Justia Government & Administrative Law Opinion Summaries

Articles Posted in Health Law
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MSHA’s jurisdiction, the Federal Mine Safety and Health Review Commission (“Commission”) held that for the list of items in Section 802(h)(1)(C) to be considered a “mine,” the items had to be located at an extraction site, or the roads appurtenant thereto.  Because neither the trucks nor the facility associated with the citations at issue were located on land covered under subsections (A)–(B), the Commission found they failed to constitute a “mine” and vacated the citations. The Commission also found that, as an independent contractor not engaged in servicing a mine at the time of the citation, KC Transport failed to qualify as an “operator” under Section 802(d) of the Mine Act. The Secretary of Labor (“the Secretary”), acting through MSHA, appealed the Commission’s decision and asked the court to uphold the two citations as an appropriate exercise of the Secretary’s jurisdiction under the Mine Act. In the Secretary’s view, subsection (C) of the “mine” definition covers KC Transport’s facility and trucks because they were “used in” mining activity.   The DC Circuit vacated and remanded the Commission’s decision, allowing the Secretary to interpret the statute’s ambiguous language. The court explained that given the Mine Act’s language, context, and the court’s binding precedent, it finds that the Commission erred in its interpretation of the “mine” and “operator” definitions. And we generally defer to the Secretary’s reasonable interpretation of an ambiguous statute—even when the Commission disagrees. But here, the Secretary’s position treats subsection (C) as 4 unambiguous and makes no meaningful effort to address the numerous practical concerns that would arise under such an interpretation. View "Secretary of Labor v. KC Transport, Inc." on Justia Law

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A company providing crane services, TNT Crane & Rigging, Inc., petitioned the Fifth Circuit to overturn the final orders of the Occupational Safety and Health Review Commission. Those orders reversed decisions by an administrative law judge that were favorable to the company. The principal dispute is whether regulations applicable to the disassembly of a crane apply to the tragic accident that occurred here.   The Fifth Circuit denied the petition. The court held that substantial e supports the Commission’s determination that TNT did not have a work rule designed to prevent violations of Section 1926.1407(b)(3). Second, substantial evidence supports the Commission’s determination that TNT did not adequately monitor employee compliance with its power line safety rules. Finally, substantial evidence supports the Commission’s determination that TNT did not prove it effectively enforced its power line safety rules when it discovered violations. View "TNT Crane & Rigging v. OSHC" on Justia Law

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The Supreme Court held that a claim for reimbursement of emergency medical services may be maintained against a health care service plan when the plan is operated by a public entity and that the Government Claims Act, Cal. Gov. Code 810 et seq., did not immunize the County of Santa Clara from such a claim in this case.Two hospitals submitted reimbursement claims for the emergency medical services they provided to three individuals enrolled in a County-operated health care service plan. The hospitals sued for the remaining amounts based on the reimbursement provision of the Knox-Keene Act, and the trial court concluded that the hospitals could state a quantum merit claim against the County. The court of appeal reversed, determining that the County was immune from suit under the Government Claims Act. The Supreme Court reversed, holding that the County was not immune from suit under the circumstances of this case and that the hospitals' claims may proceed. View "County of Santa Clara v. Superior Court" on Justia Law

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The FDA issued marketing denial orders for Petitioners’ flavored products, finding that Petitioners’ applications lacked sufficient evidence showing that their flavored products would provide a benefit to adult use.   The Ninth Circuit denied petitions for review challenging the denial of Petitioners’ premarket tobacco product applications seeking FDA authorization to sell nicotine-containing e-liquids in the United States. The panel held that the text of the Family Smoking Prevention and Tobacco Control Act (the “Tobacco Control) Act”) plainly authorizes the FDA to require that manufacturers submit comparative health risk data, which necessarily includes comparisons of flavored e-liquids to tobacco-flavored e-liquids. The panel also held that the FDA did not arbitrarily or capriciously deny Petitioners’ applications and that any error the agency committed by failing to consider Petitioners’ marketing plans was harmless.   The panel held that the FDA did not introduce a new evidentiary standard; rather, it consistently required evidence that evaluated the impacts of flavored versus non-flavored products on initiation and cessation. Further,the panel concluded that, even if the agency erred by failing to consider Petitioners’ marketing plans, any error was harmless, and it would not remand on this basis. Finally, the panel addressed Petitioners’ post-argument motions to supplement the administrative record and file supplemental briefing, seeking judicial notice of a premarket tobacco product application deficiency letter, FDA internal memoranda, and FDA press releases. View "NUDE NICOTINE INC. V. FDA" on Justia Law

