Justia Government & Administrative Law Opinion Summaries

The Clinics filed suit challenging California Welfare and Institutions Code 14131.10, which eliminated certain Medi-Cal benefits that the state deemed optional, including adult dental, podiatry, optometry, and chiropractic services. The court reversed the district court's holding that the Clinics have a private right of action to challenge the Department's implementation of the state plan amendments (SPA) prior to obtaining approval; affirmed that the Clinics have a private right of action to bring a claim pursuant to 42 U.S.C. 1983 challenging the validity of section 14131.10; and reversed the district court's interpretation of the Medicaid Act, 42 U.S.C. 1396 et seq., holding that section 14131.10 impermissibly eliminated mandatory services from coverage. View "California Ass'n of Rural Health Clinics v. Douglas" on Justia Law

In the 1980s, the owners bought the Cottonwood seasonal campground in Cedar Grove, Indiana. Each of 50-80 campsites has a water spigot and sewer hookup for recreational vehicles. The property also has two restrooms with working toilets, sinks, and showers. In 1998, the Environmental Protection Agency (EPA) issued an Administrative Order under the Safe Drinking Water Act, 42 U.S.C. 300g-3(b), (g), finding that Cottonwood operated as a public water system and was required to sample its water system, and to notify any individuals who use the property of its past failure to monitor the water system. The owners tested the water only sporadically over the following years. They denied that the water system constituted a public water system under SDWA because the water spigots are marked as “Non-Potable,” so users would know that water is not provided for human consumption. The district court entered summary judgment, finding violation of SDWA. The Seventh Circuit dismissed an appeal, finding that the owners had not raised any of their appellate arguments in the district court. View "United States v. Ritz" on Justia Law

Plaintiffs, several nursing homes approved by the Iowa Department of Human Services (DHS) as Medicaid providers, submitted annual reports disclosing their income and expenses to DHS. DHS used the reports to calculate the Medicaid per diem reimbursement rates for the nursing homes. Some of the facilities' expenses were disallowed by DHS, and DHS reduced reimbursement rates accordingly. The facilities appealed the adjustments. The director of human services upheld the action. The district court affirmed. The court of appeals reversed, concluding that the DHS rules did not support its decision that the disputed costs were not allowable. The Supreme Court affirmed, holding that DHS's exclusion of the facilities' lab, x-ray, and prescription drug costs from the nursing homes' reports was based on an incorrect interpretation of its rules. View "Sunrise Ret. Cmty. v. Iowa Dep't of Human Servs." on Justia Law

The State Health Planning & Development Agency (SHPDA) granted Rainbow Dialysis (Rainbow) a conditional certificate of need to establish two dialysis facilities in Maui. Liberty Dialysis-Hawaii (Liberty), another Maui dialysis provider, sought reconsideration of SHPDA's decision. A five-member reconsideration committee unanimously approved Rainbow's certificate of need. Liberty appealed, arguing that the SHPDA administrator and another committee member should have been disqualified from participating in the reconsideration decision. The circuit court affirmed, holding that the SHPDA administrator should have been disqualified but his participation was harmless. The Supreme Court affirmed, holding that neither the administrator nor the other committee member was disqualified from participating in the reconsideration decision. View "Liberty Dialysis-Hawaii, LLC v. Rainbow Dialysis, LLC" on Justia Law

Millard petitioned for review of the Commission's affirmance of citations issued to Millard for committing violations of emergency response, training, record-keeping, and other requirements after more than 30,000 pounds of anhydrous ammonia escaped from one of Millard's refrigerated storage facilities. The court concluded that Millard's challenges to the two process safety management violations, Millard's contention that OSHA was estopped from asserting that the company violated agency regulations, and Millard's ten remaining challenges either lacked merit or merited neither reversal nor further discussion. Accordingly, the court denied the petition for review. View "Millard Refrigerated Services v. Secretary of Labor" on Justia Law

