Justia Government & Administrative Law Opinion Summaries

The Supreme Court affirmed the judgment of the court of appeals affirming the decision of the circuit court to overturn a final order of the Secretary of the Cabinet for Health and Family Services dismissing an administrative action against Appalachian Hospice Care, Inc., holding that there was no error.At issue on appeal was whether the Secretary erred in concluding that a non-lawyer's request for an administrative hearing on behalf of a corporate entity constitutes the unauthorized practice of law requiring dismissal of the administrative action. The lower courts answered the question in the negative. The Supreme Court affirmed, holding that there was no unauthorized practice of law in this case. View "Cabinet for Health & Family Services v. Appalachian Hospice Care, Inc." on Justia Law

The Fifth Circuit affirmed the district court's grant of summary judgment in favor of the HHS Defendants in an action challenging HHS's risk-adjustment program, implemented under the Patient Protection and Affordable Care Act (ACA), and repromulgation of the 2017 and 2018 rules. In this case, Vista Health Plan, a health insurance company in Texas, was assessed risk-adjustment fees that exceeded its premium revenue, causing the company to cease operations.After determining that it has jurisdiction over the appeal, the court concluded that the 2017 and 2018 Final Rules adopted by HHS were not impermissibly retroactive under Landgraf v. USI Film Prods., 511 U.S. 244, 268 (1994). The court also concluded that HHS's failure to follow the Administrative Procedure Act's notice-and-comment procedures in its repromulgation of the 2017 Final Rule was at worst harmless error. Rather, the new rule actually maintained the settled expectations of insurers covered by the previous version of the rule. Finally, the court concluded that Vista's other issues on appeal regarding the administrative record before the district court, Chevron deference as to HHS's interpretation of the governing law, and the district court's "sua sponte" summary judgment on Vista's regulatory taking claim lack merit. View "Vista Health Plan, Inc. v. United States Department of Health and Human Services" on Justia Law

This case arose out of South Carolina's termination of Planned Parenthood's Medicaid provider agreement. The district court granted a preliminary injunction, concluding in relevant part that the individual plaintiff had demonstrated that she was likely to succeed on her Medicaid Act claim since the free-choice-of-provider provision conferred a private right enforceable under 42 U.S.C. 1983 and South Carolina had violated that provision by terminating Planned Parenthood's Medicaid provider agreement. The Fourth Circuit affirmed the district court's decision. The district court then issued a permanent injunction, which South Carolina now challenges in this appeal.The Fourth Circuit first concluded that this case presents a live case or controversy and rejected South Carolina's claim of mootness. Even assuming that the court were free to reexamine its precedents, the court declined to do so in this case. Rather, the court concluded that its previous decision was handed down as a matter of law and resolved the precise legal issue upon which South Carolina now seeks review.The court reaffirmed its prior decision, concluding that the free-choice-of-provider provision confers on Medicaid recipients an individual right enforceable under section 1983. The court stated that the statute plainly reflects Congress's desire that individual Medicaid recipients be free to obtain care from any qualified provider and it implements this policy in direct and unambiguous language. In this case, all three Blessing factors in determining whether a statute creates a private right enforceable under section 1983 are met. Furthermore, the Medicaid Act does not evince Congress's intent to specifically foreclose a remedy under section 1983. Finally, the Supreme Court's decision in O’Bannon v. Town Court Nursing Center, 447 U.S. 773 (1980), does not undermine the court's analysis. The court refused to nullify Congress's undeniable desire to extend a choice of medical providers to the less fortunate among us, individuals who experience the same medical problems as the more fortunate in society but who lack under their own means the same freedom to choose their healthcare provider. View "Planned Parenthood South Atlantic v. Kerr" on Justia Law

