Justia Government & Administrative Law Opinion Summaries

Wade T. Hamilton, a pediatric cardiologist, recommended a patient for a cardiac MRI scan but warned her that due to her COVID-19 vaccination, which he claimed included "magnets and heavy metals", it would be unsafe for her to enter an MRI machine. The patient's mother reported Hamilton's statements to the nurse practitioner who had referred the patient to Hamilton, leading to a report being filed against Hamilton with the Board of Licensure in Medicine. The Board, in response, opened a complaint proceeding and demanded that Hamilton undergo a neuropsychological evaluation.Hamilton challenged the Board's order in the Superior Court, arguing that the Board had overstepped its authority and violated his rights to due process and free speech. However, the Superior Court denied his petition and ruled in favor of the Board. Shortly before this decision, Hamilton's medical license in Maine expired and he did not renew it.The Maine Supreme Judicial Court dismissed Hamilton's appeal as nonjusticiable, stating that there had been no final agency action and that the challenged order was moot because Hamilton had allowed his medical license to lapse. The court also noted that Hamilton's challenge to the order directing the evaluation was fully reviewable at the conclusion of the complaint proceedings, making his petition premature. Furthermore, since Hamilton was no longer licensed in Maine, the Board no longer had authority to pursue his evaluation. The court vacated the judgment and remanded the case to the Superior Court for dismissal of the petition for judicial review as nonjusticiable. View "Hamilton v. Board of Licensure in Medicine" on Justia Law

Seth Lookhart, a dentist, was convicted of numerous crimes related to a fraudulent scheme that endangered his patients' health and safety. The scheme involved unnecessary sedation of patients to fraudulently bill Alaska’s Medicaid program, overcharging it by more than $1.6 million. Lookhart also stole $412,500 from a business partner. His reckless sedation practices nearly resulted in the loss of two patients' lives. He was arrested in April 2017 and convicted on 46 charges in January 2020, leading to a sentence of 20 years in prison with eight years suspended.Following Lookhart's convictions, the Division of Corporations, Business and Professional Licensing sought to revoke his dental license. Lookhart agreed to the facts of the accusation but argued that revocation was not an appropriate sanction. The administrative law judge (ALJ) disagreed, stating that Lookhart's misconduct was more severe than any prior case and that revocation was the clear and obvious sanction. The Board of Dental Examiners adopted the ALJ's decision.Lookhart appealed to the superior court, arguing that the Board's decision was inconsistent with its prior decisions. The court disagreed, stating that the Board had wide discretion to determine appropriate sanctions and that no prior case was comparable to Lookhart's. The court affirmed the Board's decision. Lookhart then appealed to the Supreme Court of the State of Alaska.The Supreme Court affirmed the lower court's decision. It held that the Board of Dental Examiners did not abuse its discretion by revoking Lookhart's license. The court found that none of the Board's prior licensing cases involved misconduct of the scope and severity in this case, so there was no applicable precedent to limit the Board's exercise of its discretion. View "Lookhart v. State of Alaska, Board of Dental Examiners" on Justia Law

Michele Rawlins, a former school principal and member of the Teachers' Retirement System of the City of New York (TRS), was diagnosed with post-traumatic stress disorder (PTSD) following a series of incidents involving a disgruntled food-service worker. The worker's behavior left Rawlins feeling threatened and harassed, leading to her inability to perform her job responsibilities. The final incident occurred in April 2019, when the worker, who had been transferred to another location, entered the school and demanded to speak with Rawlins, insisting she had his "belt and wallet." Rawlins interpreted the worker's remarks as having "sexual overtones" and felt she was being stalked. She left the school building and never returned to work following the incident.Rawlins applied for accidental disability retirement benefits (ADR) from the TRS, but her application was denied. The TRS Medical Board determined that she did not sustain an accident in the work setting and that "purposeful conduct by coworkers giving rise to a disabling injury is not an accident within the meaning of the pension statute." Rawlins reapplied for ADR, but the Board maintained its previous determination. Rawlins then commenced a CPLR article 78 proceeding to annul the Board's determination. The Supreme Court denied the petition and dismissed the proceeding, stating that the Board's determination had a rational basis. The Appellate Division affirmed the Supreme Court's decision, and Rawlins was granted leave to appeal.The Court of Appeals affirmed the lower courts' decisions. The court held that substantial evidence supported the Board's determination that Rawlins' injury was not caused by an "accident" within the meaning of the statutory scheme. The court declined to adopt a rule that "purposeful conduct by coworkers" can never be the basis for an award of ADR. Instead, the court stated that when a member's disability is alleged to have resulted from the intentional acts of any third party, the relevant question continues to be whether the injury-causing event was sudden, unexpected, and outside the risks inherent in the work performed. View "Matter of Rawlins v Teachers' Retirement Sys. of the City of N.Y." on Justia Law

