Justia Government & Administrative Law Opinion Summaries

Under the Medicaid program, the federal government offsets some state expenses for medical services to low-income persons; a state’s plan must cover medical assistance for specific populations, but a state may expand its Medicaid program by obtaining a waiver for an “experimental, pilot, or demonstration project.” In 1993, Tennessee obtained a waiver for TennCare, to cover uninsured and uninsurable individuals. Following approval, hospitals received reimbursement under the umbrella of TennCare. Because hospitals serving large numbers of low-income patients generally incur higher costs than Medicaid flat payment rates reflect, hospitals that treated a disproportionate share of low-income patients could apply for the “DSH” adjustment. A fiscal intermediary processed requests for reimbursement, including DSH adjustment payments. Due to discrepancies between the practices of fiscal intermediaries in different states, the Secretary issued a 2000 rule, providing that eligibility waiver patients were to be included as individuals “eligible for medical assistance” under Medicaid for purposes of DSH adjustment calculations. The 2005 Deficit Reduction Act ratified the rule. Adventist, a not-for-profit hospital network, provided more than 1,200 patient care days to TennCare expansion waiver patients 1995-2000. The fiscal intermediary did not include those days in calculating the adjustment. The Secretary’s Provider Reimbursement Review Board upheld the exclusion. The district court dismissed, concluding that section 1315 provided the Secretary discretion to exclude expansion waiver patient days from the DSH calculation. The Sixth Circuit affirmed. View "Adventist Health Sys./Sunbelt, Inc. v. Sebelius" on Justia Law

In 2007, the Army Corps of Engineers issued two nationwide general permits that authorized surface and underground coalmining operations to discharge dredged and fill material into waters of the United States. The Corps conducted a public notice-and-comment period and completed a cumulative-impacts analysis that projected the permits’ respective environmental impacts before determining that compensatory mitigation would reduce adverse impacts to a minimal level. The Corps disclosed its analyses and findings in each permit’s Environmental Assessment in lieu of an environmental impact statement. Riverkeeper sued, alleging violations of the Clean Water Act, 33 U.S.C. 1344(e), the National Environmental Protection Act, 42 U.S.C. 4332(2)(C), and the Administrative Procedure Act, 5 U.S.C. 706, during the Corps’ issuance of two nationwide coal-mining waste-discharge permits in 2007. The district court granted summary judgment to the Corps. During Riverkeeper’s appeal, the permits at issue expired. The Sixth Circuit concluded that the case remains in controversy and reversed in part. Although the Corps repeatedly objected to the feasibility of Riverkeeper’s demands, in taking the “easier path” of preparing an environmental assessment instead of an environmental impact statement the Corps failed to follow CWA and NEPA regulations by documenting its assessment of environmental impacts and examining past impacts. View "KY Riverkeeper, Inc. v. Rowlette" on Justia Law

In 1997, Warf began working for Veterans Affairs as a program assistant to the Chief of Psychology. In 2004, a specialist from Human Resources performed an audit and concluded that Warf was performing duties that warranted GS-7 status on the government pay scale, a step higher than her GS-6 status. Between 2004 and 2008, Warf requested promotions, but nothing happened. In 2008 Warf filed a complaint with the Equal Employment Opportunity Commission. The director retroactively promoted Warf and she received back pay. Warf was subsequently denied a promotion and brought claims of hostile work environment, gender discrimination, retaliation, and Equal Pay Act violations under Title VII of the Civil Rights Act, 42 U.S.C. 2000(e), and the Equal Pay Act, 29 U.S.C. 206(d)(1). The district court entered summary judgment in favor of the department. The Sixth Circuit affirmed. Warf provided no any evidence that she and DeLong (who got the promotion) performed substantially similar jobs. Warf’s position was that of an administrative assistant, which did not encompass any education or training responsibilities. There is a significant difference between DeLong, who held a master’s degree in business and had seven years of experience teaching, and Warf, who was working towards her bachelor’s degree. View "Warf v. U.S. Dep't of Veterans Affairs" on Justia Law

In 1977, the Environmental Protection Agency sued Michigan, Detroit, and the Detroit Water and Sewerage Department for exceeding effluent limitations and failing to satisfy monitoring requirements under the Clean Water Act, 33 U.S.C. 1251. In 1977, the district court entered an initial Consent Judgment. Over the next 30 years, the DWSD fell in and out of compliance. In the most recent round of violations and court orders, the district judge gave a committee of local officials 60 days to fashion a final plan or face more intrusive court-ordered remedies. The judge adopted most of the committee’s recommendations but also directly abrogated some provisions in collective bargaining agreements of approximately 20 different bargaining units. None of the DWSD unions were parties. Unions sought to intervene. The district court denied the motions as untimely. The Sixth Circuit reversed. Although the unions were aware of the potential significance of the proceedings and failed to intervene before the court-approved committee returned its recommendations, total denial of intervention was an abuse of discretion. The unions have substantial interests at stake that “may as a practical matter” be impaired absent intervention. While concerns of delay and re-litigation are serious, they can be alleviated by limiting the scope of intervention. View "Unted States v. City of Detroit" on Justia Law

MedQuest is a diagnostic testing company that operates more than 90 testing facilities in 13 states. In 2006 a former MedQuest employee, brought a qui tam suit against MedQuest alleging violations of the False Claims Act. The United States intervened and obtained summary judgment ($11,110,662.71) that MedQuest used supervising physicians who had not been approved by the Medicare program and the local Medicare carrier to supervise the range of tests offered at the Nashville-area sites, and after acquiring one facility, MedQuest failed to properly re-register the facility to reflect the change in ownership and enroll the facility in the Medicare program, instead using the former owner’s payee ID number. The Sixth Circuit reversed, stating that the Medicare regulatory scheme (42 U.S.C. 1395x) does not support FCA liability for failure to comply with the supervising-physician regulations. MedQuest’s failure to satisfy enrollment regulations and its use of a billing number belonging to a physician’s practice it controlled do not trigger the hefty fines and penalties created by the FCA. View "United States v. MedQuest Assocs, Inc." on Justia Law

