Justia Government & Administrative Law Opinion Summaries

"The facts as alleged in the complaint and in plaintiff’s declaration in opposition to the motion to strike are not at all clear." Plaintiff Un Hui Nam, a new medical resident in the anesthesiology department at UC Davis Medical Center, "got off to a rocky start" in July of 2009. The Court of Appeal surmised that there appeared to have been some tension and misunderstandings right from the beginning of plaintiff's residency. What occurred thereafter and why was the subject of the underlying lawsuit and appeal. Plaintiff labeled the hospital's actions as "retaliation" when she questioned whether residents were allowed to intubate patients. She expressed her disagreement with any policy that would compel the residents in an emergency to wait for the on-call team rather than independently intubating a patient. The week prior to this email, she had received excellent performance evaluations. Plaintiff copied all of the residents in her email. Some of these residents thereafter informed her that she should expect retaliation for sending it. Defendant, however, insisted the e-mail excited no such reaction. Defendant’s version of plaintiff's residency file consisted of a series of complaints, warnings, investigations, and leaves of absence necessitated by plaintiff’s "shortcomings" over a three-year period and culminating in her ultimate termination. The record contained both complaints and testimonials about plaintiff’s performance. Apparently she had a particularly good rapport with nurses. Defendant built a paper trail of warnings for unprofessional conduct and an inability to get along with other doctors. But many of defendant’s allegations were not substantiated during the internal investigations that ensued, and the anesthesiology department was criticized repeatedly for what it did, and did not do, to teach plaintiff the clinical and interpersonal skills needed to succeed in the program. Plaintiff requested, without success, a formal hearing to contest the termination. In January 2013 she filed her complaint for retaliation, discrimination, sexual harassment, wrongful termination, violations of the Business and Professions Code, and breach of contract. Defendant filed a motion to strike pursuant to section 425.16 of the Code of Civil Procedure, alleging that plaintiff’s complaint constituted a SLAPP (strategic lawsuit against public participation) and arose from written complaints made in connection with an official proceeding. Defendant argued that the investigations and corrective action were protected conduct. The trial court disagreed and denied the motion. The trial court's denial of defendant's motion to strike was affirmed: "It is hard to imagine that a resident’s complaint alleging retaliatory conduct was designed to, or could, stifle the University from investigating and disciplining doctors who endanger public health and safety. The underlying lawsuit may or may not have merit that can be tested by summary judgment, but it is quite a stretch to consider it a SLAPP merely because a public university commences an investigation." View "Nam v. Regents of UC" on Justia Law

In a 2007 ruling, the Alaska Supreme Court recognized that the State had "compelling interests" in aiding parents to help their minor children make informed and mature pregnancy-related decisions, and at that time, the Court indicated that a parental notification law might be implemented without unduly interfering with minors’ fundamental privacy rights. The 2010 voter-enacted Parental Notification Law revived an exception in the existing medical emancipation statute, creating considerable tension between a minor’s fundamental privacy right to reproductive choice and how the State could advance its compelling interests. By this 2016 opinion, the Alaska Court concluded that the Notification Law violated the Alaska Constitution’s equal protection guarantee and could not be enforced. "But the decision we reach today is narrow in light of the limited State interests offered to justify the Notification Law. The State expressly disclaims any interest in how a minor exercises her fundamental privacy right of reproductive choice, and it does not suggest that it has an interest in limiting abortions generally or with respect to minors specifically. And as a court we are not concerned with whether abortion is right, wrong, moral, or immoral, or with whether abortions should be available to minors without restriction. We are concerned only with whether, given its stated underlying justifications, the current Notification Law complies with the Alaska Constitution’s equal protection guarantee — and it does not." View "Planned Parenthood of the Great Northwest v. Alaska" on Justia Law

