Justia Health Law Opinion Summaries

The Supreme Court reversed the judgment of the court of appeals affirming the decision of the circuit court upholding the State Health Commissioner's denial of Chesapeake Regional Medical Center's (CMRC) application for a Certificate of Public Need, holding that the harmless error doctrine does not apply to an error of law in an administrative agency case under the Virginia Administrative Process Act.CMRC applied for a new open-heart surgery service and additional cardiac catheterization equipment. The Commissioner denied the application. CRMC appealed, contending that the Commissioner erred in his interpretation of the relevant administrative regulation. The circuit court affirmed, determining that the Commissioner's incorrect interpretation and application of the regulation was harmless error. The court of appeals affirmed. The Supreme Court reversed, holding (1) the court of appeals erred in applying the harmless error doctrine to the agency's legal error in interpreting and applying its own regulations; and (2) the lower courts erred by failing to remand the case to the Commissioner for further proceedings. View "Chesapeake Hospital Authority v. State Health Commissioner" on Justia Law

Petitioner Lisa French went to respondents Centura Health Corporation and Catholic Health Initiatives Colorado d/b/a St. Anthony North Health Campus (collectively, “Centura”) for surgery. Upon reviewing French’s insurance information prior to surgery, Centura advised her that she would personally be responsible for $1,336.90 of the amounts to be billed. After the surgery, however, Centura determined that it had misread French’s insurance card and that she was, in fact, an out-of-network patient. Centura then billed French $229,112.13 and ultimately sued her to collect. The Colorado Supreme Court granted certiorari to review: (1) whether here, Centura’s database used by listing rates for specific medical services and supplies, was incorporated by reference into hospital services agreements (“HSAs”) that French had signed; and (2) if so, whether the price term in the HSAs was sufficiently unambiguous to render the HSAs enforceable. The Court concluded that because French neither had knowledge of nor assented to the chargemaster, which was not referenced in the HSA or disclosed to her, the chargemaster was not incorporated by reference into the HSA. Accordingly, the HSA left its price term open, and therefore, the jury appropriately determined that term. The Court reverse the judgment of the division below, and did not decide whether the price that French was to pay was unambiguous, even if the HSA incorporated the chargemaster. View "French v. Centura Health" on Justia Law

Defendants Kim Reynolds, Governor of Iowa, and Ann Lebo, Director of the Iowa Department of Education, appealed the district court’s entry of a preliminary injunction completely barring enforcement of Iowa’s facial covering statute, Code Section 280.31. The Eighth Circuit vacated the district court’s entry of preliminary injunction completely barring enforcement of Iowa Code Section 280.31 as moot.   The court reasoned that the issue surrounding the preliminary injunction is moot because the current conditions differ vastly from those prevailing when the district court addressed it. The court reasoned that COVID-19 vaccines are now available to children and adolescents over the age of four, greatly decreasing Plaintiffs’ children’s risk of serious bodily injury or death from contracting COVID-19 at school. Further, when Plaintiffs sought a preliminary injunction, delta was the dominant variant, producing high transmission rates and caseloads throughout the country. Now, omicron has become dominant and subsided, leaving markedly lower transmission rates and caseloads throughout Iowa and the country. The court noted that to the extent that the case continues, the Court emphasized that the parties and district court should pay particular attention to Section 280.31’s exception for “any other provision of law.” Iowa Code Section 280.31. This exception unambiguously states that Section 280.31 does not apply where “any other provision of law” requires masks. The word "any” makes the term “provision of law” a broad category that does not distinguish between state or federal law. View "The Arc of Iowa v. Kimberly Reynolds" on Justia Law

This putative class action against California and San Diego County officials challenged California Governor Gavin Newsom’s emergency orders and related public health directives restricting business operations during the COVID-19 pandemic. Plaintiffs, owners of affected restaurants and gyms (Owners), primarily contended the orders were procedurally invalid because they were adopted without complying with the Administrative Procedure Act (APA). Furthermore, Owners contended that the business restrictions were substantively invalid because they effected a taking without compensation, violating the Fifth Amendment to the United States Constitution. Rejecting these claims, the superior court sustained demurrers to the third amended complaint without leave to amend and dismissed the action. While the Court of Appeal sympathized with the position some Owners find themselves in and the significant financial losses they alleged, the unambiguous terms of the Emergency Services Act and controlling United States Supreme Court regulatory takings caselaw required that the judgment be affirmed. View "640 Tenth, LP v. Newsom" on Justia Law

On November 21, 2017, Richard Bush presented to Saint Bernard Parish Hospital for depression and suicidal ideations. At the hospital, Dr. Miguel Aguilera treated and discharged him. Bush attempted re-admittance with the same complaints, but was refused re-admittance. Thereafter, Bush attempted suicide in the hospital bathroom. He was found alive and transported to University Hospital in New Orleans for treatment; however, he succumbed to his injuries from the suicide attempt and died on November 30, 2017. In November 2018, his wife, Patricia Bush, on behalf of herself, her daughters, Madalyn and Ashley Bush, and on behalf of the decedent, Richard Bush, filed a formal pro se complaint with the Patient Compensation Fund (“PCF”) to convene a medical review panel (“MRP”), naming Saint Bernard Parish Hospital and Dr. Aguilera for malpractice relating to Richard Bush's death. The Louisiana Supreme Court granted this writ application in order to determine: (1) whether contra non valentem interrupted prescription; and (2) whether the court of appeal erred in relying on documents that were not entered as evidence and were not part of the record. The Court found that, while contra non valentem may interrupt prescription in a wrongful death claim in certain instances, it did not interrupt prescription in this case due to the fact that the court of appeal incorrectly considered documents that were not in evidence. The Court reversed the court of appeal’s ruling in part, affirmed in part, and remanded for further proceedings. View "Medical Review Panel for the Claim of Richard Bush" on Justia Law