Berrien worked for a civilian contractor (TECOM) at a military base in Michigan. He was fatally injured by a gutter that fell from the liquor store on the base while he was working alone, behind the store. The district court awarded $1.18 million in damages for failure to warn, under the Federal Tort Claims Act, 28 U.S.C. 1346(b)(1). The Sixth Circuit reversed. Because the Act does not waive the immunity of the United States for acts of independent contractors, liability could only be based on the negligence of government employees. There was no evidence that government employees actually knew of the dangerous condition of the liquor store, so that, under applicable Michigan law, any liability for failure to warn an invitee of a dangerous condition would have to have been based on a negligent failure to discover the dangerous condition. Even though the United States retained the right to conduct spot checks under its contract with TECOM, this right does not subject it to FTCA liability. View "Berrien v. United States" on Justia Law

NHTSA is a federal agency within the Department of Transportation that writes and enforces safety standards for motor vehicles. NTEA is a trade organization representing manufacturers who customize bodies for special-purpose commercial vehicles. In 2005, NHTSA initiated a rulemaking proceeding at Congress’s behest to upgrade the safety standard establishing strength requirements for passenger compartment roofs in certain vehicles. NHTSA proposed, among other things, extending the scope of the safety standard to include a previously unregulated class of vehicles, many of which are produced by NTEA’s members. NTEA objected, but in 2009, NHTSA promulgated Federal Motor Vehicle Safety Standard (FMVSS) No. 216a. The Sixth Circuit denied review. “To ask for more process in a situation like this would render NHTSA’s standard-setting mission a practical impossibility.” The standard complies with “minimum substantive criteria” specified by Congress: that any new safety standard “shall be practicable, meet the need for motor vehicle safety, and be stated in objective terms.” View "Nat'l Truck Equip. Assoc v. Nat'l Hwy. Traffic Safety Admin." on Justia Law

Tennessee participates in Medicaid through “TennCare,” Tenn. Code 71-5-102. The Medicaid Act requires that TennCare administer an Early and Periodic Screening, Diagnosis, and Treatment program for all enrollees under age 21, 42 U.S.C. 1396a(a)(43), 1396d(r) and must provide outreach to educate its enrollees about these services. In 1998 plaintiffs filed a putative class action under 42 U.S.C. 1983, alleging that TennCare had failed to fulfill these obligations. The district court entered a consent decree that explained in detail the requirements that TennCare had to meet to “achieve and maintain compliance” with the Medicaid Act, based on the assumption that the Act created rights enforceable under section 1983. Eight years later, the Sixth Circuit held that one part of the Medicaid Act was unenforceable under section 1983. Following a remand, the district court vacated paragraphs of the decree that were based on parts of the Act that are not privately enforceable. After a thorough review of TennCare’s efforts, the court then vacated the entire decree, finding that TennCare had fulfilled the terms of the decree’s sunset clause by reaching a screening percentage greater than 80% and by achieving current, substantial compliance with the rest of the decree. The Sixth Circuit affirmed. View "John B. v.Emkes" on Justia Law

Gayheart applied for Social Security disability insurance benefits in 2005 due to manifestations of anxiety, panic disorder, bipolar disorder, and depression. After an initial denial and three separate hearings, an administrative law judge (ALJ) found that the limitations caused by Gayheart’s impairments did not preclude him from performing a significant number of jobs available in the national economy and denied Gayheart’s application. Gayheart’s request for an administrative appeal was denied. The Report and Recommendation issued by the federal court’s assigned magistrate judge concluded that the ALJ’s decision was not supported by substantial evidence and that Gayheart should be awarded benefits. But the district court sustained the Commissioner’s objections and affirmed the ALJ’s decision. The Sixth Circuit reversed and remanded, holding that the ALJ failed to weigh the medical opinions according to 20 C.F.R. 404.1527. View "Gayheart v. Comm'r of Soc. Sec." on Justia Law

The Rail Passenger Service Act of 1970, created Amtrak, 84 Stat. 1327, and allowed railroads to be excused from providing intercity passenger service by entering into a contract with Amtrak. In1971, after filing for bankruptcy, APU’s predecessor contracted to pay Amtrak $52 million and provide Amtrak use of its tracks, facilities and services; Amtrak was to relieve it of responsibility for intercity rail passenger service and issue it about 5.2 million stock shares. A 1978 Settlement Agreement released existing claims between APU’s predecessor and Amtrak. In 1997, Congress enacted the Amtrak Reform and Accountability Act, 111 Stat. 2570, requiring that Amtrak, before redeem all common stock for the fair market value. More than 10 years later, Amtrak has not redeemed APU’s stock. In 2000 APU rejected Amtrak’s offer of $0.03 per share. In 2008 APU filed suit. The district court dismissed for failure to state a claim, finding that Amtrak qualified as an agency for purposes of constitutional violations, that federal agencies cannot be sued for damages for constitutional violations, and that the statute did not create a private right of action for redemption. The Sixth Circuit reversed as to a claim that Amtrak’s valuation of APU’s shares denied APU due process, but otherwise affirmed. View "Am. Premier Underwriters v. Nat'l R.R. Passenger Corp." on Justia Law