Justia Government & Administrative Law Opinion Summaries

In 2018, B.W. went to his primary car provider’s office for “anxiety” and “agitation.” The provider’s notes reflect B.W. discussed making “credible threats of violence against a co-worker.” The provider recommended inpatient treatment, “involuntary if necessary.” B.W. made no threats to the provider’s staff. The provider certified B.W. needed involuntary examination and treatment, and B.W. was transported to another hospital for such examination. The hospital evaluator noted B.W. was “homicidal toward a co-worker,” and was “severely mentally disabled and in need of treatment.” B.W. was involuntarily committed and released after 72 hours. Thereafter, B.W. petitioned to expunge his mental health record, averring there was no basis for the involuntary commitment. A trial court found it undisputed B.W. made threats to harm his co-worker. Though he made no “act in furtherance” of his threats, the court concluded the medical evaluators’ records reflecting B.W.’s statement he would “strangle his co-worker the next time he saw” that person, was sufficient to support B.W. was a clear and present danger to others. The Pennsylvania Supreme Court considered whether the superior court erred in ordering the expungement of B.W.’s records on grounds that the trial court’s conclusion was wrong. The Supreme Court determined the records contained sufficient facts to prove B.W. made a threat to harm another person, and acted in furtherance of that threat, which the physicians found credible. Accordingly, judgment was reversed. View "In Re: B. W., Appeal of: Blair Dept Human Services" on Justia Law

The issue presented for the New Mexico Supreme Court’s review centered on the executive branch’s authority to impose business restrictions during a pandemic. Specifically, the Court was asked to address: (1) whether Petitioners were authorized to restrict or close businesses when necessary for the protection of public health; and (2) whether the renewed temporary closure of indoor dining at restaurants and breweries, mandated by a July 13, 2020, emergency public health order (July Order), was arbitrary and capricious. With respect to the first question the Supreme Court held, consistent with its opinion in Grisham v. Reeb, 2020-NMSC-___, (S-1-SC-38336, Nov. 5, 2020), that Petitioners were so authorized. With respect to the second question, the Court held that the July Order’s temporary closure of indoor dining was not arbitrary and capricious. View "Lujan Grisham v. Romero" on Justia Law

The Ninth Circuit affirmed the district court's grant of summary judgment for HHS in an action brought by plaintiff, challenging HHS's denial of his claim for reimbursement from the Medicare program for services that he provided covered patients. The Supreme Court recently reaffirmed that a reviewing court should defer to an agency's reasonable interpretation of ambiguous regulations in Kisor v. Wilkie, 139 S. Ct. 2400 (2019).The panel agreed with the district court that the governing regulation, 42 C.F.R. 424.520(d), is genuinely ambiguous and that the agency's interpretation is reasonable. In this case, section 424.520(d) does not specify whether a certification submitted to reactivate billing privileges constitutes a "Medicare enrollment application" that triggers a new effective date. The panel concluded that the Board's interpretation of section 424.520(d) merits Auer deference and controls this case. Therefore, plaintiff's reactivation request was "a Medicare enrollment application," and its filing date of August 31, 2015 is the effective date of his billing privileges. The panel also agreed with the district court that its review was appropriately confined to the administrative record the agency produced and that the agency was not required to supplement the record. View "Goffney v. Becerra" on Justia Law

Plaintiff, a Nevada physician who treats patients covered by Medicare, filed suit seeking an injunction compelling the contractor that administers Medicare in his region to change the method of evaluating his claims. The district court granted the injunction.The Ninth Circuit vacated the preliminary injunction, concluding that the Medicare statute permits a court to review only claims that have been presented to the agency. The panel explained that, because this case does not involve a claim that was presented to the agency, the district court lacked subject matter jurisdiction. Accordingly, the panel remanded to the district court with instructions to dismiss the complaint for lack of jurisdiction. View "Odell v. U.S. Department of Health & Human Services" on Justia Law

Plaintiffs, a group of nursing homes that participate in both the Medicare and Medicaid programs, challenge the legality of DHS's Final Rule permitting survey teams conducting certain inspections of nursing homes not to include a registered nurse. The district court dismissed plaintiffs' claims, brought under the Medicare and Medicaid Acts, for lack of subject-matter jurisdiction based on claim-channeling and jurisdiction-stripping provisions governing claims arising under the Medicare Act.The Second Circuit reversed, concluding that the district court has jurisdiction under 28 U.S.C. 1331 over plaintiffs' claim arising under the Medicaid Act, which does not incorporate the same claim-channeling and jurisdiction-stripping provisions as the Medicare Act. The court explained that the Medicare Act's review provisions do not preclude plaintiffs from challenging the Final Rule in federal court because their challenge is independently rooted in the Medicaid Act. Furthermore, plaintiffs' Medicaid Act claim is not inextricably intertwined with a Medicare Act claim for benefits or compliance determination, and the government's policy rationale does not support claim channeling and jurisdiction stripping in this case. Accordingly, the court remanded for further proceedings. View "Avon Nursing & Rehabilitation v. Becerra" on Justia Law

