Justia Government & Administrative Law Opinion Summaries

After her Father's death, Mother underwent intrauterine insemination using Father's cryopreserved sperm. The procedure was successful, and Mother gave birth to a child. Mother subsequently applied to the Social Security Administration (SSA) for surviving child's insurance benefits on behalf of the child. SSA denied the application. An ALJ decided that the child was entitled to child's insurance benefits on Father's Social Security record. SSA's appeal council reversed. On appeal, the U.S. district court certified the following question to the Nebraska Supreme Court: "Can a child, conceived after her biological father's death through intrauterine insemination using his sperm, and born within nine months of his death, inherit from him as the surviving issue under Nebraska intestacy law?" The Supreme Court answered in the negative, holding that under the relevant Nebraska statutes, a child conceived after her biological father's death cannot inherit from her father as surviving issue for purposes of intestacy. View "Amen v. Asture" on Justia Law

Applicant Marilyn Clifford appealed the denial of long-term home-care benefits under the Medicaid-funded Choices for Care program, arguing that a second home on an adjacent piece of property should have been excluded from the financial-eligibility calculation. Given the language of the regulation, the legislative history that led to its promulgation, and the policy considerations attending the Medicaid program, the Supreme Court concluded that the Secretary correctly interpreted the home-exclusion rule when he reinstated the determination of the Department of Children and Families denying the benefits. Thus, the Court found no compelling indication of error in the Secretary’s determination and affirmed. View "In re Marilyn Clifford" on Justia Law

The dispute before the Tenth Circuit in this case centered on interest earned on block grants made to Indian tribes pursuant to the Native American Housing Assistance and Self-Determination Act. Specifically, Appellant Muscogee (Creek) Nation's Division of Housing challenged both a regulation placing a two-year limit on the investment of grant funds and two notices issued by the U.S. Department of Housing and Urban Development stating that any interest accrued after the expiration of this two-year period must be returned to the Department. The Nation sought declaratory relief invalidating the regulation and notices as well as an injunction to prevent HUD from recouping interest earned on grant funds. The Nation also sought recoupment of the approximately $1.3 million of earned interest it wired to HUD after HUD sent a letter threatening an enforcement action based on the Nation’s investment of grant funds for longer than two years. The district court dismissed the complaint, holding that HUD’s sovereign immunity was not waived by the Administrative Procedures Act and, in the alternative, that the Nation had failed to state a claim on which relief could be granted because HUD’s interpretation of the statute was permissible. Upon review, the Tenth Circuit concluded that HUD was authorized to promulgate a regulation limiting the period for investments, and required to demand remittance of interest earned in violation of the regulation. The Nation was therefore not entitled to recouping the interest it paid to HUD pursuant to HUD's enforcement of its rules. View "Muscogee (Creek) Nation v. HUD, et al" on Justia Law

Appellant Collette Bishop appealed a district court judgment that affirmed an administrative law judge's order ("ALJ") which affirmed an order of Workforce Safety and Insurance ("WSI") denying further vocational rehabilitation benefits and temporary total disability benefits to Bishop. Upon review, the Supreme Court also affirmed, concluding the ALJ's finding that Bishop was capable of performing the return-to-work options identified in her vocational rehabilitation plan was supported by a preponderance of the evidence. View "Bishop v. No. Dakota Workforce Safety & Ins." on Justia Law

In 2004, Illinois enacted Hospital Provider Funding Legislation imposing a tax on hospital providers, except for certain categories of exempt hospitals, for fiscal years 2004 and 2005, 305 ILCS 5/5A-2(a). The Centers for Medicare and Medicaid Services disallowed the reimbursement of Medicare expenses (42 U.S.C. 1395f(b)(1)) to a group of Illinois hospitals, finding that the amount of a tax assessment paid by the hospitals was a reasonable cost, but was subject to offset by any payments those hospitals received from an Illinois State fund. The district court and Seventh Circuit affirmed, finding that the decision was not inconsistent with established policy. The court rejected an argument that the hospitals incurred the full cost of the tax, as they were billed by and wrote checks to the state, reasoning that the argument ignored the real net impact of the tax and of Access Payments by the state.View "Abraham Lincoln Mem'l Hosp. v. Sebelius" on Justia Law

Plaintiffs Kenneth Bond and Deborah Thibault, on behalf of themselves and a class of others similarly situated, appealed a superior court order granting summary judgment to the defendants, the City of Manchester and Paul Martineau in his official capacity as Commissioner of the Manchester Welfare Department (collectively, the City). In January 2010, the plaintiffs applied for general assistance from the City pursuant to RSA chapter 165. See RSA 165:1, I (2002). On February 24, 2010, the City approved $140.00 per week in rental assistance. On March 18, 2010, the City suspended this assistance for seven days because of the plaintiffs' failure to provide certain documentation, including that which related to $30 the plaintiffs used to buy gas for a vehicle. The City lifted this suspension on March 25, 2010, noting that the plaintiffs were "unable to show compliance with the $30 purchase of vehicle gas that [they] stated [they] had previously purchased through an alternate financial resource." On April 9, 2010, the City revoked an April 8 voucher and denied the plaintiffs all assistance for six months because they had misrepresented information related to their vehicle. The plaintiffs petitioned the superior court to enjoin the City from suspending their assistance. Because the Supreme Court held that RSA 165:1-b and the Guidelines pertaining to rental assistance actually conflict, the Court reversed the trial court's grant of summary judgment in favor of the City and remanded the case for further proceedings. View "Bond v. Martineau" on Justia Law

