Justia Government & Administrative Law Opinion Summaries

Appellant, a medical doctor practicing medicine in Kansas and Missouri, appealed from the district court's order denying her petition to revoke an administrative subpoena issued by the Kansas Board of Healing Arts. The Supreme Court affirmed the district court's determination that Appellant was not required to exhaust administrative remedies before seeking relief from the district court under Kan. Stat. Ann. 65-2839a(b)(3)(B). On the merits of the appeal, the Court affirmed the district court's denial of Appellant's petition based on its conclusion that the Board had authority under the Kansas Healing Arts Act to investigate and subpoena Appellant, a Kansas licensee who was practicing under the Act, even though the investigation was based upon her practice of medicine in Missouri. View "Ryser v. State" on Justia Law

Infant was born with severe brain damage. Respondent, Infant's mother, on behalf of Infant, applied for and received Medicaid benefits from the West Virginia Department of Health and Human Resources (DHHR). Respondent later filed a medical malpractice lawsuit on behalf of Infant. Subsequently, Respondent petitioned the circuit court for approval of the settlement, requesting that Medicaid not be reimbursed. DHHR intervened. The court granted the motion of Respondent for allocation of the $3,600,000 settlement, holding that, pursuant to Arkansas Department of Health and Human Services v. Ahlborn, a proportional reduction of DHHR's recovery was required based on the ratio of the settlement to the "full value" of the case among the various damages categories. Using this allocation method, the court reduced DHHR's statutory reimbursement from the requested amount of $289,075 to $79,040 and directed that the net settlement proceeds be placed in a special needs trust for the benefit of Infant. The Supreme Court reversed in part and affirmed in part, holding (1) a $500,000 cap on noneconomic damages was applicable in this case; and (2) under the formula applied in Ahlborn, the DHHR was entitled to approximately $98,080, less its pro rata share of attorney's fees and costs. Remanded.

At issue in this direct appeal to the Supreme Court was a statutory prerequisite to the obligation of the Insurance Department to defend certain medical professional liability actions asserted against health care providers, and to the requirement for payment of claims asserted in such actions from the Medical Care Availability and Reduction of Error Fund. Specifically, resolution of the appeal turned on when, under the governing statute, a "claim" is "made" outside a specified four-year time period. On June 4, 2007, Joanna Ziv filed a praecipe for a writ of summons naming Appellant Phillip Yussen, M.D. and other medical providers as defendants. A complaint was filed on August 2, 2007, alleging medical negligence last occurring on July 7, 2003. Appellant’s primary insurer, Pennsylvania Healthcare Providers Insurance Exchange, requested that the claim be accorded Section 715 status by the Insurance Department. The Department denied such request, however, on the basis that the claim had been made less than four years after the alleged malpractice. Appellant initially challenged this determination in the administrative setting, and a hearing ensued. Before the examiner, Appellant argued that, consistent with the policy definition of a "claim," the date on which a claim is made for purposes of Section 715 cannot precede the date on which notice is provided to the insured. Appellee, on the other hand, contended that a claim is made when it is first asserted, instituted, or comes into existence - including upon the tender of a demand or the commencement of a legal action - and that notice to the insured or insurer is not a necessary prerequisite. In this regard, Appellee Medical Care Availability & Reduction of Error Fund highlighted that Section 715 does require "notice" of the claim to trigger the provider's obligation to report the claim to the Fund within 180 days, but the statute does not contain such an express notice component in delineating the four-year requirement. The Commonwealth Court sustained exceptions to the hearing examiner's recommendation lodged by Appellee and entered judgment in its favor. In its review, the Supreme Court found "claim" and "made" as used in Section 715 ambiguous. The Court determined that for purposes of Section 715, the mere filing of a praecipe for a writ of summons does not suffice to make a claim, at least in absence of some notice or demand communicated to those from whom damages are sought. The Court remanded the case for entry of judgment in Appellant's favor.

Decedent was treated at a non-profit clinic, by volunteer physicians. The U.S. Department of Health and Human Services deemed those physicians to be Public Health Service employees (Public Health Service Act, 42 U.S.C. 233(o)), immune from suit under the Federal Tort Claims Act, 28 U.S.C. 1346, 2671-2680. A suit against the U.S. was the exclusive remedy for alleged malpractice at the clinic. Decedent also treated at a facility where physicians did not enjoy those protections. Her estate sued the U.S., the clinic, the other facility, the doctors at that facility, and their physicians' group. The district court granted summary judgment for the clinic, predicated on immunity under the New Jersey Charitable Immunity Act (NJCIA), and ultimately dismissed. The Third Circuit affirmed, except for remanding with respect to the physicians' group. The trial court properly held that the U.S. was immune from suit under the NJCIA, which provides that a similarly-placed private employer would be entitled to the defense. The court properly held that the treatment provided constituted emergency medicine, so that N.J. Stat. 2A:53A-41 applied and one of plaintiff's experts was not qualified to testify. The court erred in not considering treatment by a physicians' assistant in considering claims against her employer, the physicians' group.