The Supreme Court affirmed in part the decision of the court of appeals automatically staying the circuit court's order of commitment for treatment with the involuntary administration of medication after finding Defendant incompetent, holding that the automatic stay of involuntary medication orders pending appeal established in State v. Scott, 914 N.W.2d (Wis. 2018), does not apply to pretrial proceedings.Defendant was charged with first-degree intentional homicide with use of a dangerous weapon. The circuit court found Defendant incompetent and ordered him to be involuntary medicated. Defendant appealed and filed an emergency motion for stay of the involuntary medication order pending appeal. The circuit court automatically granted the motion pursuant to Scott. The court of appeals reversed the involuntary medication order and the order lifting the automatic stay of involuntary medication. The Supreme Court affirmed in part, holding (1) the automatic stay created in Scott shall not be applied during pretrial proceedings; and (2) Wis. Stat. 971.14(5)(a)1. is not subject to tolling in a pretrial context. View "State v. Green" on Justia Law

The Supreme Court reversed in part the judgment of the trial court awarding Plaintiff $200,309 in damages for Defendants' breach of a lease agreement, holding that the trial court improperly allocated the burden of proof as to mitigation in determining the damages award.At issue in this appeal was how the executive orders issued by Governor Ned Lamont during the earliest months of the COVID-19 pandemic affected the enforceability of a commercial lease agreement for premises that Defendants leased from Plaintiff. Both parties appealed from the judgment of the trial court awarding Plaintiff damages. The Supreme Court reversed in part, holding that the trial court (1) did not err in determining that the economic effects of the executive orders did not relieve Defendants of their obligations under the lease agreement; but (2) improperly relieved Defendants of their burden of proving that Plaintiff's efforts were commercially unreasonable under the circumstances, thus necessitating a new damages hearing. View "AGW Sono Partners, LLC v. Downtown Soho, LLC" on Justia Law

Illinois Insurance Guaranty Fund is a state-created insolvency insurer; when a member insurer becomes insolvent, the Fund pays covered claims. In cases involving insolvent health insurance, many claims are for patients who are eligible for both Medicare benefits and private health insurance. The Fund sought a determination that it is not subject to reporting requirements under section 111 of the 2007 Medicare, Medicaid, and SCHIP Extension Act, 42 U.S.C. 1395y(b)(7) & (b)(8), which is intended to cut Medicare spending by placing financial responsibility for medical costs with available primary plans first. Because time may be of the essence in medical treatment, the government may make conditionally cover medical expenses for Medicare beneficiaries insured by a primary plan, subject to later reimbursement from a primary plan. Section 111 imposes reporting requirements so that the government can identify the primary plan responsible for payment. The Fund believes that it is not an “applicable plan.”The district court dismissed for lack of subject-matter jurisdiction, reasoning the government had not made a final decision through its administrative processes. The Seventh Circuit affirmed. The Fund can obtain judicial review of its claim in a federal court only by channeling its appeal through the administrative process provided under 42 U.S.C. 405(g). The usually-waivable defense of failure to exhaust administrative remedies is a jurisdictional bar here. View "Illinois Insurance Guaranty Fund v. Becerra" on Justia Law

The Supreme Judicial Court dismissed this case challenging two emergency orders issued by Governor Charles D. Baker Jr. pursuant to the Massachusetts Civil Defense Act, holding that the case was moot.During the state of emergency occasioned by the COVID-19 pandemic in the Commonwealth the Governor issued sixty-nine emergency orders. Ariana Murrell, individually and as manager of Liberty Tax Service, challenged two of those orders and the statewide face-covering requirements associated with them - Orders 37 and 55. The trial court held that the two orders were not preempted by the Occupational Safety and Health Act, 29 U.S.C. 651 et seq., and that the public interest required an order shutting down Liberty Tax. Murrell filed an interlocutory appeal, but while the appeal was pending, the Governor issued Order 69, which lifted most COVID-19 related orders and restrictions. The Supreme Judicial Court dismissed the interlocutory appeal, holding that Order 69 revoked Orders 37 and 55 while interlocutory appeal was pending, rendering this case moot. View "City of Lynn v. Murrell" on Justia Law

Jennings, who was not a medical professional, ran Results Weight Loss Clinic in Lombard, Illinois. Jennings paid Mikaitis, who was working full‐time for a hospital in Lockport, Illinois cash to secure a Drug Enforcement Agency registration number for the clinic and to review patient charts. Over the next two years, Jennings ordered over 530,000 diet pills (controlled substances) for over $84,000 using Mikaitis’s credit card and DEA number. Mikaitis appeared at Results weekly to get $1,750 cash and review four to eight charts. Results also gave drugs—in person and by mail— to many patients whose charts he never reviewed. A nurse practitioner who worked at the clinic later testified she noticed almost immediately that Jennings was unlawfully distributing drugs. Jennings paid Mikaitis about $98,000 cash, in addition to reimbursement for drug costs.Mikaitis was tried on 17 counts. He denied knowing about illegal activity. The district judge issued a deliberate avoidance (ostrich) instruction. Convicted, Mikaitis was sentenced to 30 months. The Seventh Circuit affirmed. Ample evidence demonstrated that Mikaitis subjectively believed that there was a high probability he was participating in criminal activity and that he took specific, deliberate actions to avoid learning that fact. Mikaitis was a medical professional with corresponding duties. The jury was free to conclude the red flags were obvious to him. View "United States v. Mikaitis" on Justia Law