An inmate, Timothy Finley, who suffers from severe psychiatric disorders, was placed in a heavily restrictive cell in administrative segregation for approximately three months by prison officials. Finley brought a case against the deputy wardens, Erica Huss and Sarah Schroeder, alleging violations of the Eighth Amendment and his right to procedural due process, as well as disability-discrimination claims under the Americans with Disabilities Act and the Rehabilitation Act.The district court granted summary judgment to Huss and Schroeder on all claims. On appeal, the United States Court of Appeals for the Sixth Circuit affirmed the lower court's decision on Finley’s procedural due process and statutory discrimination claims. However, the court reversed the lower court's decision on Finley’s Eighth Amendment claim, finding that he presented sufficient evidence to find that the deputy wardens violated his clearly established rights. The court remanded the case for further proceedings on the Eighth Amendment claim. View "Finley v. Huss" on Justia Law

The case involves the West Virginia Department of Health, Office of the Chief Medical Examiner, and Dr. Allen R. Mock (collectively "Petitioners") and Dr. Patsy Cipoletti, Jr., administrator of the estate of his deceased wife, June Cipoletti ("Respondent"). The Respondent filed a complaint against the Petitioners, alleging that they violated the West Virginia Medical Professional Liability Act (MPLA) by negligently determining Mrs. Cipoletti’s cause of death. The Petitioners filed a motion to dismiss, arguing that the Respondent had not asserted a proper cause of action under the MPLA. The circuit court denied the motion to dismiss, determining that the MPLA applied and that Petitioners were not entitled to qualified immunity.The Circuit Court of Kanawha County denied the Petitioners' motion to dismiss. The court determined that the MPLA applied and that Petitioners were not entitled to qualified immunity. The court found that Dr. Mock’s conduct fell under and was governed by the MPLA, thus depriving Petitioners of qualified immunity.The Supreme Court of Appeals of West Virginia reversed the circuit court's decision. The court found that the Petitioners' actions were discretionary and not in violation of any "clearly established statutory or constitutional rights or laws" and were not "otherwise fraudulent, malicious, or oppressive." Therefore, the court concluded that the Petitioners were entitled to qualified immunity from the lawsuit. The court also found that the Respondent had failed to plead a viable MPLA cause of action against the Petitioners. The court remanded the case to the circuit court with directions to grant the Petitioners' motion to dismiss. View "West Virginia Department of Health v. Cipoletti" on Justia Law

The case involves Novartis Pharmaceuticals Corporation and United Therapeutics Corporation, both drug manufacturers, and the Health Resources and Service Administration (HRSA). The dispute centers around Section 340B of the Public Health Service Act, which mandates drug manufacturers to sell certain drugs at discounted prices to select healthcare providers. These providers often contract with outside pharmacies for distribution. The manufacturers argued that these partnerships have left the Section 340B program vulnerable to abuse, leading them to impose their own contractual terms on providers, such as limits on the number of pharmacies to which they will make shipments. The government contended that these restrictions violate the statute.The case was initially heard in the United States District Court for the District of Columbia. The district court ruled that Section 340B does not prohibit manufacturers from limiting the distribution of discounted drugs by contract.The case was then reviewed by the United States Court of Appeals for the District of Columbia Circuit. The court agreed with the district court's ruling, stating that Section 340B does not categorically prohibit manufacturers from imposing conditions on the distribution of covered drugs to covered entities. The court further held that the conditions at issue in this case do not violate Section 340B on their face. The court did not rule out the possibility that other, more onerous conditions might violate the statute or that these conditions may violate Section 340B as applied in particular circumstances. The court affirmed the district court's decision to set aside the enforcement letters under review, while reserving the possibility of future enforcement under theories of liability narrower than the one pressed here. View "Novartis Pharmaceuticals Corporation v. Johnson" on Justia Law

The case involves D.K., a patient diagnosed with an unspecified schizophrenia spectrum and other psychotic disorders, who was found incompetent to stand trial and committed to the Department of State Hospitals (DSH) by the Orange County Superior Court. After D.K.'s transfer to Napa State Hospital, DSH filed a petition for an interim order to compel involuntary medication of D.K. with antipsychotic medication. An administrative law judge (ALJ) conducted an evidentiary hearing and ordered D.K. involuntarily medicated from January 17, 2023, to February 7, 2023. D.K. filed a petition for a writ of administrative mandate with the Napa County Superior Court, challenging the medication order. The superior court denied her petition, concluding D.K. was not entitled to writ review.The Court of Appeal of the State of California First Appellate District Division Three found that D.K.'s appeal was moot because the order had expired and no meaningful relief could be effectuated through review of that order. However, the court exercised its discretion to address D.K.'s appeal of the superior court's finding that the statutory scheme of section 1370 precluded her from filing a writ of administrative mandamus to challenge the medication order. The court concluded that both the significant liberty interests at issue and the language of section 1370 support D.K.'s right to seek writ review. The court reversed the superior court's holding that D.K. was not entitled to writ review. However, it dismissed as moot D.K.'s challenge to the court's finding that substantial evidence supported the involuntary medication order, so it did not remand the case for further proceedings. View "D.K. v. Office of Admin. Hearings" on Justia Law

