Justia Government & Administrative Law Opinion Summaries

An association representing naturopathic physicians challenged a new Alaska regulation that effectively forbade naturopaths from using and prescribing injectable vitamins and minerals. The association argued the statutory definition of naturopathy included the use of dietetics, that dietetics included injectable vitamins and minerals obtained by pharmaceutical prescription, and that the statutory restrictions on the practice of naturopathy prohibited the use of only prescription drugs, not all prescription medicines. After review, the Alaska Supreme Court concluded the statutory text, the larger statutory context, and the legislative history together suggest that the legislature did not intend to grant prescriptive authority to naturopaths. Therefore, the Court affirmed the superior court’s decision to grant summary judgment against the association on this issue. View "Alaska Association of Naturopathic Physicians v. Alaska Division of Corporations, Business & Professional Licensing" on Justia Law

The Second Circuit denied a petition for review of OSHA's final order affirming a citation issued to a construction company for a repeat violation of an excavation standard and assessing a penalty of $25,000. The court held that the Commission did not abuse its discretion by relying on previous violations more than three years old, because neither the Manual nor the Commissionʹs precedent limits OSHA to a three‐year look back period. Furthermore, the Commissionʹs precedents established that ʺthe time between violations does not bear on whether a violation is repeated.ʺ Finally, this was the company's third violation in six years. View "Triumph Construction Corp. v. Secretary of Labor" on Justia Law

Plaintiff Jimmy Vasquez, an inmate in the Colorado Department of Corrections (“CDOC”), filed suit under 42 U.S.C. 1983, contending CDOC medical providers were deliberately indifferent to his serious medical needs in violation of the Eighth Amendment. Vasquez specifically alleged Defendants delayed treating him for the hepatitis C virus (“HCV”), resulting in his suffering life-threatening permanent liver damage. In appeal No. 17-1026, the Tenth Circuit affirmed the district court’s decision to grant Defendants summary judgment, concluding Vasquez’s claims against Defendants Davis, Webster, Melloh, and Chamjock were time-barred, and Vasquez failed to present sufficient evidence that Defendant Fauvel acted with deliberate indifference. In appeal No. 17-1044, the Court vacated an injunction requiring the CDOC to test Vasquez’s liver function every three months. View "Vasquez v. Davis" on Justia Law

In 2016, Kansas sent notices of decisions to terminate its Medicaid contracts with two Planned Parenthood affiliates, Planned Parenthood of Kansas and Mid-Missouri (“PPGP”), and Planned Parenthood of the St. Louis Region (“PPSLR”). The notices cited concerns about the level of PPGP’s cooperation in solid-waste inspections, both Providers’ billing practices, and an anti-abortion group’s allegations that Planned Parenthood of America (“PPFA”) executives had been video-recorded negotiating the sale of fetal tissue and body parts. Together, the Providers and three individual Jane Does (“the Patients”) immediately sued Susan Mosier, Secretary of the Kansas Department of Health and Environment (“KDHE”), under 42 U.S.C. 1983, alleging violations of 42 U.S.C. 1396a(a)(23) and the Equal Protection Clause of the Fourteenth Amendment. The Plaintiffs sought a preliminary injunction enjoining Kansas from terminating the Providers from the state’s Medicaid program. "States may not terminate providers from their Medicaid program for any reason they see fit, especially when that reason is unrelated to the provider’s competence and the quality of the healthcare it provides." The Tenth Circuit joined four of five circuits that addressed this same provision and affirmed the district court’s injunction prohibiting Kansas from terminating its Medicaid contract with PPGP. But the Court vacated the district court’s injunction as it pertained to PPSLR, remanding for further proceedings on that issue, because Plaintiffs failed to establish standing to challenge that termination. But on this record, the Court could not determine whether PPSLR itself could establish standing, an issue the district court declined to decide but now must decide on remand. View "Planned Parenthood v. Andersen" on Justia Law

St. Alexius Medical Center, doing business as Great Plains Rehabilitation ("Great Plains"), appealed a district court judgment affirming a Department of Human Services ("the Department") determination that the Department was entitled to recoup overpayments made to Great Plains. Great Plains argued the Department's decision had to be reversed because the Department did not issue the decision within the statutory time limit, the Department did not provide a fair process for disputing the Department's position, and the Department's findings of fact are not supported by the evidence. Finding no reversible error in the district court or the Department's decisions, the North Dakota Supreme Court affirmed. View "St. Alexius Medical Center v. N.D. Dep't of Human Services" on Justia Law

