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The Hospitals challenged HHS's implementation of a Medicare outlier-payment program in the late 1990s and early 2000s. The Hospitals contend that HHS violated the Administrative Procedure Act (APA), 5 U.S.C. 551 et seq., by failing to identify and appropriately respond to flaws in its methodology that enabled certain "turbo-charging" hospitals to manipulate the system and receive excessive payments at the expense of non-turbo-charging hospitals, including the Hospitals. The DC Circuit held that District Hospital Partners, L.P. v. Burwell, 786 F.3d 46 (D.C. Cir. 2015), controlled to the extent that the Hospitals repeated challenges decided in that case. In regard to the remaining challenges, the court affirmed the district court's denials of the Hospitals' motions to supplement the record and to amend their complaint, and its decision that HHS acted reasonably in a manner consistent with the Medicare Act in fiscal years (FYs) 1997 through 2003, and 2007. However, because HHS inadequately explained aspects of the calculations for FYs 2004 through 2006, the court reversed summary judgment in that regard and remanded for further proceedings. View "Banner Health v. Price" on Justia Law

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The Hospitals challenged HHS's implementation of a Medicare outlier-payment program in the late 1990s and early 2000s. The Hospitals contend that HHS violated the Administrative Procedure Act (APA), 5 U.S.C. 551 et seq., by failing to identify and appropriately respond to flaws in its methodology that enabled certain "turbo-charging" hospitals to manipulate the system and receive excessive payments at the expense of non-turbo-charging hospitals, including the Hospitals. The DC Circuit held that District Hospital Partners, L.P. v. Burwell, 786 F.3d 46 (D.C. Cir. 2015), controlled to the extent that the Hospitals repeated challenges decided in that case. In regard to the remaining challenges, the court affirmed the district court's denials of the Hospitals' motions to supplement the record and to amend their complaint, and its decision that HHS acted reasonably in a manner consistent with the Medicare Act in fiscal years (FYs) 1997 through 2003, and 2007. However, because HHS inadequately explained aspects of the calculations for FYs 2004 through 2006, the court reversed summary judgment in that regard and remanded for further proceedings. View "Banner Health v. Price" on Justia Law

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Constitution petitioned for review of the Department's decision denying its application for certification pursuant to Section 401 of the Federal Water Pollution Control Act, more commonly known as the Clean Water Act (CWA), 33 U.S.C. 1341. Constitution sought certification that its proposed interstate natural gas pipeline would comply with New York State water quality standards. NYSDEC denied the application on the ground that Constitution had not provided sufficient information. The Second Circuit held that, to the extent Constitution challenged the timeliness of the NYSDEC decision, the petition was dismissed for lack of jurisdiction. On the merits, the court held that NYSDEC's actions were within its statutory authority and that its decision was not arbitrary or capricious. The court deferred to NYSDEC's expertise as to the significance of the information requested from Constitution, given the record evidence supporting the relevance of that information to NYSDEC's certification determination. Accordingly, the court denied the petition for review. View "Constitution Pipeline Co. v. New York Sate Department of Environmental Conservation" on Justia Law

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Constitution petitioned for review of the Department's decision denying its application for certification pursuant to Section 401 of the Federal Water Pollution Control Act, more commonly known as the Clean Water Act (CWA), 33 U.S.C. 1341. Constitution sought certification that its proposed interstate natural gas pipeline would comply with New York State water quality standards. NYSDEC denied the application on the ground that Constitution had not provided sufficient information. The Second Circuit held that, to the extent Constitution challenged the timeliness of the NYSDEC decision, the petition was dismissed for lack of jurisdiction. On the merits, the court held that NYSDEC's actions were within its statutory authority and that its decision was not arbitrary or capricious. The court deferred to NYSDEC's expertise as to the significance of the information requested from Constitution, given the record evidence supporting the relevance of that information to NYSDEC's certification determination. Accordingly, the court denied the petition for review. View "Constitution Pipeline Co. v. New York Sate Department of Environmental Conservation" on Justia Law

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The Eleventh Circuit affirmed the district court's dismissal of the Hospitals' suit to recover recoupments. At issue was whether, under the Medicare Act, 42 U.S.C. 1395w-21 to 1395w-29, the Hospitals must exhaust their administrative remedies before bringing suit for underpayment by the Medicare Advantage Organization (MAO) that manages enrollee benefits. The court held that the Hospitals, who were challenging CIP's recoupment decision, were parties to an "organization determination" who were subject to the administrative exhaustion requirements of the Medicare Act. The court noted that although it was sympathetic to the concern HHS has expressed in amicus briefs, the language of the Medicare Act and its implementing regulations was clear that billing disputes between MAOs and noncontract provider assignees qualify as "organization determinations" and were thus subject to the Act's exhaustion requirement. View "Tenet HealthSystem GB, Inc. v. Care Improvement Plus South Central Insurance Co." on Justia Law