The case involves the family of Todd Kerchen, who died from a lethal dose of fentanyl. The family filed a complaint against the University of Michigan and Dr. James Woods, alleging violations under 42 U.S.C. § 1983 and Michigan state law. The family claimed that the fentanyl that killed Todd originated from a University of Michigan pharmacology lab where Christian Raphalides, the person who allegedly provided the drug to Todd, worked. The lab was overseen by Dr. Woods. The family argued that the lab's lax policies surrounding the use of controlled substances led to Todd's death.The district court denied the defendants' motion to dismiss and ordered limited discovery on whether the action was barred by the statutes of limitations applicable to the plaintiffs' claims. The defendants appealed this decision.The United States Court of Appeals for the Sixth Circuit reversed the district court's decision. The court found that the University of Michigan and Dr. Woods in his official capacity were entitled to sovereign immunity, barring all claims against them. The court also found that Dr. Woods in his individual capacity was entitled to qualified immunity, barring the § 1983 claim against him. Furthermore, the court found that the wrongful death claim against Dr. Woods in his individual capacity should be dismissed as it was barred by governmental immunity. The court dismissed the remainder of the defendants' appeal for lack of jurisdiction. View "Kerchen v. University of Michigan" on Justia Law

A Mexican national, J.R., who worked seasonally in Sully County, South Dakota, required emergency medical treatment for appendicitis. He was taken to Avera St. Mary’s Hospital in Hughes County, where he received treatment and incurred medical bills totaling over $75,000. J.R. had no health insurance, few assets, and returned to Mexico without paying the bills. Avera sought reimbursement from Sully County under county poor-relief statutes.The Sully County Board of Commissioners denied Avera's application for reimbursement, citing J.R.'s status as a nonresident of Sully County. Avera appealed this decision to the circuit court, which remanded the case back to the Commission for a more detailed factual record. After a hearing, the Commission again denied Avera's claim, determining that J.R. was indigent by design and was not in distress in Sully County at the time the county was notified. Avera appealed this decision to the circuit court, which affirmed the Commission's decision.The Supreme Court of the State of South Dakota affirmed the lower court's decision. The court found that the county's obligation to support poor persons is statutory, not common law. The court interpreted the poor-relief statutes to require every county to support all poor and indigent persons who have established residency therein. However, the parties agreed that J.R. was not a resident of Sully County. The court found that the county had no statutory obligation to reimburse Avera for J.R.'s emergency medical services, as he was a nonresident indigent who had left Sully County before the Commission learned he was in distress. The court concluded that in these circumstances, where temporary relief had already been administered to the nonresident indigent by a third party in another county, Sully County had no statutory obligation to reimburse Avera for J.R.'s emergency medical services. View "Avera St. Mary’s Hospital V. Sully County" on Justia Law

The case involves Asif Sayeed and three associated healthcare companies who were found liable for violating the Anti-Kickback Statute and False Claims Act, resulting in a nearly $6 million judgment. Sayeed owned a healthcare management company, Management Principles, Inc. (MPI), which managed two smaller companies that provided home-based medical services to Medicare recipients in Illinois. Sayeed's companies received a significant amount of their business from the Healthcare Consortium of Illinois. In December 2010, Sayeed devised a scheme to bypass the Consortium’s referral process by directly soliciting its clients for additional services. MPI signed a Management Services Agreement with the Consortium, which gave MPI full access to its clients’ healthcare data. MPI used this information to identify and directly solicit Medicare-eligible seniors who might want or need additional healthcare services.The district court held a bench trial in July 2019 and found that Sayeed and his companies had not violated the Anti-Kickback Statute or False Claims Act because they had paid the Consortium with the intent to obtain information, not patient referrals. The plaintiff appealed, and the court of appeals reversed the decision, concluding that the defendants' conduct qualified as a form of indirect referral giving rise to an unlawful kickback scheme.On remand, the district court found the defendants liable under both the Anti-Kickback Statute and False Claims Act. The court imposed $5,940,972.16 in damages, which it calculated by trebling the value of the Medicare claims it deemed false and then adding a per-claim penalty of $5,500. The defendants appealed, challenging both the damages award and the underlying finding of liability. The United States Court of Appeals for the Seventh Circuit affirmed the judgment of liability but reversed in part to permit the district court to clarify which Medicare claims, all or some, resulted from the defendants’ illegal kickback scheme. View "Stop Illinois Health Care Fraud, LLC v. Sayeed" on Justia Law