Three teaching hospitals challenged the denial of Medicare reimbursements. At that time, a teaching hospital could obtain reimbursement only by incurring “substantially all” of a resident’s training costs. Because the teaching hospitals had shared the training costs for each resident, the government denied reimbursement. The denials led the teaching hospitals to file administrative appeals. While they were pending, Congress enacted the Affordable Care Act (ACA), which created a new standard for reimbursement. The parties disagreed on whether the ACA’s new standard applied to proceedings reopened when Congress changed the law. The agency answered no, and the district court granted summary judgment to the agency. Finding no reversible error in that decision, the Tenth Circuit affirmed. View "St. Francis Hospital, et al. v. Becerra" on Justia Law

The Fifth Circuit denied defendants' motion for a partial stay of the district court's preliminary injunction enjoining the Department of Defense, United States Secretary of Defense Lloyd Austin, and United States Secretary of the Navy Carlos Del Toro from enforcing certain COVID-19 vaccination requirements against 35 Navy special warfare personnel and prohibiting any adverse actions based on their religious accommodation requests. Specifically, defendants seek a partial stay pending appeal insofar as the injunction precludes them from considering plaintiffs' vaccination statuses "in making deployment, assignment and other operational decisions."The court weighed the Mindes abstention factors and determined that this dispute is justiciable. However, the court concluded that defendants have not carried their burden to warrant the issuance of the stay. The court agreed with the district court that defendants have not shown a compelling interest to deny religious accommodations under the Religious Freedom Restoration Act of 1993 to each of the 35 plaintiffs at issue. Rather, the "marginal interest" in vaccinating each plaintiff appears to be negligible and thus defendants lack a sufficiently compelling interest to vaccinate plaintiffs. The court also concluded that the preliminary injunction does not irreparably damage the Navy and the public; partially staying the preliminary injunction pending appeal would substantially harm plaintiffs; and issuance of the requested stay would disserve the public interest. View "U.S. Navy SEALs 1-26 v. Biden" on Justia Law

The Supreme Court held that Fla. Stat. 120.68(3), which entitles a party to a presumptive stay upon the appeal of an agency decision that "has the effect of suspending or revoking a license," does not apply to an agency decision to administratively withdraw an incomplete renewal license application.When Ybor Medical Injury and Accident Clinic, Inc. (the clinic), applied to the Agency for Health Care Administration (AHCA) to renew its expiring license the AHCA invited the clinic to supplement its application, which was incomplete. After the clinic failed to do so, AHCA administratively withdrew the incomplete renewal license application from further consideration. The AHCA appealed and sought a presumptive stay under section 120.68(3). The court of appeals granted the presumptive stay. The Supreme Court quashed the decision below, holding that the appeal of an agency’s withdrawal decision does not trigger the statute’s presumptive stay provision. View "Agency for Health Care Administration v. Ybor Medical Injury & Accident Clinic, Inc." on Justia Law

The Supreme Court affirmed the judgment of the circuit court denying the petition for a permanent writ of prohibition filed by the Missouri Department of Health and Senior Services, holding that the circuit court did not err in denying the writ.After the Department denied the applications filed by Kings Garden Midwest LLC seeking two medical marijuana cultivation facility licenses Kings Garden requested that the Department provide complete and unreacted copies of successful cultivation license applications in discovery. The administrative hearing commission (AHC) granted the motion to compel. The Department filed a petition for a writ of prohibition seeking to bar enforcement of the AHC's order. The circuit court denied the writ. The Supreme Court affirmed, holding that because the plain language of allows confidential information to be used for purposes of appealing the Department's decision to deny a license, the AHC did not err in sustaining Kings Garden's motion to compel. View "State ex rel. Department of Health & Senior Services v. Slusher" on Justia Law

