Justia Government & Administrative Law Opinion Summaries

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

The DC Circuit affirmed the district court's dismissal of RICU's complaint alleging that the Department's determination that critical care telehealth services provided by physicians who are outside of the United States are ineligible for Medicare reimbursement. The court concluded that RICU seeks to avoid well-settled authority requiring administrative exhaustion under the Medicare Act by presenting a concrete claim for payment of rendered services to the Department for decision. Because RICU has neither satisfied the channeling requirement of 42 U.S.C. 405(g) nor demonstrated that the Illinois Council exception applies, the court dismissed based on lack of subject matter jurisdiction. The court has no jurisdiction to consider the merits of RICU's motion for a preliminary injunction. View "RICU LLC v. Department of Health and Human Services" on Justia Law

The Secretary of Labor, through OSHA, enacted a vaccine mandate, to be enforced by employers. The mandate preempted contrary state laws and covered virtually all employers with at least 100 employees, with exemptions for employees who exclusively work remotely or outdoors. It required that covered workers receive a COVID–19 vaccine or obtain a medical test each week at their own expense, on their own time, and also wear a mask at work. Challenges were consolidated before the Sixth Circuit, which allowed OSHA’s rule to take effect.The Supreme Court stayed the rule. Applicants are likely to succeed on the merits of their claim that the Secretary lacked the authority to impose the mandate. The rule is “a significant encroachment into the lives—and health—of a vast number of employees,” not plainly authorized by statute; 29 U.S.C. 655(b) empowers the Secretary to set workplace safety standards, not broad public health measures. Although COVID–19 is a risk in many workplaces, it is not an occupational hazard in most. COVID–19 spreads everywhere that people gather. Permitting OSHA to regulate the hazards of daily life would significantly expand OSHA’s regulatory authority without clear congressional authorization. The vaccine mandate is unlike typical OSHA workplace regulations. A vaccination “cannot be undone.” Where the virus poses a special danger because of the particular features of an employee’s job or workplace, targeted regulations are permissible but OSHA’s indiscriminate approach fails to distinguish between occupational risk and general risk. The equities do not justify withholding interim relief. States and employers allege that OSHA’s mandate will force them to incur billions of dollars in unrecoverable compliance costs and will cause hundreds of thousands of employees to leave their jobs. View "National Federation of Independent Business v. Department of Labor, Occupational Safety & Health Administration" on Justia Law

In November 2021, the Secretary of HHS announced that, in order to receive Medicare and Medicaid funding, participating facilities must ensure that their staff—unless exempt for medical or religious reasons or teleworking full-time—are vaccinated against COVID–19. Two district courts enjoined enforcement of the rule. The Supreme Court stayed the injunctions pending appeals in the Fifth and Eighth Circuits. The rule falls within the Secretary’s statutory authority to promulgate regulations “necessary to the efficient administration of the functions with which [he] is charged,” 42 U.S.C. 1302(a), including ensuring that the healthcare providers who care for Medicare and Medicaid patients protect their patients’ health and safety. Conditions with which facilities must comply to be eligible to receive Medicare and Medicaid funds have long included a requirement that certain providers maintain and enforce an “infection prevention and control program.” Vaccination requirements are a common feature of the provision of healthcare in America. The rule is not arbitrary. The Court noted the Secretary’s findings that in addition to the threat posed by in- facility transmission itself, “fear of exposure” to the virus “from unvaccinated health care staff can lead patients to themselves forgo seeking medically necessary care.” Nor did the Secretary fail to consider that the rule might cause staffing shortages. The Secretary’s finding of good cause to delay notice and comment was based on a finding that accelerated promulgation of the rule in advance of the winter flu season would significantly reduce COVID–19 infections, hospitalizations, and deaths. View "Biden v. Missouri" on Justia Law

In a suit challenging the emergency temporary standards (ETS) promulgated by the California Occupational Safety and Health Standards Board in response to the COVID-19 pandemic, the trial court denied a request for a preliminary injunction suspending enforcement of the ETS. The trial court concluded that the plaintiffs had not shown a likelihood of prevailing on the merits and found the public interest in curbing the spread of COVID-19 weighed “heavily” in favor of ongoing enforcement of the ETS.The court of appeal affirmed, rejecting arguments that the trial court erroneously applied a deferential standard of review, the findings of emergency lacked necessary findings, and the ETS exceeded the Board’s statutory authority. The administrative record demonstrated the Board did not abuse its discretion in adopting prescriptive standards in the ETS; the Board considered performance standards during the rulemaking process, including existing regulations, and concluded certain prescriptive standards were necessary to assure “to the extent feasible, that no employee will suffer material impairment of health or functional capacity.” The Board did not abuse its discretion in establishing regulations excluding workers exposed to COVID-19 cases from the workplace and mandating a continuation of pay, benefits, and seniority during such periods of exclusion. View "Western Growers Association v. Occupational Safety & Health Standards Board" on Justia Law