Legacy, a Federally Qualified Health Center (FQHC), filed suit against the Commission, alleging that Texas's reimbursement scheme violated the Medicaid Act. The Fifth Circuit reversed the district court's grant of summary judgment for Legacy, holding that the Commission's requirement that Managed Care Organizations (MCOs) fully reimburse FQHCs did not violate the Medicaid Act; Legacy lacked standing to challenge the Commission's lack of a policy that the state directly reimburse an FQHC if it is not fully reimbursed by the MCO; and Legacy was not entitled to reimbursement for the non-emergency, out-of-network services about which it complained. Accordingly, the court remanded with instructions. View "Legacy Community Health Services, Inc. v. Smith" on Justia Law

The Idaho Supreme Court answered a certified question of Idaho law from the United States District Court for the District of Idaho. The question certified centered on whether, for purposes of the dispute in this lawsuit, the terms ‘state board of correction’ as used in Idaho Code 20-237B(1) and ‘department of correction’ as used in Idaho Code § 20-237B(2), included privatized correctional medical providers under contract with the Idaho Department of Correction. The Court answered the question certified in the negative. View "In Re: Pocatello Hospital, LLC v. Corazon, LLC" on Justia Law

Dr. Erdle was arrested for possession of cocaine. He successfully completed drug treatment under a deferred entry of judgment program. Before completion of his drug program and dismissal of his criminal matter, the Medical Board filed an accusation. Erdle argued that he could not be disciplined because the action was based entirely on information obtained from his arrest record. Penal Code 1000.4 provides that “[a] record pertaining to an arrest resulting in successful completion of a pretrial diversion program shall not ... be used in any way that could result in the denial of any employment, benefit, license, or certificate.” Business and Professions Code section 492, however, states: “Notwithstanding any other provision of law, successful completion of any diversion program under the Penal Code . . . shall not prohibit" disciplinary action by specific agencies, "notwithstanding that evidence of that misconduct may be" in an arrest record. The ALJ concluded that section 492 permits discipline but that arrest records should not be permitted at the hearing; that testimony by the arresting officer was allowable; and that cause for discipline existed. The court of appeal held that section 492 creates a blanket exemption from the restrictions contained in section 1000.4 for licensing decisions made by the specified healing arts agencies. View "Medical Board of California v. Superior Court" on Justia Law

Erie is a Chicago “Federally Qualified Health Center” (FQHC), 42 U.S.C. 254b (2012). FQHCs rely heavily on federal grants and Medicaid reimbursement. Erie Employees are federal employees under the Federal Tort Claims Act, 42 U.S.C. 233(a). Erie was founded as a project between Northwestern Memorial Hospital (NMH) and Erie Neighborhood House in 1957. NMH provides financial support and technical assistance, but Erie physicians seeking NMH privileges are required to apply for them. In 2005, Yarbrough went to the Erie after searching for a clinic that would not require insurance coverage. Yarbrough was informed that she would have her ultrasounds done at Northwestern and would likely deliver her baby at NMH. Based upon information she received during the visit, Yarbrough believed that Erie and NMH were the same entity. Yarbrough sued NMH. based on her daughter’s premature birth, alleging medical negligence. The Illinois Supreme Court answered a certified question: A hospital cannot be held vicariously liable under the doctrine of apparent agency set forth in Gilbert v. Sycamore, for the acts of the employees of an unrelated, independent clinic that is not a party to the litigation. Yarbrough sought treatment at Erie but looks to impose liability on NMH. Erie is neither owned nor operated by NMH. While Erie receives some charitable assistance from NMH, it relies heavily on federal money. Erie does not utilize the Northwestern name, Northwestern-related branding, or Northwestern’s trademark purple color. View "Yarbrough v. Northwestern Memorial Hospital" on Justia Law

The DC Circuit reversed the district court's grant of summary judgment in favor of Clarian in an action challenging the legality of HHS's decision to set forth certain policies regarding the means of calculating reimbursements for Medicare providers in an instruction manual without engaging in notice and comment rulemaking. The court held that the Manual instructions embodied a general statement of policy, not a legislative rule, setting forth HHS's enforcement priorities; policy statements did not establish binding norms; they were not "rules" that must be issued through notice and comment rulemaking; nor were the instructions subject to the Medicare Act's independent notice and comment requirement because they did not establish or change a substantive legal standard. Therefore, neither the Administrative Procedure Act nor the Medicare Act required that the Manual instructions be established by regulation. View "Clarian Health West, LLC v. Hargan" on Justia Law