Petitioner Dewey MacKay, M.D. petitioned the Tenth Circuit to review a decision of the Deputy Administrator of the Drug Enforcement Administration (DEA) that revoked his registration to dispense controlled substances and denied all pending requests for renewal of modification. This case concerned Petitioner's prescribing behavior from 2005 to 2009 when his practice focused primarily on chronic pain management. The DEA began investigating Petitioner after receiving information from local authorities that he was issuing unlawful prescriptions for controlled substances. the Deputy Administrator of the DEA issued an order to show cause why it should not revoke Petitioner's registration, alleging that Petitioner "issued numerous purported prescriptions for controlled substances without a legitimate medical purpose outside the usual course of professional practice." The Tenth Circuit denied Petitioner's petition for review: "Petitioner never admitted any fault or taken responsibility for his misconduct. Nor [could] he point to any evidence that he reformed his habits. Instead, he continued to illegitimately dispense controlled substances even when he knew the DEA was investigating him. The Deputy Administrator’s revocation of [Petitioner's] registration is consistent with the DEA’s policy and practice of revoking registration under such circumstances."

This was an interlocutory appeal from the denial of a motion to sever and transfer venue. Plaintiffs Hattie Douglas, Kevin Hamlin, and the victimâs five siblings (collectively Plaintiffs) filed a complaint in circuit court against Sunshine Medical Clinic; Dr. Vibha Vig, in her official and personal capacities and Lisa Hoehn, nurse practitioner, in her official and personal capacities (collectively Defendants). The Plaintiffs alleged a medical-negligence and negligent-hiring cause of action against Defendants concerning the treatment and care of their minor son and brother, Kaddarius Douglas (Kaddarius) received before he died. Plaintiffs, in the same complaint, also brought claims against the Mississippi Crime Laboratory; Mississippi State Medical Examiners; Dr. Steven Hayne, in his official and personal capacities; Expertox, Inc.; and MedScreens, Inc. (Wrongful Incarceration Defendants) asserting that their acts and omissions in performing a postmortem examination and toxicological tests on Kaddarius's body, as well as in storing and handling blood and urine samples, caused the wrongful incarceration of Hattie Douglas for the murder of Kaddarius. All Defendants moved to have the trial court sever the claims and to transfer the claims against the Wrongful-Incarceration Defendants and to transfer the claims against the medical-negligence Defendants to another county court. The trial court denied the motion. All Defendants brought an interlocutory appeal to severe the two claims and transfer venue. Upon review, the Supreme Court concluded that the trial court erred in not severing and transferring the claims to their proper venues. The Court the circuit court's judgment and remanded the case for severance and transfer.

Until 2005, when the Puerto Rico Board of Medical Examiners promulgated a first-in-the-nation regulation that limited the practice of cosmetic medicine to particular classes of medical specialists, all licensed physicians in Puerto Rico could perform cosmetic surgery. The Board enforced the regulation against a physician who did not possess the required specialty board certification. The district court disposed of challenges on the ground that the defendants enjoyed various kinds of immunity and did not reach constitutional issues. The First Circuit affirmed, rejecting claims that the suspension of plaintiff's license amounted to a substantive due process violation and was retaliation for past testimony. The Board afforded due process protections in its hearing process.

A newborn suffered severe brain damage because doctors failed to promptly diagnose and treat an infection contracted at his 2003 birth. He was born prematurely and certain tests, normally done during pregnancy, were not performed by the federally-subsidized clinic where the mother received care. The clinic and its doctors are deemed federal employees under the Federally Supported Health Centers Assistance Act, 42 U.S.C. 233(g)-(n), and shielded from liability under the Federal Tort Claims Act. In 2005 the parents filed suit in state court and, in 2006, HHS denied an administrative claim for damages. Within six months of the denial the case was removed to federal court. In 2010, the district court held that the claim was filed within the two year statute of limitations under the FTCA (28 U.S.C. 2401(b)) and awarded more than $29 million in damages against the government. The Seventh Circuit affirmed. A claim only accrues when a plaintiff obtains sufficient knowledge of the government-related cause of his injury; the plaintiffs were reasonably diligent.

Plaintiff suffered a stroke and claimed that the VA hospital failed to properly diagnose and take appropriate measures. He and his wife sued under the Federal Tort Claims Act, 28 U.S.C. 1346(b), 2671-80, and also sued their attorney for malpractice. The district court ruled in favor of the government and the attorney. The Sixth Circuit dismissed an appeal as forfeited because plaintiff had supplied only a transcript of the testimony of the government's expert witness Fed. R. App. P. 10(b)(3) and had failed to supplement. The district court properly refused to sanction plaintiff's attorney for ex parte communication with treating physicians. The court also properly credited the government expert and held that the hospital's actions were not the proximate cause of the stroke.

This appeal involved a putative class action filed by three Pennsylvania Medicaid beneficiaries subject to the Pennsylvania Department of Public Welfare's (DPW) liens against future settlements or judgments. At issue was whether state agencies responsible for administering the Medicaid program have the authority to assert such liens and, if so, whether Pennsylvania's statutory framework was consistent with the Supreme Court's decision in Arkansas Department of Health and Human Services v. Ahlborn. The court examined the text, structure, history, and purpose of the Social Security Act, 42 U.S.C. 301 et seq., and held that liens limited to medical costs were not prohibited by the anti-lien and anti-recovery provisions of the Act, 42 U.S.C. 1396p(a)-(b). Accordingly, the court upheld Pennsylvania's longstanding practice of imposing such liens. The court also held that Pennsylvania's current statutory framework, which afforded Medicaid recipients a right of appeal from the default allocation, was a permissible default apportionment scheme.