Justia Government & Administrative Law Opinion Summaries
Articles Posted in Health Law
Mercer v. Thomas B. Finan Center
The Court of Appeals held that an administrative law judge (ALJ) with the Maryland Office of Administrative Hearings erred in declining Petitioner's request to be represented by counsel at an administrative hearing regarding the approval to give Petitioner forced medication, holding that the ALJ erred.Petitioner, a patient at a psychiatric institution, refused to take prescribed psychotropic medication. After a panel approved forced medication, Petitioner requested a hearing. On the day of the hearing, Petitioner asked for counsel. The ALJ treated the request for counsel as a request for a postponement, concluding that there was not good cause to postpone the hearing, and convened the hearing with Petitioner unrepresented. The Court of Appeals reversed, holding (1) under the plain language of HG 10-708 an individual possesses a right to counsel upon request; (2) an on-the-record waiver colloquy of the kind required in a criminal case is unnecessary, but there must be verification that the individual has knowingly and voluntarily waived the right to counsel and elected to proceed without representation; and (3) the ALJ erred in declining Petitioner's request to be presented by counsel at the administrative hearing. View "Mercer v. Thomas B. Finan Center" on Justia Law
Clawson v. Board of Registered Nursing
Nina’s was a residential care facility for the elderly (RCFE) licensed by the Community Care Licensing Division (CCL) of the State Department of Social Services. Plaintiff, an RN-certified legal nurse consultant, was hired to assist with the closure of Nina’s and agreed to assess each of the residents and recommend a new facility, as required by RCFE closing procedures, Health and Safety Code 1569.682(a)(1)(A).Caregivers from the new RCFE, Frye’s, came to transfer J.N. They immediately noticed that J.N. was in significant pain; multiple bandages “stuck to [J.N.’s] skin and her wounds,” which “all smelled really bad.” J.N.’s toes were black. Frye’s caregivers called 911. J.N. died weeks later. A CCL investigator contacted plaintiff, who confirmed that he had performed J.N.’s assessment. Plaintiff later denied performing J.N.’s physical assessment, stating that Mia “was the one in charge.” He denied guiding or instructing Mia during the assessment, stating he only acted as a “scribe.” The ALJ found clear and convincing evidence that plaintiff committed gross negligence in connection with J.N.'s appraisal, unprofessional conduct in carrying out nursing functions in connection with the appraisal, and unprofessional conduct by not being truthful with the Board investigator regarding J.N.'s care provided.The court of appeal upheld the revocation of plaintiff’s nursing license. Substantial evidence supports the finding that plaintiff engaged in a “usual nursing function” when he performed J.N.’s resident appraisal. Plaintiff’s dishonesty during the investigation constitutes unprofessional conduct. View "Clawson v. Board of Registered Nursing" on Justia Law
Louisiana v. Becerra
The Secretary of DHS and other federal government defendants moved to stay the district court's nationwide, preliminary injunction barring enforcement of one of the federal COVID-19 vaccination mandates related to the staff of many Medicare- and Medicaid-certified providers such as hospitals, long-term care facilities, home-health agencies, and hospices.The Fifth Circuit denied the motion insofar as the order applies to the 14 Plaintiff States, concluding that the Secretary has not made a strong showing of likely success on the merits in light of BST Holdings, L.L.C. v. OSHA, 17 F.4th 604 (5th Cir. 2021). In BST, the Fifth Circuit relied in part on the "major questions doctrine" in staying the COVID-19 vaccination mandate OSHA issued for employers of a certain size. In this case, the Secretary identifies meaningful distinctions between its rule for Medicare and Medicaid-funded facilities and the broader OSHA rule — the statutory authority for the rule is different; Medicare and Medicaid were enacted under the Spending Clause rather than the Commerce Clause; and the targeted health care facilities, especially nursing homes, are where COVID-19 has posed the greatest risk. Nonetheless, the court concluded that the first stay factor requires more than showing a close call. Therefore, the court could not say that the Secretary has made a strong showing of likely success on the merits. Furthermore, the other three factors for a stay — injury to the movant, injury to the opponent, and the public interest — are important but, regardless of the outcome of analyzing them, they will not overcome the court's holding that the merits of the injunction will not likely be disturbed on appeal.Applying principles of judicial restraint, the court granted the stay as to the order's application to any other jurisdiction, concluding that the district court gave little justification for issuing an injunction outside the 14 States that brought this suit. View "Louisiana v. Becerra" on Justia Law