The 1949 Federal Property and Administrative Services Act is intended to facilitate the “economical and efficient” purchase of goods and services on behalf of the federal government, 40 U.S.C. 101. In November 2021, the Safer Federal Workforce Task Force, under the supposed auspices of the Act, issued a “Guidance” mandating that employees of federal contractors in “covered contract[s]” with the federal government become fully vaccinated against COVID-19. Ohio, Kentucky, and Tennessee and Ohio sheriffs’ offices sued, alleging that the Property Act does not authorize the mandate, that the mandate violates other federal statutes, and that its intrusion upon traditional state prerogatives raises federalism and Tenth Amendment concerns.The district court enjoined enforcement of the mandate throughout the three states and denied the federal government’s request to stay the injunction pending appeal. The Sixth Circuit denied relief. The government has established none of the showings required to obtain a stay. The government is unlikely to succeed on claims that the plaintiffs lack standing and the plaintiffs likely have a cause of action under the Administrative Procedure Act. The court noted the plaintiff’s concerns about disruptions to the supply chain if workers leave their jobs rather than receiving vaccinations and also stated: Given that expansive scope of the Guidance, the interpretive trouble is not figuring out who’s “covered”; the difficult issue is understanding who, based on the Guidance’s definition of “covered,” could possibly not be covered. View "Commonwealth of Kentucky v. Biden" on Justia Law

B.W., a two-year-old in good health, experienced immune thrombocytopenic purpura after receiving his measles, mumps, and rubella vaccine. Later blood tests showed his condition had resolved. More than six months after he was first diagnosed, B.W. presented with bruising, a possible symptom of immune thrombocytopenic purpura, but blood tests showed the condition had not recurred. In a suit under the National Childhood Vaccine Injury Act of 1986, the Claims Court ruled in favor of B.W., holding that those blood tests, occurring more than six months after his initial diagnosis, were “residual effects” of B.W.’s vaccine injury that satisfied the severity requirement of 42 U.S.C. 300aa-11(c)(1)(D).The Federal Circuit reversed. A residual effect must be a change within the patient that is caused by the vaccine injury. B.W.’s later bruising was not caused by his vaccine injury, and his tests did not reveal, constitute, or cause any somatic change. Tests revealed B.W. had no lingering symptoms or recurrence of thrombocytopenic purpura. There was no argument that the testing itself was detrimental to B.W.’s health such that it might qualify under section 300aa-11(c)(1)(D)(i) as a “residual effect” or a “complication” of thrombocytopenic purpura. View "Wright v. Secretary of Health and Human Services" on Justia Law

D&G, a Medicare service provider for nursing homes and homebound individuals, filed suit against the H.H.S. Secretary in federal court seeking repayment of recouped funds, which then amounted to $4,136,258.19 in principal and $593,294.54 in accrued interest. The district court dismissed D&G's case for lack of subject matter jurisdiction, holding that there was no federal court jurisdiction pursuant to 42 U.S.C. 405(g), as applied to Medicare appeals by 42 U.S.C. 1395ff(b)(1)(A).The Fifth Circuit held that "effectuations" of final agency decisions when sought to liquidate the amount of repayment owed, are reviewable under 42 U.S.C. 405(g) as continuous aspects of the initial, properly exhausted, administrative decision. The court concluded that the district court had jurisdiction under section 405(g) to resolve this dispute because "effectuations" are inextricably intertwined with the initial exhausted agency action. Therefore, the district court committed reversible error when it granted the Secretary' motion to dismiss. Furthermore, the Secretary's attempted reopening of the "effectuation" was untimely and the purported reopening was void ab initio. The court reversed and remanded for further proceedings. View "D&G Holdings, LLC v. Becerra" on Justia Law

A man with severe mental illness stabbed his parents during a psychotic episode and was subsequently committed to a psychiatric hospital. He appealed that commitment order. Before the commitment hearing, he stopped taking prescribed medications, leading hospital staff to petition for permission to administer medication involuntarily. The court granted the medication petition as well as a revised petition requesting a higher dose. He also appealed the order authorizing involuntary administration of medication. Finding the superior court did not err in its finding there was no less restrictive alternative to confinement, or that the court did not err petitioner lacked capacity to give or withhold consent to psychotropic medication, the Alaska Supreme Court affirmed both orders. View "In the Matter of the Necessity for the Hospitalization of: Mark V." on Justia Law