Justia Government & Administrative Law Opinion Summaries

Plaintiff, the Chapter 7 trustee for the bankruptcy estate of BioniCare Medical Technologies, contested determinations of the Medicare Appeals Council (MAC) refusing to provide coverage for the BIO-1000, a device to treat osteoarthritis of the knee. Plaintiff alleged that the Secretary improperly used the adjudicative process to create a policy of denying coverage for the BIO-1000, that the MAC's decisions were not supported by substantial evidence, and that the MAC's decisions were arbitrary and capricious on account of a variety of procedural errors. The court rejected those contentions and affirmed the judgment of the district court.

Plaintiff appealed the district court's dismissal of claims he brought against Board Members, in their individual capacities, under 42 U.S.C. 1983. Plaintiff alleged that the Board Members deprived him of his constitutional rights when, in an ex parte emergency proceeding, they summarily suspended his authority to prescribe medication. The court held that the Board Members were absolutely immune from plaintiff's claims for money damages where they were functionally comparable to judges and their summary suspension authority was comparable to a judicial act. The court also held that Younger abstention barred plaintiff's claims for equitable relief. Accordingly, the court affirmed the judgment.

Petitioners provide protection and advocacy services to individuals with developmental disabilities. After receiving a complaint regarding the discharge practices of respondent, petitioners requested access to the clinical records of all individuals residing at two respondent facilities to investigate whether they were being denied the opportunity to live in less restrictive settings. Relying on Mental Hygiene Law 45.09(b) and 33.13(c)(4), petitioners asserted that they were entitled to unrestricted access to the clinical records. Answering a certified question, the court concluded that section 45.09(b) and section 33.13(c)(4) must be read in accord with federal law and that actively-involved family members could possess sufficient decision-making authority to qualify as legal representatives under the pertinent regime. Accordingly, the order of the Appellate Division should be modified, without costs, and the case remitted to Supreme Court for further proceedings in accordance with the opinion and, as so modified, affirmed.

St. John's Mercy Health System challenged the validity of the Missouri Health Facilities Review Committee (MHFRC) rule that exempted new hospitals costing less than $1 million from the statutory requirement of obtaining a certificate of need. St. John's further sought to enjoin the MHFRC from applying the rule and granting Patients First Community Hospital an exemption from the certificate of need requirement. The trial court held that the case was not justiciable and dismissed the action without prejudice but proceeded to address the merits of St. John's claim, finding that the MHFRC had not exceeded its authority in promulgating the rule. The Supreme Court affirmed the judgment as modified, holding (1) the case was ripe for judicial review; and (2) the new hospital rule was valid, and the MHFRC was within its authority to promulgate the rule.

Plaintiff, a physician, sought compensation under the National Childhood Vaccine Injury Act of 1986, 42 U.S.C. 300aa-1 to -34, alleging that Hepatitis B vaccination caused her multiple sclerosis. The Special Master dismissed her petition as untimely. The Court of Federal Claims affirmed. The Federal Circuit held that, contrary to precedent, the Act's statute of limitations is not jurisdictional, and that some claims brought under the Act are subject to equitable tolling. The court rejected a discovery rule and concluded that plaintiff's claim did not meet equitable tolling criteria. The Sixth Circuit subsequently remanded for a determination of whether plaintiff should be awarded reason-able attorneys’ fees and costs. Although she did not ultimately prevail on the merits, her appeal prompted a change of law in a limited way that potentially opens the door to certain Vaccine Act petitioners who otherwise would have been precluded from seeking redress.

The Board appealed from a Superior Court decision reversing the Board's decision to suspend the nursing licenses of appellee. The Board suspended appellee's licenses for two years based upon a finding that she failed to report child sexual abuse as required by state statute. The Board contended that it did not err in finding that appellee committed the violations at issue and the Board submitted that its decision finding a violation of the applicable provisions was supported by substantial evidence. Appellee argued that the Board's appeal was barred by a conflict of interest. The court concluded that the Board's contentions were without merit. Therefore, the judgment of the Superior Court must be affirmed and the court need not reach the conflict of interest issue.

This appeal arose from the district court's order granting final judgment to the United States upon equitable claims of payment by mistake of fact and unjust enrichment against Tuomey arising out of alleged violations of the Social Security Act, 42 U.S.C. 1395nn, (the Stark Law), and awarding damages plus pre- and post-judgment interest. Because the court concluded that the district court's judgment violated Tuomey's Seventh Amendment right to a jury trial, the court vacated the judgment and remanded for further proceedings. Because the court was remanding the case, the court also addressed other issues raised on appeal that were likely to recur upon retrial.

Employers must maintain a log of work-related deaths, injuries, and illnesses, 29 C.F.R. 1904.4(a); an incident is "work-related" if "the work environment either caused or contributed to the resulting condition." Employees in the company's packing department fill containers, a process requiring repetitive hand movements, and pronation. When an employee developed lateral epicondylitis, painful swelling of ligaments and tendons around a joint, in her right arm, the company did not log the injury. The Department of Labor assessed a $900 penalty for failing to log a work-related injury. An ALJ sustained the penalty. The Occupational Safety and Health Review Commission declined review. The Seventh Circuit vacated, holding that substantial evidence was not enough to sustain the administrative decision. The ALJ was required to take account of competing evidence and inferences; the ALJ ignored strong indications that its favored witness was wrong. The court noted that inclusion of the work-relatedness requirement, requiring employers to judge the source of injury, "is a puzzle."

Alabama sued CMS claiming that it violated the federal Administrative Procedures Act (APA), 5 U.S.C. 500-596, 701-706, by issuing - without notice and an opportunity for public comment - an October 28, 2008 letter to state health officials (SHO letter). The district court held that the SHO letter constituted a substantive administrative rule issued without the notice-and-comment procedures mandated by the APA. Because the district court did not abuse its discretion in denying injunctive relief in addition to vacating the SHO letter, and because Alabama's remaining claims were unripe, the district court's judgment was affirmed.

Dayton was served with a citation alleging over 100 willful violations of the Occupational Safety and Health Act, 29 U.S.C. 654. Dayton contested the citation and by 1997, its appeal was before the Occupational Safety and Health Review Commission. Twelve years later, the Commission issued an order affirming nearly all of the violations and assessed a penalty. Dayton asked the court to set aside the order because of the Commission's delay. The court declined, holding that the delay alone was not enough to set aside the order. The court held, however, that the Commission lacked substantial supporting evidence for its finding that Dayton's violations were willful. Accordingly, the court vacated that portion of the Commission's order and remanded for the Commission to reassess the nature of Dayton's violations and recalculate the appropriate penalty. The court affirmed the Commission's order in all other respects.