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The Eleventh Circuit affirmed the district court's dismissal of the Hospitals' suit to recover recoupments. At issue was whether, under the Medicare Act, 42 U.S.C. 1395w-21 to 1395w-29, the Hospitals must exhaust their administrative remedies before bringing suit for underpayment by the Medicare Advantage Organization (MAO) that manages enrollee benefits. The court held that the Hospitals, who were challenging CIP's recoupment decision, were parties to an "organization determination" who were subject to the administrative exhaustion requirements of the Medicare Act. The court noted that although it was sympathetic to the concern HHS has expressed in amicus briefs, the language of the Medicare Act and its implementing regulations was clear that billing disputes between MAOs and noncontract provider assignees qualify as "organization determinations" and were thus subject to the Act's exhaustion requirement. View "Tenet HealthSystem GB, Inc. v. Care Improvement Plus South Central Insurance Co." on Justia Law

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The Department of Game, Fish, and Parks appealed the administrative actions of Troy, Valley, and Butler Townships’ respective boards of supervisors that vacated portions of several section-line highways in Day County, arguing that the highways provided access to bodies of water held in trust by the State for the public. The circuit court affirmed in part and reversed in part. The Supreme Court affirmed the circuit court’s decision in regard to Valley and Butler Townships but reversed and remanded in regard to Troy Township, holding (1) the circuit court did not err in imposing the burden of proof on the Department; (2) the question of whether the public harm of cutting of access to a public resource is outweighed by the public benefit in vacating the highway at issue is a policy question and therefore not properly answered by the courts; (3) the circuit court’s findings that the Valley and Butler Townships’ actions were not arbitrary were not erroneous, but Troy Township’s resolutions and orders were arbitrary; and (4) the Department was not denied due process. View "State Department of Game, Fish & Parks v. Troy Township" on Justia Law

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The First Circuit upheld the finding of the Board of Immigration Appeals (BIA) that Petitioner was eligible for removal because third-degree larceny under Connecticut law is an aggravated felony. Removal proceedings were commenced against Petitioner on the basis that his conviction was for a “theft offense” within the meaning of 8 U.S.C. 1101(a)(43) (G) and was therefore an “aggravated felony” that rendered him eligible for removal. The BIA dismissed Petitioner’s appeal. The First Circuit upheld the BIA’s decision, holding that Petitioner’s Connecticut conviction is a conviction for a “theft offense” because the range of conduct sufficient to sustain a conviction for third-degree larceny under Connecticut law is not broader than that which constitutes a “theft offense” under the Immigration and Nationality Act. View "De Lima v. Sessions" on Justia Law

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Between 1996-1999, Skulason was convicted of three misdemeanors involving the operation of a vehicle. In 2000, she applied for a real estate salesperson’s license. The Bureau of Real Estate initiated an administrative proceeding by filing a statement listing Skulason’s three convictions and alleging that they “constitute[d] cause for denial of [Skulason’s] application,” Gov. Code, 11504. The proceeding settled in 2004. Skulason admitted the allegations; the Board agreed to issue a restricted license. The settlement did not require the parties to maintain its confidentiality. In 2010, Skulason obtained an unrestricted license. Three years later, she obtained court dismissals of her three misdemeanor convictions. The Bureau maintains a public website that contains information about real estate licensees, including Skulason. It identifies her license number, its unrestricted status, the dates of issuance and expiration, and actions the Bureau has taken involving her license. Under the heading “Disciplinary or Formal Action Documents,” is a link to the case number of the administrative proceeding that resulted in Skulason’s 2004 restricted license. The court of appeal reversed an order that the Bureau remove the information. The Board has no mandatory duty to remove from its website publicly available information about a licensee’s convictions, including convictions that are eventually dismissed under Penal Code sections 1203.4 and 1203.4a. View "Skulason v. California Bureau of Real Estate" on Justia Law

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Plaintiff Dennis Ponte demanded defendant County of Calaveras (County) to pay him over $150,000 to reimburse him for work purportedly performed on the County’s behalf pursuant to an oral contract. The contract did not contain any fixed payment, and no bid was submitted nor approved pursuant to relevant county ordinances governing public contracts. Ponte disregarded opportunities to abandon his claims after the County provided him with pertinent legal authority demonstrating that his claims lacked merit. After multiple sustained demurrers, the trial court granted summary judgment to the County on Ponte’s third amended complaint. The court later awarded substantial attorney fees, finding Ponte’s claims, including those based on promissory estoppel, were not brought or maintained in both subjective and objective good faith. Ponte appealed. Finding no reversible error, the Court of Appeal affirmed. View "Ponte v. County of Calaveras" on Justia Law