Justia Government & Administrative Law Opinion Summaries

Andrew J. Winterbottom, a veteran, was awarded a 30% disability rating for his service-connected post-traumatic stress disorder (PTSD), which was later increased to 50%. He appealed to the Board of Veterans’ Appeals seeking a higher rating. During a Board hearing in June 2021, the judge questioned Winterbottom about specific violent episodes, which he later claimed demonstrated judicial bias. In May 2022, the Board denied a higher rating, concluding that his violent behavior was not unprovoked.Winterbottom appealed to the Court of Appeals for Veterans Claims, arguing that the Board failed to provide adequate reasons for its decision and exhibited bias. The Veterans Court partially agreed, remanding the case because the Board did not adequately explain why it gave less weight to a private counselor's opinion. However, the court found no bias warranting reassignment, stating the judge's questions aimed to determine if the violent conduct was provoked.Winterbottom then appealed to the United States Court of Appeals for the Federal Circuit. The Federal Circuit dismissed the appeal, stating it lacked jurisdiction to review non-final orders from the Veterans Court. The court noted that exceptions to the finality requirement, as outlined in Williams v. Principi, did not apply to Winterbottom's case. The court also declined to create a new exception for judicial bias claims, suggesting that such claims should be raised through a mandamus petition or after a final judgment. Thus, the appeal was dismissed. View "WINTERBOTTOM v. MCDONOUGH " on Justia Law

Steven M. Camburn, a former sales specialist for Novartis Pharmaceuticals Corporation, filed a qui tam action under the False Claims Act (FCA) and equivalent state and municipal laws. Camburn alleged that Novartis violated the Anti-Kickback Statute (AKS) by offering remuneration to physicians to induce them to prescribe its drug Gilenya, which treats multiple sclerosis. He claimed that Novartis used its peer-to-peer speaker program and other forms of illicit remuneration to influence physicians' prescribing practices.The United States District Court for the Southern District of New York dismissed Camburn's Third Amended Complaint (TAC) with prejudice, concluding that he had not pleaded his allegations with the particularity required under Rule 9(b) to support a strong inference of an AKS-based FCA violation. The court found that Camburn's allegations did not adequately demonstrate the existence of a kickback scheme.The United States Court of Appeals for the Second Circuit reviewed the case and held that a plaintiff states an AKS violation if they allege with particularity that at least one purpose of the purported scheme was to induce fraudulent conduct. The court found that Camburn had adequately pleaded certain categories of factual allegations that gave rise to a strong inference of an AKS violation. Specifically, Camburn sufficiently alleged that Novartis held sham speaker events with no legitimate attendees, excessively compensated physician speakers for canceled events, and selected and retained speakers to incentivize prescription-writing.The Second Circuit affirmed the district court's dismissal in part but vacated the judgment and remanded the case in part. The court instructed the district court to evaluate whether Camburn had stated all the elements of an FCA claim with respect to the adequately pleaded AKS violations and to assess the adequacy of Camburn's claims under state and municipal law. View "Camburn v. Novartis Pharmaceuticals Corporation" on Justia Law

Dr. Judith Robinson, a former employee of HealthNet, a federally qualified health center in Indiana, brought a qui tam action against HealthNet, alleging fraudulent billing practices, including improper Medicaid billing for ultrasound readings. She claimed that HealthNet billed Medicaid for face-to-face encounters that did not occur. Dr. Robinson initially filed a suit in 2013 (Robinson I), which was settled in 2017, excluding the wrap-around claims. These claims were dismissed without prejudice, allowing for future litigation.In 2019, Dr. Robinson filed a new suit (Robinson II) to address the wrap-around claims. The United States declined to intervene, but Indiana did. Indiana moved to dismiss all claims except for the wrap-around claims from October 18, 2013, to February 28, 2015, as the rest were time-barred. The district court dismissed Count III of Dr. Robinson's complaint, which sought to enforce an alleged oral settlement agreement, due to lack of standing, as Dr. Robinson failed to provide competent proof of the agreement's existence.The United States Court of Appeals for the Seventh Circuit reviewed the case. The court affirmed the district court's dismissal of Count III, agreeing that Dr. Robinson lacked standing because she did not demonstrate any breach of the alleged oral agreement by HealthNet. The court also upheld the district court's approval of the settlement between Indiana and HealthNet, finding it fair, adequate, and reasonable. The court noted that the reduction in the relator’s share was due to Dr. Robinson's own actions, including the failure to obtain a tolling agreement, which led to many claims being time-barred. The court also agreed with the application of the Federal Medical Assistance Percentage (FMAP) in calculating the settlement amount. View "Robinson v. Healthnet, Inc." on Justia Law