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Third-Party Plaintiff Dynasty Healthcare, LLC, a medical billing firm, claimed that a Medicare Administrative Contractor (“MAC”) negligently processed and misclassified the enrollment and payment application of one of Dynasty’s clients, a medical services supplier, and that. As a result, the client was underpaid for providing Medicare services. When the client sued Dynasty for the error, Dynasty sued the MAC, blaming it for the error. The district court dismissed Dynasty’s claims for lack of subject matter jurisdiction because Dynasty failed to pursue administrative channels through the United  States Department of Health and Human Services before seeking judicial review. At issue on appeal is whether Dynasty’s claims “arise under” the Medicare Act, such that the administrative channeling requirement set forth in 42 U.S.C. 14 Section 405(h) applies; and second, if so, whether the district court nonetheless had jurisdiction based on a narrow exception to the  Medicare Act’s jurisdiction stripping provision recognized in Shalala v. Illinois Council on Long Term Care, Inc.   The Second Circuit affirmed. The court concluded that the claims arise under the Medicare Act and that the Illinois Council exception does not apply to these claims. The court explained that Dynasty is not entitled to the exception because Retina’s financial interests in the claims alleged in this case were aligned with Dynasty’s interests at all relevant times, and Retina had both the incentive and the ability to seek administrative review. That Retina pursued a different course is irrelevant to the court's analysis under Illinois Council’s “objective inquiry.” View "Dynasty Healthcare, LLC v. Nat'l Gov't Services, Inc." on Justia Law

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In the winter of 2020, the Secretary of Health and Human Services (HHS) determined that the threat posed by the novel SARS-CoV-2 virus constituted a public health emergency. The CDC published the rule at issue—the Requirement for Persons to Wear Masks While on Conveyances and at Transportation Hubs, 86 Fed. Reg. 8025-01 (Feb. 3, 2021) (“Mandate”). Plaintiffs initiated this litigation, arguing that the Mandate was unlawful under the Administrative Procedure Act, 5 USC Section 706(2) (APA), and unconstitutional under non-delegation and separation-of-powers tenets.   The Eleventh Circuit vacated the district court’s judgment and instructed the district court to dismiss the case as moot. The court explained that it found Plaintiffs’ contention that there is a reasonable expectation that the CDC will issue another nationwide mask mandate for all conveyances and transportation hubs to be speculative. Conjectures of future harms like these do not establish a reasonable expectation that a mask mandate from the CDC will reissue. Further, the court reasoned that there is no “reasonable expectation or a demonstrated probability that the same controversy will recur involving the same complaining party.” View "Health Freedom Defense Fund, et al v. President of the United States, et al" on Justia Law

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Petitioners filed this original proceeding objecting to two pieces of legislation passed by the Oklahoma legislature during the 2022 legislative session: S.B. 1503 and H.B. 4327. Both acts prohibited abortion after certain cutoff points while providing for a civil enforcement mechanism; both acts prohibited enforcement by the State, its subdivisions, and its agents--instead, the bills created a cause-of-action maintainable by any person for performing, or aiding and abetting the performance of, an abortion in violation of the acts. Petitioners challenged the bills on many grounds, but the Oklahoma Supreme Court did not address them here. The Court held both bills were unconstitutional; the Court found it unnecessary to address the Petitioners' request for injunctive relief and/or writ of prohibition or Respondents' claims that Petitioners did not have a justiciable claim against them. Petitioners' request for injunctive relief and/or a writ of prohibition was denied. View "Oklahoma Call for Reproductive Justice v. Oklahoma" on Justia Law

