Justia Government & Administrative Law Opinion Summaries

A group of hospitals challenged the calculation of their Medicare fractions for fiscal year 2007, which is a key component in determining eligibility and payment amounts under the Medicare disproportionate share hospital (DSH) adjustment. The DSH adjustment provides increased reimbursement to hospitals serving a high number of low-income patients. The hospitals disputed the inclusion of Medicare Part C beneficiaries in the Medicare fraction, arguing that this reduced their payments. After the Centers for Medicare and Medicaid Services (CMS) published the Medicare fractions, the hospitals appealed to the Provider Reimbursement Review Board, seeking review of the calculation before the final DSH adjustment was determined.The Provider Reimbursement Review Board dismissed the hospitals’ appeal for lack of jurisdiction, reasoning that a challenge could only be brought after the final determination of the DSH adjustment was made and reflected in the Notice of Program Reimbursement (NPR). The Board concluded that publication of the Medicare fraction alone did not constitute a “final determination” as required by statute. The hospitals then sought review in the United States District Court for the District of Columbia, which disagreed with the Board and held that the hospitals’ challenge could proceed, interpreting precedent to allow appeals at the stage of Medicare fraction publication.The United States Court of Appeals for the District of Columbia Circuit reviewed the case and reversed the district court’s judgment. The court held that the Board lacked jurisdiction to hear the hospitals’ challenge prior to the issuance of the NPR, because only the NPR constitutes the Secretary’s “final determination as to the amount of the payment” under the relevant statutory provision. The court clarified that while some prospective payment system components may be appealed before the NPR, retrospective adjustments like the DSH adjustment require final settlement before an appeal is ripe. View "Battle Creek Health System v. Kennedy" on Justia Law

In 2020, the Transportation Security Administration (TSA) proposed a rule to address insider threats in airports, specifically targeting the risk that aviation workers with unescorted access to secured areas could facilitate the introduction of weapons or dangerous items onto aircraft. Instead of following the usual public notice-and-comment procedures required by the Administrative Procedure Act (APA), TSA provided notice and an opportunity to comment only to airport operators. The finalized rule, known as the National Amendment, required major airports to physically screen aviation workers entering certain secured areas and to acquire explosives-detection equipment. Noncompliance could result in civil enforcement actions by TSA.After TSA finalized the National Amendment in April 2023, various municipalities operating airports and a trade organization, Airport Council International-North America (ACI-NA), submitted timely requests for reconsideration, arguing that TSA lacked statutory authority, that the APA required public notice and comment, and that the rule unlawfully compelled local officials to implement a federal scheme. TSA denied all reconsideration requests, maintaining that its own regulations permitted it to amend airport security programs by providing notice and comment only to affected operators. The petitioners then sought review of TSA’s denial in the United States Court of Appeals for the District of Columbia Circuit.The United States Court of Appeals for the District of Columbia Circuit held that the National Amendment is a legislative rule subject to the APA’s notice-and-comment requirements, which TSA failed to follow. The court vacated the National Amendment but withheld its mandate, allowing TSA time to promulgate a procedurally proper rule or inform the court if no rule is needed. The court required TSA to submit periodic status reports until a final resolution. View "City of Billings v. TSA" on Justia Law

Members of the Crow Tribe who own trust allotments on the Crow Reservation challenged the loss of their historic water rights following the ratification of the Crow Tribe-Montana Compact and the Crow Tribe Water Rights Settlement Act. The Settlement Act, passed by Congress in 2010, codified a negotiated agreement among the Crow Tribe, the state of Montana, and the United States, which defined tribal water rights and provided substantial federal funding for water infrastructure. In exchange, the Tribe and allottees agreed to waive all other water rights claims. The Act required the Secretary of the Interior to publish a Statement of Findings certifying that certain conditions were met, which would trigger the waiver of prior water rights.After the Secretary published the Statement of Findings in June 2016—following a deadline extension agreed to by the Tribal Chairman and the Secretary—several allottees filed suit nearly six years later. They argued that the extension was invalid because, under the Crow Constitution, only the Tribal General Council or Legislature could authorize such an agreement. They also alleged that the Secretary’s action exceeded statutory authority, breached trust obligations, and violated their Fifth Amendment rights. The United States District Court for the District of Columbia dismissed the complaint for failure to state a claim.The United States Court of Appeals for the District of Columbia Circuit reviewed the dismissal de novo. The court held that the Secretary’s publication of the Statement of Findings constituted final agency action reviewable under the Administrative Procedure Act, but found the Secretary reasonably relied on the Tribal Chairman’s authority to extend the deadline. The court further held that the Settlement Act created specific trust duties, but the plaintiffs failed to plausibly allege any breach. The court also concluded that the plaintiffs’ Fifth Amendment claims for takings, due process, and equal protection failed as a matter of law. The judgment of the district court was affirmed. View "Hill v. DOI" on Justia Law