Bontrager filed a putative class action complaint challenging Indiana’s $1,000 annual limit for dental services covered by Medicaid, 42 U.S.C. 1396. The district court granted a preliminary injunction, holding that Indiana is required to cover all medically necessary dental services, irrespective of the monetary cap. The Seventh Circuit affirmed. Bontrager has an enforceable federal right capable of redress through Section 1983. The monetary cap, which excludes medically necessary treatment, is not a utilization control procedure, but allows a state to shirk its primary obligation to cover medically necessary treatments. The court acknowledged that Bontrager’s victory may be short-lived if the state decides to end coverage for all dental services. View "Bontrager v. IN Family & Soc. Servs." on Justia Law

Plaintiff-Appellant Pennie Keyes-Zachary appealed a district court order that affirmed the Commissioner's decision denying her applications for Social Security disability and Supplemental Security Income benefits. Plaintiff alleged disability based on, among other things, neck, back, shoulder, elbow, wrist, hand, and knee problems, accompanied by pain; hearing loss; urinary frequency; anger-management problems; depression; and anxiety. The ALJ upheld the denial of her application for benefits. The Appeals Council denied her request for review of the ALJ's decision, and she then appealed to the district court. The district court remanded the case to the ALJ for further consideration. After the second hearing, the ALJ determined that Plaintiff retained residual functional capacity to perform light work with certain restrictions, but that she was not disabled within the meaning of the Social Security Act. The Appeals Council declined jurisdiction, and the ALJ's decision was then deemed the Commissioner's final decision. On appeal Plaintiff raised two issues: (1) that the ALJ "failed to properly consider, evaluate and discuss the medical source evidence;" and (2) the ALJ "failed to perform a proper credibility determination." Upon review, the Tenth Circuit found no error in the ALJ's decision and affirmed the Commission's final determination in Plaintiff's case. View "Keyes-Zachary v. Astrue" on Justia Law

The City of Gadsden appealed an order of injunctive relief in favor of John Boman, a retired Gadsden police officer. Boman and 18 other active and retired Gadsden police officers sued Gadsden alleging, among other things, that they had "been deprived of Social Security and Medicare protection which other police officers have been provided" and that, after 20 years of service, they were being required to pay a higher pension charge or percentage of base pay than their counterparts who were hired after April 1, 1986. Boman filed a "motion for immediate relief for medical care." He alleged that when he was hired, Gadsden "provided police and firemen a 20 year retirement program whereby police and firemen would receive 50% retirement benefits after 20 years of service and lifetime medical care." He averred that Gadsden had "breached its contract with [him] to provide continuing medical insurance," and he requested "immediate relief by ordering [Gadsden] to pay for [his] medical care or in the alternative ordering [Gadsden] to pay for Medicare coverage for ... Boman so he will have continuing medical insurance as agreed by the Board filed a motion to dismiss the action as to it and the plan. As to it, the Board alleged that it was an agency of the State and, therefore, was entitled to absolute immunity from suit. Also, according to the Board, the plan is not a legal entity subject to suit, but "merely a program administered by the Board to provide insurance." It also averred that, "[e]ven if [the plan] were an entity subject to suit, it would be immune for the same reasons [the] Board is immune." Boman's response to the Board's motion failed to acknowledge or mention the immunity question. The trial court, without conducting an evidentiary hearing, entered an "order granting motion for emergency relief." It ultimately dismissed the claims against the Board and the plan. Gadsden appealed. Upon review, the Supreme Court reversed based on the failure to join the officials of the Board, in their official capacities, as necessary parties. On remand, the trial court was directed to entertain an amendment to the complaint adding claims against those officials of the Board who are charged with administering the plan, in their official capacities. View "City of Gadsden, Alabama v. Boman et al. " on Justia Law

A man filed an application for both occupational and nonoccupational disability benefits from the Public Employees Retirement System, claiming disability from both physical and mental conditions. An administrative law judge (ALJ) denied his claim, finding that he failed to establish by a preponderance of the evidence that he had a physical or mental disability that presumably permanently prevented him from satisfactorily performing his job. The man appealed and the superior court affirmed the ALJ's determination. On appeal to the Supreme Court, the man challenged the ALJ's determination regarding his mental condition. Because the ALJ's written findings were sufficiently detailed to support the ALJ's conclusions, and because substantial evidence supported the ALJ's conclusion that the man’s mental condition did not amount to an occupational or nonoccupational disability, the Supreme Court affirmed the superior court’s decision to uphold the ALJ's order. View "McKitrick v. Alaska Pub. Employees Retirement Sys." on Justia Law