Respondent, C.R. (ward) appealed a circuit court order appointing a guardian over her person, arguing that petitioner New Hampshire Hospital (NHH) failed to prove beyond a reasonable doubt that she was incapacitated. She also argued the trial court’s findings of incapacity exceeded the scope of the pleadings and evidence at trial, thereby depriving her of notice and an opportunity to be heard. The ward suffered from schizoaffective disorder, and, in November 2020, was involuntarily admitted to NHH for a two-year period. NHH obtained emergency treatment authorization to provide the ward with psychiatric medication without her consent, and although her condition improved, the medication caused side effects that required a reduction in dosage. The ward declined to take any medication to treat the side effects or any alternative medication that would not cause the side effects. The emergency treatment authorization expired on January 4, 2021. In the two weeks before the February 2021 guardianship proceeding, the ward started exhibiting worsening thoughts that people were trying to target her, and her mood fluctuated more, spurring concerns that the current medication was insufficient. NHH filed the guardianship petition at issue here, alleging that, the guardianship was necessary. The New Hampshire Supreme Court concluded the evidence presented at trial was sufficient for the trial court to have found the ward “is likely to suffer substantial harm due to an inability to provide for [her] personal needs for food, clothing, shelter, health care or safety or an inability to manage . . . her property or financial affairs.” Further, the Court found there was support in the record for the trial court's finding that guardianship was the least restrictive intervention for the ward. The Court found that the guardianship petition informed the ward the trial court could “impose additional orders as a result of the hearing,” but it did not inform her that NHH was asking the court to find her incapable of exercising her rights to marry or divorce, make a will or waive a will’s provisions, hold or obtain a motor vehicle operator’s license, initiate/defend/settle lawsuits, or make decisions concerning educational matters or training. Under these circumstances, the Supreme Court held that the ward did not receive the notice contemplated by RSA 464-A:5, I, as to those rights. Therefore, the Court vacated the guardianship order to the extent that it deprived her of those rights. The Court otherwise affirmed the order appointing a guardian over the person of the ward and remanded. View "In re Guardianship of C.R." on Justia Law

Class members are Medicare Part A beneficiaries who are formally admitted to a hospital as "inpatients" before their subsequent reclassification as outpatients receiving "observation services." Plaintiffs filed suit alleging that the Secretary violated their due process rights by declining to provide them with an administrative review process for the reclassification decision. The district court entered an injunction ordering the creation of such a process.The Second Circuit affirmed, concluding that the named plaintiff had standing by demonstrating that they suffered a financial injury as a result of being reclassified as receiving observations services; the failure of the Secretary to provide an appeals process for the reclassification decision implicates the same set of concerns—namely, a loss of Part A coverage—for both the named plaintiffs and the absent class members; and the litigation incentives are sufficiently aligned so that the named plaintiffs can properly assert claims on behalf of those class members who will be hospitalized in the future. The court also concluded that the district court properly certified the plaintiff class and that the class satisfies the commonality and typicality requirements. Furthermore, the plaintiff class was properly certified under Federal Rule of Civil Procedure 23(b)(2).The court concluded that the district court did not clearly err by finding that plaintiffs' due process rights are violated by the current administrative procedures available to Medicare beneficiaries. In this case, plaintiffs have demonstrated that the Secretary violates their due process rights when utilization review committees reclassify them from inpatients to those receiving observation services without providing a mechanism to appeal that decision. View "Barrows v. Becerra" on Justia Law

Two cases were consolidated for the Mississippi Supreme Court's review. In the first appeal, Singing River MOB, LLC (MOB), argued that the leases between itself and Singing River Health System (SRHS) and the lease between Jackson County, Mississippi (County), and SRHS were valid and that the chancery court erred by finding the leases invalid under Mississippi’s “minutes rule.” In the second appeal, Jackson County and SRHS contended the chancery court erred by fashioning its own equitable relief as a result of the first ruling. MOB also raised its own objection as to the manner in which the equitable relief was fashioned. After careful review, the Supreme Court affirmed and remanded the partial summary-judgment order as to the first appeal (No. 2019-IA-01630-SCT); however, the Court reversed and remanded that order as to the second appeal (No. 2019-IA-01653-SCT). View "Singing River MOB, LLC v. Jackson County" on Justia Law