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The Supreme Court held that a reimbursement cap imposed by the Tennessee Department of Finance and Administration's Division of TennCare, the state agency tasked with administering the federal Medicaid program in Tennessee, was a "rule" within the meaning of the Uniform Administrative Procedures Act that should have been promulgated through the notice-and-comment process.Emergency Medical Care Facilities, P.C., a corporation compromised of private healthcare professionals who provide emergency-department services to TennCare enrollees, brought this action against TennCare alleging that TennCare's decision to impose a $50 cap on the amount that Emergency Medical and other healthcare professionals could recover from TennCare for certain treatment provided to TennCare enrollees was a rule and that TennCare violated the Tennessee Uniform Administrative Procedures act (UAPA) by implementing the cap without rulemaking. The chancery court granted summary judgment in favor of Emergency Medical. The court of appeals reversed, concluding that the $50 cap fell within the so-called "internal-management exception" to the UAPA. The Supreme Court reversed, holding that the $50 cap was a rule under the UAPA and should have been promulgated through notice-and-comment rulemaking. View "Emergency Medical Care Facilities, P.C. v. Division of Tenncare" on Justia Law

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The Federally Supported Health Centers Assistance Act (“FSHCAA”) provides that health centers receiving funding under Section 330 of the Public Health Service Act (“PHSA”) may be deemed Public Health Service (“PHS”) employees. Plaintiffs alleged that Defendants violated their duty to report a court-ordered Lane County Mental Health patient’s refusal to comply with the terms of his probation. Plaintiffs alleged they were injured as a result of Defendants’ failure to report a patient’s repeated failures to comply with his mental health treatment plan. Defendants contended that they were entitled to Section 233 immunity. The district court held that Section 233 immunity did not apply to Defendants and remanded to state court.   The Ninth Circuit reversed the district court’s order remanding to state court Plaintiffs’ action alleging negligence and wrongful death claims against federally funded community health centers and their employees (“Defendants”), and remanded to the district court to enter an order substituting the United States as the defendant and deeming the action as one brought under the Federal Tort Claims Act. The panel first addressed whether there was jurisdiction to review the district court’s remand order. Ordinarily, a remand order is not reviewable on appeal, except for cases removed pursuant to 28 U.S.C. Section 1442. The panel agreed with Defendants that Section 233 immunity did not turn on who brings the claim, but rather on whether the conduct giving rose to the claim arose out of the Defendants’ performance of “medical, surgical, dental or related functions.” View "SAM FRIEDENBERG, ET AL V. LANE COUNTY, ET AL" on Justia Law

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Middle schooler A.K. struggled with suicidal ideation for many years and attempted suicide numerous times, resulting in frequent emergency room visits and in-patient hospitalizations. A.K.’s physicians strongly recommended she enroll in a residential treatment facility to build the skills necessary to stabilize. Despite these recommendations and extensive evidence in the medical record, United Behavioral Health (“United”) denied coverage for A.K.’s stay at a residential treatment facility beyond an initial three month period. Her parents appealed United’s denial numerous times, requesting further clarification, and providing extensive medical evidence, yet United only replied with conclusory statements that did not address the evidence provided. As a result, A.K.’s parents brought this lawsuit contending United violated its fiduciary duties by failing to provide a “full and fair review” of their claim for medical benefits. Both sides moved for summary judgment, and the district court ruled against United. The issue this case presented for the Tenth Circuit's review was whether United arbitrarily and capriciously denied A.K. medical benefits and whether the district court abused its discretion in awarding A.K. benefits rather than remanding to United for further review. The Court ultimately concluded United did act arbitrarily and capriciously in not adequately engaging with the opinions of A.K.’s physicians and in not providing its reasoning for denials to A.K.’s parents. The Court also concluded the district court did not abuse its discretion by awarding A.K. benefits outright. View "D.K., et al. v. United Behavioral Health, et al." on Justia Law