The case concerns a series of actions taken by the leadership of the Consumer Financial Protection Bureau (CFPB) in early 2025, following a change in presidential administration. The new Acting Directors, first Scott Bessent and then Russell Vought, implemented measures to significantly downsize the agency. These included pausing most agency activities, terminating employees (including the Student Loan Ombudsman), canceling contracts, declining additional funding, moving to smaller headquarters, and requiring advance approval for agency work. Some statutorily required services were neglected during this period, though agency leadership later clarified that legally mandated work should continue.Several plaintiffs, including organizations representing CFPB employees and groups that use CFPB services, filed suit in the United States District Court for the District of Columbia. They alleged that the agency’s actions amounted to an unlawful attempt to “shut down” the CFPB, violating both statutory mandates and the separation of powers. The district court found that agency leadership had indeed decided to shut down the Bureau and issued a preliminary injunction. This injunction required the government to reinstate terminated employees, refrain from further firings except for cause, maintain certain services, and rescind contract terminations, among other measures.On appeal, the United States Court of Appeals for the District of Columbia Circuit reviewed the case. The court held that the district court lacked jurisdiction over claims related to loss of employment, as such claims must proceed through the Civil Service Reform Act’s specialized review scheme. For the remaining plaintiffs, the court found that their claims did not challenge a final agency action reviewable under the Administrative Procedure Act (APA), nor did they present a constitutional claim reviewable in equity. The court concluded that the plaintiffs’ attempt to challenge an inferred, overarching decision to shut down the CFPB was not viable under the APA or in equity. Accordingly, the D.C. Circuit vacated the preliminary injunction and remanded the case. View "National Treasury Employees Union v. Vought" on Justia Law

A pharmaceutical company sought approval from the Food and Drug Administration (FDA) to market tasimelteon, a drug previously approved for a rare sleep disorder, as a treatment for jet lag. The company submitted results from several clinical trials, focusing on both objective sleep measures and subjective assessments of alertness and next-day functioning. The FDA’s Center for Drug Evaluation and Research issued a complete response letter indicating that the application did not provide substantial evidence of efficacy, particularly criticizing the measurement of next-day impairment and the tools used for subjective endpoints. The company engaged in further discussions and dispute resolution with the FDA, including proposing a narrower indication for approval, but these efforts were unsuccessful.After the FDA issued a formal notice of opportunity for a hearing (NOOH), the company requested a hearing and submitted expert declarations supporting the adequacy of its clinical evidence. The FDA ultimately denied both the application and the hearing request, finding no genuine and substantial issue of fact warranting a hearing. The company then petitioned the United States Court of Appeals for the District of Columbia Circuit for review, arguing that the FDA was required to hold a hearing, that material factual disputes existed, that the FDA’s decision-making was arbitrary and capricious, and that the final decision violated the Appointments Clause.The United States Court of Appeals for the District of Columbia Circuit held that the Food, Drug, and Cosmetic Act does not require the FDA to hold a hearing before denying every new drug application, but the agency must grant a hearing if there are material factual disputes. The court found that, in this case, the FDA’s refusal to hold a hearing was arbitrary and capricious because the company’s expert evidence created genuine disputes over the adequacy of the clinical trials. The court remanded the case to the FDA for further proceedings consistent with its opinion. View "Vanda Pharmaceuticals, Inc. v. FDA" on Justia Law