CKY, Inc. entered into a fixed-price construction contract with the United States Army Corps of Engineers (Corps) in October 2012. CKY encountered unexpected conditions, including heavy rainfall and undisclosed culverts, which led to additional expenses. CKY sought compensation for these expenses, but the Corps denied the requests. CKY then filed a claim under the Contract Disputes Act, seeking $1,146,226 for the additional costs incurred. The Armed Services Board of Contract Appeals (Board) ruled in favor of CKY regarding the undisclosed culverts but denied compensation for other claims.The Board awarded CKY $185,000 plus interest for the expenses related to the undisclosed culverts. CKY then applied for attorney’s fees and expenses under the Equal Access to Justice Act (EAJA). The Board granted the application, concluding that the government’s position regarding the undisclosed culverts was not substantially justified. The Board limited its substantial-justification inquiry to the government’s litigation position on the specific claim where CKY prevailed.The United States Court of Appeals for the Federal Circuit reviewed the case. The court held that the Board erred by categorically narrowing its substantial-justification inquiry to the government’s litigation position and to the specific claim on which CKY prevailed. The court emphasized that the substantial-justification inquiry should consider both the agency’s pre-litigation conduct and its litigation position, and should treat the case as an inclusive whole rather than focusing on individual claims. The court vacated the Board’s decision and remanded the case for reconsideration without the categorical limitations previously applied. View "In Re SECRETARY OF THE ARMY " on Justia Law

Port City Air Leasing, Inc. (Port City) leases land and buildings at Pease International Tradeport for aircraft-related services. Pease Aviation Partners LLC, doing business as Million Air Portsmouth (Million Air), proposed to lease adjacent land to build a similar facility and applied for a permit to dredge and fill wetlands to construct an access road. The New Hampshire Department of Environmental Services (DES) issued the permit in June 2022. Port City filed an administrative appeal with the New Hampshire Wetlands Council (Council), arguing that the permit issuance was unlawful and unreasonable. Million Air intervened and moved to dismiss the appeal, claiming Port City lacked standing.The Hearing Officer ruled that Port City lacked standing because it was not a "person aggrieved" under RSA 482-A:10, I, which includes the applicant and those entitled to notice by mail under RSA 482-A:8 and RSA 482-A:9. The Hearing Officer determined that Port City was not an "abutting landowner" entitled to notice. Port City's motion for reconsideration and rehearing was denied, leading to this appeal.The Supreme Court of New Hampshire reviewed the case and affirmed the Council's decision. The court held that Port City is not a "landowner" under RSA 482-A:9 because its lease does not grant interests equivalent to fee ownership. Consequently, Port City is not a "person aggrieved" with standing to appeal under RSA 482-A:10, I. The court also rejected Port City's due process claims, concluding that the absence of an administrative remedy does not violate its state or federal due process rights, as Port City still has potential legal remedies for any injuries. The court affirmed the dismissal of Port City's appeal. View "Appeal of Port City Air Leasing, Inc." on Justia Law

Troy Olhausen, a former Senior Vice President of Business Development and Marketing at Arriva Medical, LLC, filed a qui tam action under the False Claims Act against his former employers, Arriva, Alere, Inc., and Abbott Laboratories, Inc. He alleged that the defendants submitted fraudulent claims to the Center for Medicare and Medicaid Services (CMS) for reimbursement. Specifically, Olhausen claimed that Arriva submitted claims without obtaining required assignment-of-benefits signatures and failed to disclose or accredit certain call-center locations that processed claims.The United States District Court for the Southern District of Florida dismissed Olhausen’s third amended complaint, holding that he failed to plead with the particularity required under Federal Rule of Civil Procedure 9(b) that any fraudulent claims were actually submitted to the government. The district court found that Olhausen did not provide sufficient details to establish that false claims had been submitted, as he did not work in the billing department and lacked firsthand knowledge of the claim submissions.On appeal, the United States Court of Appeals for the Eleventh Circuit reviewed the case. The court concluded that Olhausen adequately pled with particularity that allegedly false claims were submitted under Count II, which involved claims for heating pads that lacked assignment-of-benefits signatures. The court found that the internal audit allegations provided sufficient indicia of reliability to satisfy Rule 9(b). However, the court upheld the dismissal of Count IV, which alleged that Arriva failed to disclose or accredit certain call-center locations, as Olhausen did not adequately allege that any claims involving these locations were actually submitted. Consequently, the court vacated the dismissal of Counts II and VI (conspiracy) and remanded them for further proceedings, while affirming the dismissal of Count IV. View "Olhausen v. Arriva Medical, LLC" on Justia Law