In 2013, the State Board of Nursing invoked N.J.A.C. 13:37-1.3(c)(2) to deny accreditation to the Licensed Practical Nurse to Registered Nurse Bridge Program (Bridge Program), a nursing program instituted by Eastwick College (Eastwick). Interpreting the term graduating class in N.J.A.C. 13:37-1.3(c)(2) to include all graduates of the program who took the licensing examination during a given calendar year, regardless of the year a particular student graduated from the program, the Board found that Eastwick's Bridge Program's first and second graduating classes failed to achieve the 75% pass rate mandated by the regulation. Eastwick appealed the Board's determination, challenging the methodology used by the Board to calculate the pass rate of the Bridge Program's graduates on the licensing examination. Eastwick contended that only students who graduated during a specific calendar year and took the licensing examination in that year should be included in that year's graduating class. Using that methodology, Eastwick argued that its second graduating class had a pass rate in excess of 75%, and that the Board improperly declined to accredit its nursing program. An Appellate Division panel affirmed the Board's determination denying accreditation. Based on the plain language of N.J.A.C. 13:37-1.3(c)(2), the New Jersey Supreme Court concluded that the Board's construction of its regulation was plainly unreasonable, and accordingly held that the Board improperly denied accreditation to Eastwick's Bridge Program. The Court therefore reversed the Appellate Division's judgment affirming the Board's action, and remanded this matter for further proceedings. View "In the Matter of the Revocation or the Suspension of the Provisional Accreditation of and/or the Imposition of Probation on Eastwick College LPN-to-RN Bridge Program" on Justia Law

The Public Health Service Act (PHSA), 42 U.S.C. 201, establishes coverage requirements for all health insurance plans except those it deems “excepted benefits.” The Patient Protection and Affordable Care Act (ACA), 26 U.S.C. 5000A(a), updated the PHSA’s coverage requirements and mandated that all applicable individuals maintain “minimum essential coverage.” The ACA left intact and incorporated the PHSA’s rules regarding excepted benefits. In May 2014, HHS announced its plan “to amend the criteria for fixed indemnity insurance to be treated as an excepted benefit” in the individual health insurance market. On top of the requirements codified in the PHSA, HHS added another. To be an “excepted benefit,” the plan may be “provided only to individuals who have . . . minimum essential coverage.” Several providers challenged the rule as an impermissible interpretation of the PHSA, and after a hearing, the district court permanently enjoined HHS’s enforcement of the rule under Chevron Step One. The court affirmed the district court's permanent injunction because HHS lacked authority to demand more of fixed indemnity providers than Congress required. View "Central United Life Ins. v. Burwell" on Justia Law

West Virginia filed suit challenging the President’s determination not to enforce certain controversial provisions of the Affordable Care Act, 42 U.S.C. 300gg-22(a)(1), for a transitional period. That decision, implemented by a letter from the Secretary of the Department of Health and Human Services, left the responsibility to enforce or not to enforce these provisions to the States, and West Virginia objects to being put in that position. The district court concluded that West Virginia lacked standing. The court agreed, rejecting the State's claim that requiring the States to assume the political responsibility of deciding whether or not to implement a federal statute supposedly creates an injury-in-fact. The court concluded that there is simply no support for this extraordinary claim. The court stated that the State's injury is nothing more than the political discomfort in having the responsibility to determine whether to enforce or not – and thereby annoying some West Virginia citizens whatever way it decides. And no court has ever recognized political discomfort as an injury-in-fact. Even assuming that the administration’s action created a theoretical breach of State sovereignty, West Virginia nevertheless lacks a concrete injury-in-fact. Finally, the court rejected West Virginia's argument that any party, whether or not a governmental entity, has standing to challenge a delegation from the government to carry out a governmental responsibility. Accordingly, the court affirmed the judgment. View "State of West Virginia v. HHS" on Justia Law

S.H. appealed a court order committing her to the Montana State Hospital. In late 2014, S.H. sought help from the emergency department at the Billings Clinic. S.H. complained she was suffering from food poisoning, that there were snakes in her stomach, black bugs in the toilet, and the voices of God and Satan were arguing in her head. A psychiatrist at the Clinic examined S.H. and, upon his recommendation, the State filed a petition to involuntarily commit S.H. on November 12, 2014. The petition notified S.H. of her rights—including her “right to refuse any but lifesaving medication for up to 24 hours prior to any hearing held pursuant to [§ 53-21-115(11), MCA].” The District Court ordered S.H. detained at the Billings Clinic pending resolution of the petition. The District Court then appointed counsel to represent S.H., held an initial hearing, and ordered an evaluation. At the conclusion of the hearing, the District Court found that the State proved to a reasonable medical certainty that S.H. suffers from the mental disorder of bipolar disorder and that S.H. “is in a manic state, delusional, agitated and paranoid.” S.H. challenged the evidence presented against her as insufficient to support the order committing her to hospital care. The Supreme Court reviewed the District Court record, found sufficient evidence, and affirmed the District Court's decision. View "Matter of S.H." on Justia Law