The case concerns the executive branch’s decision to freeze foreign aid funds that Congress had appropriated for fiscal year 2024. On January 20, 2025, the President issued an executive order directing the State Department and USAID to pause foreign assistance spending, pending a review of those programs. This led to the suspension or termination of thousands of grant awards and significant restructuring within the agencies. Organizations that were recipients of these funds, many of which relied heavily on such funding, challenged the executive order, arguing that the freeze unlawfully impounded funds that Congress had directed to be spent.The United States District Court for the District of Columbia initially granted a temporary restraining order, and later a preliminary injunction, against the executive branch (excluding the President personally). The district court found that the plaintiffs had standing due to financial harm, and that they were likely to succeed on their claims that the executive branch’s actions violated the separation of powers, the Take Care Clause, the Impoundment Control Act (ICA), the Anti-Deficiency Act, and the Administrative Procedure Act (APA). The court ordered the government to make available the full amount of appropriated funds.The United States Court of Appeals for the District of Columbia Circuit reviewed the case and vacated the district court’s preliminary injunction. The appellate court held that the plaintiffs lacked a cause of action to pursue their claims. Specifically, it found that the plaintiffs could not bring a freestanding constitutional claim when the alleged violations were statutory in nature, that the ICA precludes APA review by private parties (reserving enforcement to the Comptroller General), and that the plaintiffs could not reframe their claims as ultra vires actions. The court concluded that, although the plaintiffs had standing, they were not entitled to the preliminary injunction because they were unlikely to succeed on the merits. View "Global Health Council v. Trump" on Justia Law

Terri R. Winnon, a former executive assistant and controller for a group of skilled nursing facilities (SNFs) in Texas, alleged that her former employers and associated entities engaged in fraudulent schemes to obtain improper reimbursements from Medicare and Texas Medicaid. She claimed that the defendants paid unlawful kickbacks to doctors and hospital discharge planners for patient referrals and inflated therapy service bills to maximize government reimbursements. Winnon’s allegations included specific practices such as employee bonuses tied to Medicare census targets, “sham” medical directorships, and “marketing gifts” to hospital staff, as well as systematic upcoding of therapy services by a contracted provider, RehabCare.After Winnon filed her qui tam action under the False Claims Act (FCA) and related Texas statutes, the United States District Court for the District of Columbia dismissed her claims. The court found that her allegations against RehabCare were barred by the FCA’s public disclosure provision, as similar claims had already been made public in a prior lawsuit, United States ex rel. Halpin & Fahey v. Kindred Healthcare, Inc. The district court also determined that Winnon’s claims against the SNF Defendants did not meet the heightened pleading requirements of Federal Rule of Civil Procedure 9(b), as they lacked sufficient particularity regarding the alleged fraudulent conduct.On appeal, the United States Court of Appeals for the District of Columbia Circuit affirmed the district court’s dismissals. The appellate court held that Winnon’s claims against RehabCare were precluded by the public disclosure bar because her allegations were substantially similar to those previously disclosed and she did not qualify as an “original source” under the FCA. Regarding the SNF Defendants, the court concluded that Winnon’s allegations failed to satisfy Rule 9(b)’s requirement for particularity, as she did not provide enough specific details to support a strong inference that false claims were actually submitted. The court affirmed the district court’s judgments in full. View "USA v. Lozano" on Justia Law

After Georgia enacted the Election Integrity Act (SB 202) following the 2020 elections, several organizations and the United States Department of Justice (DOJ) filed lawsuits in the U.S. District Court for the Northern District of Georgia, challenging the law on various grounds, including race discrimination. The DOJ and several plaintiff organizations entered into a common-interest agreement to coordinate their litigation efforts and share privileged attorney work product. Georgia, suspecting improper coordination, submitted a Freedom of Information Act (FOIA) request to the DOJ seeking all communications between the DOJ and the aligned non-governmental plaintiffs. The DOJ produced many documents but withheld or redacted others, citing FOIA Exemption 5, which protects privileged attorney work product from disclosure.The United States District Court for the District of Columbia reviewed Georgia’s suit to enforce its FOIA request. The district court granted summary judgment in favor of Georgia, holding that the communications between the DOJ and non-governmental parties were not “intra-agency” records under Exemption 5 and that the DOJ had waived any work-product privilege by sharing the materials with third parties, even under a common-interest agreement.The United States Court of Appeals for the District of Columbia Circuit reviewed the case de novo. The court held that when the government shares attorney work product with aligned parties under a common-interest agreement, those communications qualify as “intra-agency” materials for purposes of FOIA Exemption 5. The court further held that such sharing does not waive the attorney work-product privilege, provided the parties are aligned and the sharing is pursuant to a common-interest agreement. The court affirmed the district court’s judgment only as to two emails predating the agreement but reversed the remainder of the district court’s decision, allowing the DOJ to withhold the other documents. View "State of Georgia v. DOJ" on Justia Law