The Supreme Court affirmed the order of the circuit court vacating the finding of the West Virginia Department of Health and Human Resources of maltreatment by Respondent as to her son, holding that the circuit court correctly determined that the conduct engaged in by the lay representative of the West Virginia Department of Health and Human Resources (DHHR) constituted the unauthorized practice of law.The circuit court concluded (1) the decision of the administrative law judgment upholding the DHHR's finding of maltreatment was erroneous because it was not supported by a witness with personal knowledge and was based upon inadmissible DHHR records; and (2) the administrative hearing before DHHR's board of review was conducted in an unlawful manner because DHHR's non-lawyer representative engaged in the unauthorized practice of law. The Supreme Court affirmed, holding that the circuit court did not err in concluding that the administrative proceedings were based upon unlawful procedure brought about by DHHR's lay representative engaging in the unauthorized practice of law. View "W. Va. Department of Health and Human Resources v. C.P." on Justia Law

The Federal Food, Drug, and Cosmetic Act (FDCA), 21 U.S.C. 301, sets forth separate and detailed regimes for the regulation of medical products classified as drugs or devices. Since 2017, the U.S. Food and Drug Administration (FDA) has exercised its claimed discretion to classify Genus’s “Vanilla SilQ” line of diagnostic contrast agents as drugs, notwithstanding the FDA’s recognition that the products “appear” to satisfy the statutory definition for devices. Contrast agents are used in medical imaging to improve the visualization of tissues, organs and physiological processes. The FDA claims that, if a medical product satisfies the statutory definitions of both a “drug” and a “device,” the Act’s overlapping definitions grant by implication the FDA broad discretion to regulate the product under either regime. Genus challenged the FDA’s classification decision as inconsistent with the Administrative Procedure Act (APA), 5 U.S.C. 706(2), and the FDCA.The D.C. Circuit affirmed summary judgment in favor of Genus. The FDCA unambiguously forecloses the FDA’s interpretation. “It would make little sense, then, for the Congress to have constructed such elaborate regulatory regimes—carefully calibrated to products’ relative risk levels—only for the FDA to possess the authority to upend the statutory scheme by reclassifying any device as a drug, no matter its relative risk level.” View "Genus Medical Technologies LLC v. United States Food and Drug Administration" on Justia Law

The Supreme Court affirmed the decision of the court of appeals reversing the judgment of the circuit court denying The Mix Up's motion for temporary injunctive relief challenging Emergency Order 3 issued by the Department of Health Services (DHS) Secretary-designee, Andrea Palm, holding that the order met the definition of a rule and should have been promulgated according to statutory rulemaking procedures.Emergency Order 3 was issued as a response to the COVID-19 pandemic and limited the size of indoor public gatherings. Plaintiffs initiated this lawsuit, alleging that the order was a rule and that DHS did not undertake proper rulemaking procedures. The circuit court granted Plaintiffs' motion for an ex parte temporary injunction. The Mix Up was granted intervention and moved for a temporary injunction. The circuit court vacated the ex part order denying The Mix Up's motion for temporary injunctive relief. The court of appeals reversed, holding that the order was invalid and unenforceable as a matter of law. The Supreme Court affirmed, holding (1) Emergency Order 3 met the definition of a rule, and therefore, the order should have been promulgated according to rule making procedures set forth in Wis. Stat. ch. 227; and (2) therefore, Emergency Order 3 was not validly enacted and was unenforceable. View "Tavern League of Wisconsin, Inc. v. Palm" on Justia Law

After the Indian Health Service agreed to pay the Swinomish Indian Tribal Community to run a health program on the Swinomish Reservation, Swinomish filed suit under the Contract Disputes Act and Declaratory Judgment Act, claiming that it was owed additional sums in direct and indirect contract support for costs calculated as percentages of the money it received from insurers and spent on health services. The DC Circuit affirmed the district court's grant of the government's motion for summary judgment, holding that the Indian Self-Determination and Education Assistance Act does not require Indian Health Service to pay for contract support costs on insurance money received by Swinomish. Neither does Swinomish's contract with Indian Health Service. View "Swinomish Indian Tribal Community v. Becerra" on Justia Law

The First Circuit vacated the ruling of the district court denying Plaintiffs' motion for a preliminary injunction in this case, holding that record lacked necessary findings and that remand was required.This case arose from a decision by the Speaker of the New Hampshire House of Representatives to enforce a House rule precluding any representative from participating in proceedings involving the full House, including House matters, other than in person. Plaintiffs, including seven members of the House who claimed to suffer from medical conditions making them vulnerable to COVID-19, brought this action arguing that the Speaker was required to allow them to participate remotely under Title II of the Americans with Disabilities Act, 42 U.S.C. 12132, and section 504 of the Rehabiliation Act, 29 U.S. 794. The district court denied Plaintiffs' motion for a preliminary injunction. The First Circuit vacated the district court's decision, holding that the court erred in finding that the doctrine of legislative immunity shielded the Speaker from having to comply with the ADA and/or Section 504. View "Cushing v. Packard" on Justia Law