Corbett v. Transportation Security Administration
Petitioner sought review of the TSA's Mask Directives, issued in response to the ongoing COVID-19 pandemic, claiming that the TSA has no authority to issue the directives. Petitioner argued that TSA's authority under the Aviation and Transportation Security Act does not empower TSA to require face masks to prevent the spread of COVID-19.The DC Circuit found no merit in petitioner's claim and denied the petition for review. The court concluded that the COVID-19 global pandemic poses one of the greatest threats to the operational viability of the transportation system and the lives of those on it seen in decades. TSA, which is tasked with maintaining transportation safety and security, plainly has the authority to address such threats under both sections 114(f) and (g) of the Aviation and Transportation Security Act. The court stated that the Mask Directives are reasonable and permissible regulations adopted by TSA to promote safety and security in the transportation system against threats posed by COVID-19. The Mask Directives are not ultra vires, and the court deferred to the agency's interpretation of the Act. View "Corbett v. Transportation Security Administration" on Justia Law
Med-Cert Home Care, LLC v. Becerra
Med-Cert filed suit against federal officials in charge of administering the Medicare program, alleging that HHS sought to recoup overpaid Medicare funds from Med-Cert before its hearing with an ALJ in violation of Med-Cert's due process rights. The district court enjoined the federal officials from recouping funds until after the hearing. While this case was on appeal, the Fifth Circuit issued Sahara Health Care Inc. v. Azar, 975 F.3d 523 (5th Cir. 2020), which held that a similarly situated health-care provider was not denied due process. Because Sahara is controlling in this case, the court reversed and remanded for the district court to consider Med-Cert's alternative claims. View "Med-Cert Home Care, LLC v. Becerra" on Justia Law
State of Florida v. Department of Health and Human Services
In November 2021, the Secretary of Health and Human Services issued an interim rule that requires facilities that provide health care to Medicare and Medicaid beneficiaries to ensure that their staff, unless exempt for medical or religious reasons, are fully vaccinated against COVID-19, 86 Fed. Reg. 61,555. Under the rule, covered staff must request an exemption or receive their first dose of a two-dose vaccine or a single-dose vaccine by December 6, 2021. Florida unsuccessfully sought a preliminary injunction to bar the interim rule’s enforcement.The Eleventh Circuit upheld the denial of the motion, first deciding not to apply the mootness doctrine and to exercise jurisdiction despite another district court’s issuance of a nationwide injunction. Florida failed to demonstrate a substantial likelihood that it will prevail on the merits, that it will suffer irreparable injury absent an injunction, or that the balance of the equities favors an injunction. The Secretary has express statutory authority to require facilities voluntarily participating in the Medicare or Medicaid programs to meet health and safety standards to protect patients. The Secretary provided a detailed explanation for why there was good cause for dispensing with the notice-and-comment requirement. Ample evidence supports the Secretary’s determination that facility staff vaccination will provide important protection for patients. View "State of Florida v. Department of Health and Human Services" on Justia Law
Regional Home Health Care, Inc. v. Becerra
The Eighth Circuit affirmed the district court's dismissal of Regional's declaratory judgment claims alleging that defendants' procedures in suspending Regional's Medicare payments and forcing it out of business without notice, a hearing, or an opportunity to appeal violated its Fifth Amendment rights to procedural and substantive due process. The court concluded that no actual controversy exists between Regional and defendants within the meaning of the Declaratory Judgment Act. The court explained that, having abandoned any claim for damages, Regional seeks nothing more than a judicial pronouncement that its constitutional rights were violated. Therefore, the possibility of Regional re-establishing a business that is certified to receive Medicare reimbursements, again submitting documentation insufficient to meet Medicare requirements for billed services, and again having Medicare payments suspended is too conjectural or hypothetical to pose a real and immediate threat of injury sufficient to confer subject matter jurisdiction in federal court. View "Regional Home Health Care, Inc. v. Becerra" on Justia Law
E.T. v. Paxton