Several companies incorporated in Cyprus and the Isle of Man, who were shareholders of OAO Yukos Oil Company, alleged that the Russian Federation unlawfully expropriated Yukos’s assets between 2003 and 2004. The shareholders initiated arbitration proceedings under the Energy Charter Treaty, which Russia had signed but not ratified, claiming that Russia’s actions violated the Treaty’s protections against expropriation. The arbitral tribunal in The Hague found in favor of the shareholders, awarding them over $50 billion in damages. Russia contested the tribunal’s jurisdiction, arguing that it was not bound to arbitrate under the Treaty because provisional application of the arbitration clause was inconsistent with Russian law, and that the shareholders were not proper investors under the Treaty.After the tribunal’s decision, Russia sought to set aside the awards in Dutch courts. The Dutch Supreme Court ultimately upheld the tribunal’s jurisdiction and the awards, finding that Russia was provisionally bound by the Treaty’s arbitration clause and that the shareholders qualified as investors. Meanwhile, the shareholders sought to enforce the arbitral awards in the United States District Court for the District of Columbia. Russia moved to dismiss, asserting sovereign immunity under the Foreign Sovereign Immunities Act (FSIA) and arguing that the arbitration exception did not apply because there was no valid arbitration agreement. The district court denied Russia’s motion, holding that it had jurisdiction under the FSIA’s arbitration exception, and deferred to the arbitral tribunal’s determination that an arbitration agreement existed.On appeal, the United States Court of Appeals for the District of Columbia Circuit held that the existence of an arbitration agreement is a jurisdictional fact under the FSIA that must be independently determined by the district court, rather than deferred to the arbitral tribunal. The court vacated the district court’s judgment and remanded for independent consideration of whether the FSIA’s arbitration exception applies, including whether the Dutch courts’ judgments should have preclusive effect. View "Hulley Enterprises Ltd. v. Russian Federation" on Justia Law

The appellant, a Slovenian-born U.S. permanent resident, claimed to have discovered billions of dollars dispersed across Africa after the death of Muammar Gaddafi. He sought to repatriate these funds to the United States and enlisted the help of a Washington, D.C. lawyer. The appellant alleged that, during his efforts in Kenya and Côte d'Ivoire, he was unable to complete the repatriation due to issues with verifying the legitimacy of Treasury Department letters. He further claimed that, while detained in Côte d'Ivoire, the funds were stolen and replaced with counterfeit cash, and that he was later arrested for alleged money laundering and misrepresentation of U.S. documents. Upon returning to the United States, the lawyer withdrew representation due to the criminal allegations against the appellant.The United States District Court for the District of Columbia dismissed the appellant’s fraud claims in two parts. First, it found that the complaint failed to allege any actionable misrepresentation by the lawyer, noting that the lawyer had provided legal services as agreed. Second, for the claims against three federal employees, the court allowed the United States to substitute itself as defendant under the Westfall Act, as the employees were acting within the scope of their employment. The court then dismissed the claim against the United States on the basis of sovereign immunity.The United States Court of Appeals for the District of Columbia Circuit affirmed the district court’s decision. It held that the appellant’s complaint did not allege with particularity any fraudulent misrepresentation by the lawyer at the time of contract formation. Regarding the federal employees, the court found that the appellant failed to rebut the government’s certification that the employees acted within the scope of their employment, and thus sovereign immunity barred the claim. The court also denied the appellant’s request for leave to amend and for jurisdictional discovery. View "Plevnik v. Sullivan" on Justia Law