The Iowa Board of Nursing and Iowa Department of Public Health (collectively, Defendants) enacted rules allowing advanced registered nurse practitioners (ARNPs) to supervise radiologic technologists using fluoroscopy machines. Several physician associates brought this action against Defendants to invalidate the rules. Two nursing associations intervened to defend the rules. The district court invalidated the rules, concluding that Defendants exceeded their authority in promulgating the rules. The Supreme Court reversed, holding (1) the Board's application of law to fact was not irrational, illogical, or wholly unjustifiable; (2) the rules fell within the authority of the Board and Department; and (3) the other challenges to the rules failed. Remanded. View "Iowa Med. Soc'y v. Iowa Bd. of Nursing" on Justia Law

Plaintiffs appealed the Secretary's denial of their claims for Medicare coverage for dental services. Plaintiffs contended that this denial was premised on the Secretary's unreasonable interpretation of the Medicare Act, Pub. L. No. 89-97, 79 Stat. 286, which contravened the intent of Congress and violated plaintiffs' right to equal protection under the Fifth Amendment. The court concluded that, although the statutory provision for exclusion of dental services was ambiguous in the sense that plausible divergent constructions could be urged, the Secretary's interpretation of the statute was reasonable. The court also concluded that the Secretary's statutory interpretation warranted Chevron deference and the Secretary's statutory interpretation was reasonable. Accordingly, the court affirmed the judgment. View "Fournier v. Sebelius" on Justia Law

Appellant in this case was a nine-year-old boy with severe autism, epilepsy, and chronic seizures. The Commissioner of the Minnesota Department of Human Services (DHS) found that Appellant was not dependent in "mobility" and therefore reduced his authorized personal care assistant (PCA) services covered through the Minnesota Medical Assistance program. The district court reversed the Commissioner's decision, concluding that Minn. Stat. 256B.0659 did not require Appellant to be physically incapable of mobility to be eligible for covered services. The court of appeals reversed because Appellant was physically able to begin and complete moving from place to place without assistance. At issue was whether a person who is physically able to move without assistance but lacks the ability to direct his movement to a specific location has a dependency in mobility under the statute. The Supreme Court affirmed, holding that the Commissioner's interpretation of the statute was supported by the plain and ordinary meaning of "mobility." View "A.A.A. v. Dep't of Human Servs." on Justia Law

Elgin sought review of a final decision by DHHS upholding a ruling of an ALJ affirming a determination by the CMS that Elgin had violated certain safety requirements by serving "undercooked" eggs to its elderly residents. The court concluded it would not defer to DHHS's interpretation of the State Operations Manual (SOM); there was not substantial evidence to find that Elgin violated the SOM; and DHHS could not issue ambiguous interpretative documents and then interpret those in enforcement actions. Accordingly, the court granted the petition for review and set aside the finding of deficiency and resultant penalties. View "Elgin Nursing Center v. U.S. Dept. of Health and Human Services" on Justia Law

Child was born with birth-related neurological injuries. Child's parents (Petitioners) filed a claim for compensation under the Florida Birth-Related Neurological Injury Compensation Plan. The Florida Birth-Related Neurological Injury Compensation Association agreed to pay parental compensation of $100,000 to both parents jointly under Fla. Stat. 766.31(1)(b)(1), which provides for an award not exceeding $100,000 to the parents or legal guardians of an infant found to have sustained a birth-related neurological injury. Petitioners reserved the right to have a hearing before an ALJ to raise the issue of the interpretation and constitutionality of section 766.31(1)(b)(1). The ALJ denied Petitioners' claim for an additional $100,000 as part of the parental award, finding that the Legislature clearly intended that the maximum award of $100,000 was for both parents, not for each parent. The district court upheld the ALJ's judgment and denied each of Petitioners' constitutional claims. The Supreme Court approved the district court's decision, holding that the parental award provision (1) unambiguously provides for only a single award of $100,000; (2) does not violate equal protection; and (3) neither is void for vagueness nor unconstitutionally limits the right of access to courts. View "Samples v. Fla. Birth Related Neurological Injury Comp. Ass'n" on Justia Law