plans on the same subject. View "NAOMI AYLWARD V. SELECTHEALTH, INC." on Justia Law

Appellant, a severely disabled child whose congenital abnormalities were undetected during his mother’s pregnancy, sued various medical providers for wrongful life. The California Department of Health Care Services (“DHCS”) asserted a lien on Appellant’s settlement to recover what DHCS paid for his medical care through the state’s Medi-Cal program, and the trial court awarded DHCS the full amount of the lien.   The Second Appellate District reversed, rejecting Appellant’s contentions that DHCS’s lien is preempted by federal law and that there is no substantial evidence that Appellant’s settlement included payments for past medical expenses. However, the court held that the trial court erred by failing to distinguish between past medical expenses and other damages.   The court concluded that the provisions of the Medi-Cal Act permitting DHCS to impose a lien on Appellant’s tort recovery are not preempted by federal law. Further, the court concluded that the trial court did not err by concluding that Appellant’s settlement included past medical expenses. The court reasoned that the Welfare and Institutions Code provides that DHCS “shall have a right to recover . . . the reasonable value of benefits” provided to a MediCal beneficiary, and it further provides that the court, not the Medi-Cal beneficiary, determines what portion of a settlement is fairly allocated to satisfy DHCS’s lien.  However, it does not appear that the trial court determined which portion of Appellant’s settlement was attributable to past medical expenses, thus the court remanded the trial court to apportion the settlement accordingly. View "Daniel C. v. White Memorial Medical Center" on Justia Law

Defendant was convicted of conspiracy and substantive health care fraud for fraudulently billing Medicare and Medicaid for millions of dollars for visits to nursing home patients that he never made. He challenged the convictions, sentence, restitution amount, and forfeiture amount on appeal. In an April 12, 2022 opinion, the Eleventh Circuit affirmed Defendant's convictions and sentence.Following the court's initial opinion, Defendant filed a petition for rehearing en banc. The Eleventh Circuit considered Defendant's petition as a petition for a panel rehearing. The court granted Defendant's petition, vacated its previous opinion and issued a revised opinion that did not change the court's judgment or Defendant's sentence. Defendant was given 21 days to file a supplemental brief. View "USA v. Douglas Moss" on Justia Law

During the COVID-19 pandemic, Illinois Governor J. B. Pritzker issued a series of executive orders that first required Illinois residents to shelter in place at their residences, compelled “non-essential” businesses temporarily to cease or reduce their operations and prohibited gatherings of more than 10 people (later increased to 50 people). Believing that these orders violated numerous provisions of the U.S. Constitution, several individuals joined with some Illinois businesses and sued the Governor in his official capacity. After granting the plaintiffs one opportunity to amend their complaint, the district court found that they lacked standing to sue. The court also concluded that it would be futile to allow a second amendment because, even if it had erred about the existence of a justiciable case or controversy, the plaintiffs could not state a claim upon which relief could be granted.The Seventh Circuit affirmed the dismissal of the complaint. With respect to five out of six counts, the plaintiffs have not satisfied the criteria for Article III standing to sue. The remaining count attempts to state a claim under the Takings Clause. The business plaintiffs “may have squeaked by the standing bar” for that theory but have not stated a claim upon which relief can be granted. View "Nowlin v. Pritzker" on Justia Law

The Supreme Court reversed the decision of the court of appeals and remanded this case, holding that, for property to be commandeered, the government must exercise exclusive control over or obtain exclusive possession of the property such that the government could physically use it for an emergency management purpose.Appellant brought this suit arguing that his hospitality businesses were commandeered when the Governor issued emergency executive orders in response to the COVID-19 pandemic that imposed capacity limits for dining beginning in March 2020. As the owner of the commandeered property, Appellant argued, he was entitled to just compensation for the government's use under Minn. Stat. 12.34. The district court dismissed the commandeering claim, and the court of appeals affirmed. The Supreme Court reversed, holding (1) the government exercises exclusive physical control or exclusive possession of private property when only the government may exercise control or possession of the property and the owner is denied all control over or possession of the property; and (2) remand to the district court for further proceedings was required in this case. View "Buzzell v. Walz" on Justia Law

Head Start is a federal program that funds early childhood education for low-income children and provides other resources and education to the children’s families. Michigan Head Start grantees challenged the COVID-19 vaccine mandate for Head Start program staff, contractors, and volunteers imposed by an interim final rule of the Department of Health and Human Services. The district court denied a preliminary injunction.The Sixth Circuit denied an injunction pending appeal. The plaintiffs have not shown that they will likely prevail on the merits. HHS likely did not violate the Administrative Procedure Act when it promulgated the vaccine requirement through an interim final rule instead of notice-and-comment rulemaking, 5 U.S.C. 553(b)(B). That rule contains ample discussion of the evidence in support of a vaccine requirement and the justifications for the requirement, 86 Fed. Reg. 68,055-059. HHS likely has the statutory authority to issue a vaccine requirement for Head Start program staff, contractors, and volunteers under 42 U.S.C. 9836a(a)(1)(A), (E). The risk that unvaccinated staff members could transmit a deadly disease to Head Start children—who are ineligible for the COVID-19 vaccine due to their young age—is “a threat to the health” of the children. The court noted HHS’s history of regulating the health of Head Start children and staff. View "Livingston Educational Service Agency v. Becerra" on Justia Law

In 2019 a woman sued her former husband’s medical provider, alleging that from 2003 to 2010 the provider negligently prescribed the husband opioid medications, leading to his addiction, damage to the couple’s business and marital estate, the couple’s divorce in 2011, and ultimately the husband's death in 2017. The superior court ruled the claims were barred by the statute of limitations and rejected the woman’s argument that the provider should have been estopped from relying on a limitations defense. Because the undisputed evidence shows that by 2010 the woman had knowledge of her alleged injuries, the provider’s alleged role in causing those injuries, and the provider’s alleged negligence, the Alaska Supreme Court concluded that the claims accrued at that time and were no longer timely when filed in 2019. And because the record did not show that the woman’s failure to timely file her claims stemmed from reasonable reliance on fraudulent conduct by the provider, the Supreme Court concluded that equitable estoppel did not apply. View "Park v. Spayd" on Justia Law