The plaintiff, Larissa Marland, individually and as administratrix of the estate of Norman Marland, filed a medical malpractice claim against the University of Connecticut Health Center and related entities. The decedent had been treated at the hospital and was later admitted to the intensive care unit, where he fell and subsequently died. The plaintiff alleged that the hospital staff breached the standard of care owed to the decedent.The plaintiff filed a notice of claim with the claims commissioner, including a physician’s opinion letter. The claims commissioner failed to resolve the claim within the statutory two-year period and an additional one-year extension granted by the General Assembly. Despite this, the commissioner eventually authorized the plaintiff to sue the state. The plaintiff then filed the present action in the Superior Court.The state moved to dismiss the complaint, arguing that the claims commissioner’s waiver of sovereign immunity was invalid because it was issued after the expiration of the one-year extension. The trial court agreed and dismissed the case for lack of subject matter jurisdiction, concluding that the commissioner did not have the authority to grant the waiver beyond the extension period.The Supreme Court of Connecticut reviewed the case and concluded that the trial court improperly dismissed the plaintiff’s action. The court held that, once the claims commissioner authorizes suit and waives sovereign immunity, the state cannot challenge that decision in the Superior Court. The court emphasized that such challenges should be raised before the claims commissioner. The court reversed the trial court’s judgment and remanded the case with direction to deny the state’s motion to dismiss. View "Marland v. University of Connecticut Health Center" on Justia Law

Plaintiff was injured when he lost control of his motorcycle on Lark Street in Albany, allegedly due to a road defect the City knew about but failed to repair. The case centers on whether reports submitted through the City's online system, SeeClickFix (SCF), constituted "written notice" of the defect and if those reports were "actually given" to the designated official.The Supreme Court denied both parties' motions for summary judgment, holding that SCF reports might constitute prior written notice but that factual issues precluded summary judgment. These issues included whether the complaints were based on verbal or written communications, whether the defects described were related to the accident, and whether the City's actions created or exacerbated the defect. The court also rejected the City's claim of governmental immunity.The Appellate Division affirmed the Supreme Court's decision, agreeing that SCF complaints could be considered written notice and rejecting the City's immunity argument. The Appellate Division granted the City leave to appeal and certified the question of whether it erred in affirming the denial of the City's motion.The New York Court of Appeals held that SCF reports could constitute written notice and that the City's implementation of SCF meant the reports were "actually given" to the Commissioner of General Services. The court also found that issues of fact precluded summary judgment on whether the City's negligence created a dangerous condition and rejected the City's claim of governmental immunity, as the repair of the road was a proprietary function. The Court of Appeals affirmed the Appellate Division's order and answered the certified question in the negative. View "Calabrese v City of Albany" on Justia Law

A former police officer, the petitioner, sought to annul the Comptroller's decision denying him accidental disability retirement (ADR) benefits. The petitioner was injured while on desk duty when his rolling chair tipped due to a rut in the floor, causing him to grab his desk and injure his shoulder and neck. He applied for ADR benefits, claiming the injury was accidental.The Comptroller denied the application, concluding that the petitioner could have reasonably anticipated the hazard. The petitioner testified that he was aware of the ruts in the floor and had been working desk duty for months. Photographs documented the floor's condition. The Comptroller determined that the injury was not the result of an "accident" as defined for ADR benefits.The petitioner challenged this decision through a CPLR article 78 proceeding. The Appellate Division confirmed the Comptroller's determination and dismissed the proceeding, stating that an event is not an accident if it could have been reasonably anticipated. One Justice dissented, arguing that the "reasonably anticipated" standard was inconsistent with precedent and that the chair tipping was a sudden, unexpected event.The New York Court of Appeals reviewed the case and affirmed the Appellate Division's judgment. The court held that a precipitating event that could or should have been reasonably anticipated by a person in the claimant's circumstances is not an "accident" for ADR benefits. The court found substantial evidence supporting the Comptroller's determination that the petitioner could have reasonably anticipated the near-fall from his desk chair, given his familiarity with the ruts in the floor and the documented condition of the precinct floor. The judgment was affirmed with costs. View "Bodenmiller v. DiNapoli" on Justia Law

Aleksia Lindsay filed an amended class action complaint against Patenaude & Felix, APC, and Transworld Systems Inc., alleging unfair debt collection practices. Lindsay had defaulted on $60,000 in student loans, and after receiving incomplete and inaccurate information from Transworld, Patenaude initiated two debt collection lawsuits against her. Lindsay later discovered that both entities had a history of unethical collection practices, leading to actions by various regulatory bodies. After the lawsuits against her were dismissed, Lindsay received another demand for payment and subsequently filed the class action complaint.The Superior Court of San Bernardino County struck Lindsay's complaint, relying on the anti-SLAPP law, and ruled that the public interest exception did not apply. Lindsay argued that the trial court erred in this decision. The trial court concluded that although the three conditions of the public interest exception were met, the action was not brought solely in the public interest because Lindsay sought damages.The Court of Appeal, Fourth Appellate District, Division One, State of California, reviewed the case. The court held that the action was brought solely in the public interest or on behalf of the general public, as the relief sought by Lindsay was identical to that sought for the plaintiff class. The court also found that seeking damages did not preclude the application of the public interest exception. The court concluded that the action met all three conditions of the public interest exception: it did not seek greater or different relief, it would enforce an important right affecting the public interest and confer a significant benefit, and private enforcement was necessary and placed a disproportionate financial burden on Lindsay.The Court of Appeal reversed the trial court's order, exempting Lindsay's action from the anti-SLAPP law and entitling her to costs on appeal. View "Lindsay v. Patenaude & Felix" on Justia Law