The Fifth Circuit granted the Texas Attorney General a stay pending appeal of the permanent injunction that bars him from enforcing Texas Governor Greg Abbott's Executive Order GA-38, which prohibits local governmental entities from imposing mask mandates.After determining that plaintiffs have likely failed to demonstrate standing, the court concluded that the Attorney General has demonstrated a strong likelihood of success on the merits as a matter of law. In this case, the district court lacked jurisdiction over plaintiffs' claims where plaintiffs have not exhausted their administrative remedies under the Individuals with Disabilities Education Act (IDEA). Furthermore, even if a failure to exhaust remedies does not bar plaintiffs' claims, plaintiffs likely failed to make out a prima facie case under the Americans with Disabilities Act (ADA) or the Rehabilitation Act. The court explained that, given the availability of vaccines, voluntary masking, and other possible accommodations, the record before the court likely does not support the conclusion that a mask mandate would be both necessary and obvious under the ADA or the Rehabilitation Act. The court also held that it was likely erroneous for the district court to hold that GA-38 was preempted by either the ADA or the Rehabilitation Act. To the extent that it is even properly before the court, the court did not read the American Rescue Plan Act to preempt GA-38's prohibition of local mask mandates, as the district court did. The court further concluded that, assuming plaintiffs' claims are otherwise viable, at a minimum, the district court's blanket injunction prohibiting the enforcement of GA-38 in all public schools across the State of Texas is overbroad. Finally, the court concluded that the Attorney General has demonstrated the prospect of irreparable injury absent a stay; has shown that maintaining the status quo ante pending appeal will not risk substantial injury to plaintiffs; and that the public interest favors a stay. View "E.T. v. Paxton" on Justia Law
Kane v. De Blasio
Teachers and school administrators challenge the denial of motions to preliminarily enjoin the enforcement of an order issued by the New York City Commissioner of Health and Mental Hygiene mandating that individuals who work in New York City schools be vaccinated against the COVID-19 virus.The Second Circuit concluded that the Vaccine Mandate does not violate the First Amendment on its face. However, the court concluded that plaintiffs have established their entitlement to preliminary relief on the narrow ground that the procedures employed to assess their religious accommodation claims were likely constitutionally infirm as applied to them. The court explained that the Accommodation Standards as applied here were neither neutral nor generally applicable to plaintiffs, and thus the court applied a strict scrutiny analysis at this stage of the proceeding. The court concluded that these procedures cannot survive strict scrutiny because denying religious accommodations based on the criteria outlined in the Accommodation Standards, such as whether an applicant can produce a letter from a religious official, is not narrowly tailored to serve the government's interest in preventing the spread of COVID-19. Accordingly, the court vacated the district court's orders denying preliminary relief and concurred with and continued the interim relief granted by the motions panel as to these fifteen individual plaintiffs. The court remanded for further proceedings. View "Kane v. De Blasio" on Justia Law
Callahan v. United Network for Organ Sharing
Liver-transplant candidates and transplant hospitals challenged HHS's adoption of a new policy for allocating donated livers. In 2019, the Eleventh Circuit held that the plaintiffs had not shown a substantial likelihood of success on the merits of their claim that the Secretary failed to follow procedures under 42 C.F.R. 121.4(b) during the new liver-allocation policy's development. Section 121.4(b) does not require the Secretary to refer the new liver allocation policy to an Advisory Committee on Organ Transplantation or to publish the new policy in the Federal Register for public comment. The court remanded for the district court to consider the remaining Administrative Procedure Act and Fifth Amendment claims.The district court ordered limited discovery on remand. The defendants ultimately produced requested communications between its top-level personnel and outside policymakers that, according to the plaintiffs, exposed “bad faith and improper behavior.” The district court ultimately excluded the documents from the administrative record for the APA claim, while noting that the documents included “colorable evidence of animosity and even some measure of regional bias.” The hospitals moved to unseal the documents. In 2021, the Eleventh Circuit affirmed an order unsealing the documents. The documents here are “plainly judicial records” and the appellants have not shown good cause to keep them sealed. View "Callahan v. United Network for Organ Sharing" on Justia Law