Caring Hearts Personal Home Services, Inc. provided physical therapy and skilled nursing services to “homebound” Medicare patients. It sought reimbursement from Medicare for services provided. The definition of who qualified as "homebound" or what services qualified as "reasonable and necessary" was unclear, even to the Centers for Medicare & Medicaid Services (CMS). CMS has developed its own rules on both subjects that had been repeatedly revised and expanded over time. In an audit, CMS purported to find that Caring Hearts provided services to at least a handful of patients who didn’t qualify as “homebound” or for whom the services rendered weren’t “reasonable and necessary.” As a result, CMS ordered Caring Hearts to repay the government over $800,000. It was later found that in reaching its conclusions CMS applied the wrong law: the agency did not apply the regulations in force in 2008 when Caring Hearts provided the services in dispute. Instead, it applied considerably more onerous regulations the agency adopted years later, "[r]egulations that Caring Hearts couldn’t have known about at the time it provided its services." The Tenth Circuit found that Caring Hearts "[made] out a pretty good case that its services were entirely consistent with the law as it was at the time they were rendered" when CMS denied Caring Hearts' request for reconsideration. The Tenth Circuit reversed the district court's judgment affirming CMS' denial to Caring Hearts for reimbursement, and remanded for further proceedings. View "Caring Hearts v. Burwell" on Justia Law

A class of Tennessee residents who applied for Medicaid sought declaratory and injunctive relief, alleging that the delays they have experienced in receiving eligibility determinations on their applications violate 42 U.S.C. 1396a(a)(8) of the Medicaid statute, and that the state’s failure to provide a fair hearing on their delayed applications violates that statute and the Due Process Clause. Regulations implementing the statute provide that “the determination of eligibility for any applicant may not exceed” 90 days for those “who apply for Medicaid on the basis of disability” and 45 days for all other applicants. The district court certified a class and granted a preliminary injunction, which requires the state to grant a fair hearing on delayed applications to class members who request one. The Sixth Circuit affirmed the preliminary injunction, holding that the matter is not moot and that the federal government is not a required party. The court noted that the federal government submitted an amicus brief, supporting plaintiffs’ position. Despite the passage of the Affordable Care Act, states remain ultimately responsible for ensuring their Medicaid programs comply with federal law. View "Wilson v.Gordon" on Justia Law

The Texas Optometry Act prohibits commercial retailers of ophthalmic goods from attempting to control the practice of optometry; authorizes the Optometry Board and the Attorney General to sue a violator for a civil penalty; and provides that “[a] person injured as a result of a violation . . . is entitled to the remedies. In 1992, Wal-Mart opened “Vision Centers” in its Texas retail stores, selling ophthalmic goods. Wal-Mart leased office space to optometrists. A typical lease required the optometrist to keep the office open at least 45 hours per week or pay liquidated damages. In 1995, the Board advised Wal-Mart that the requirement violated the Act. Wal-Mart dropped the requirement and changed its lease form, allowing the optometrist to insert hours of operation. In 1998, the Board opined that any commercial lease referencing an optometrist’s hours violated the Act; in 2003, the Board notified Wal-Mart that it violated the Act by informing optometrists that customers were requesting longer hours. Optometrists sued, alleging that during lease negotiations, Wal-Mart indicated what hours they should include in the lease and that they were pressured to work longer hours. They did not claim actual harm. A jury awarded civil penalties and attorney fees. The Fifth Circuit certified the question of whether such civil penalties, when sought by a private person, are exemplary damages limited by the Texas Civil Practice and Remedies Code Chapter 41. The Texas Supreme Court responded in the affirmative, noting that “the certified questions assume, perhaps incorrectly, that the Act authorizes recovery of civil penalties by a private person, rather than only by the Board or the Attorney General.” View "Wal-Mart Stores, Inc. v. Forte" on Justia Law

This appeal arose out of a 42 U.S.C. 1983 action filed against DSHS by plaintiff. At issue is whether the Due Process Clause compels the state to perform a competency evaluation of pretrial detainees within seven days of a court order requiring evaluation. The district court addressed both initial competency evaluations and the mental health restoration services that follow a determination of incompetency to stand trial and concluded that the Due Process Clause of the Fourteenth Amendment requires that services for both categories must be provided within seven days of a court order, absent an individualized determination of clinical good cause. The district court entered a permanent injunction to this effect, although Washington appeals only that portion related to initial competency evaluations. The court agreed with the district court that DSHS must conduct competency evaluations within a reasonable time following a court’s order. The district court’s seven-day mandate, however, imposes a temporal obligation beyond what the Constitution requires. Therefore, the court vacated the injunction with respect to the seven-day requirement for in-jail competency evaluations and remanded to the district court to amend the injunction. View "Trueblood V. WSDSHS" on Justia Law