Justia Government & Administrative Law Opinion Summaries

The case involves the United States government alleging that Regeneron Pharmaceuticals violated the Anti-Kickback Statute (AKS) by covering copayments for patients prescribed Eylea, a drug used to treat wet age-related macular degeneration. The government contends that this action induced doctors to prescribe Eylea, leading to Medicare claims that were "false or fraudulent" under the False Claims Act (FCA) because they "resulted from" the AKS violation.The United States District Court for the District of Massachusetts reviewed the case and agreed with Regeneron's interpretation that the phrase "resulting from" in the 2010 amendment to the AKS requires a but-for causation standard. This means that the government must prove that the AKS violation was the actual cause of the Medicare claims. The district court noted the conflict in case law and sought interlocutory review, which was granted.The United States Court of Appeals for the First Circuit affirmed the district court's ruling. The court held that the phrase "resulting from" in the 2010 amendment to the AKS imposes a but-for causation requirement. The court reasoned that the ordinary meaning of "resulting from" requires actual causality, typically in the form of but-for causation, unless there are textual or contextual indications to the contrary. The court found no such indications in the 2010 amendment or its legislative history. Therefore, to establish falsity under the FCA based on an AKS violation, the government must prove that the kickback was a but-for cause of the submitted claim. View "United States v. Regeneron Pharmaceuticals, Inc." on Justia Law

The case involves the Massachusetts Lobstermen's Association, Inc. (MALA) challenging a final rule issued by the National Marine Fisheries Service (NMFS) that seasonally bans vertical buoy lines used in lobster and Jonah crab trap fishing in certain federal waters off Massachusetts from February 1 to April 30 each year. The NMFS issued this rule to protect the endangered North Atlantic right whales from entanglement in these buoy lines during their foraging period.Previously, the U.S. District Court for the District of Massachusetts ruled in favor of MALA, holding that the final rule conflicted with a temporary statutory authorization for lobster and Jonah crab fishing contained in a rider to the Consolidated Appropriations Act of 2023. The district court found that the final rule did not fall within the exception provided in the rider, which allowed for actions to extend or make final an emergency rule that was in place on the date of the rider's enactment, December 29, 2022. The court concluded that the 2022 emergency rule was not "in place" on that date because it was not actively preventing fishing in the Wedge area at that time.The United States Court of Appeals for the First Circuit reviewed the case and reversed the district court's decision. The appellate court held that the 2022 emergency rule was indeed "in place" on December 29, 2022, for the purposes of the rider's exception. The court reasoned that the emergency rule's findings and authority were still relevant and could serve as a basis for future regulatory actions, such as the final rule. Therefore, the final rule was lawful and enforceable under the exception provided in the rider. The case was remanded for further proceedings consistent with this opinion. View "Mass. Lobstermen's Ass'n, Inc. v. Nat'l Marine Fisheries Serv." on Justia Law

The plaintiffs, Norene Rodríguez and Iris Rodríguez, sued Encompass Health Rehabilitation Hospital of San Juan, Inc. and Dr. José Báez Córdova for medical malpractice related to the treatment of their mother, Gloria Rodríguez González, who died after being treated for COVID-19. They alleged negligence in her care, particularly in failing to provide timely prophylactic medication for deep vein thrombosis, which they claimed led to her death.The United States District Court for the District of Puerto Rico granted summary judgment in favor of the defendants. The court concluded that the plaintiffs had not demonstrated any genuine issue of material fact and that the defendants were entitled to judgment as a matter of law. The court also found that Dr. Báez was immune from suit under Puerto Rico law, as he was acting within his duties as a faculty member of the University of Puerto Rico (UPR) at the time of the alleged malpractice. Consequently, Encompass could not be held vicariously liable for his actions. The plaintiffs' remaining claims were deemed waived for lack of development.The United States Court of Appeals for the First Circuit reviewed the case and affirmed the district court's decision. The appellate court agreed that Dr. Báez was immune from suit under Puerto Rico law, as he was acting in his capacity as a UPR faculty member supervising medical residents. The court also upheld the district court's application of the local anti-ferret rule, which disregarded certain facts not adequately supported by specific citations to the record. The plaintiffs' argument that Encompass was vicariously liable for the actions of other non-immune personnel was deemed waived, as it was not raised in the lower court. The appellate court found no abuse of discretion in the district court's denial of an evidentiary hearing. View "Rodriguez v. Encompass Health Rehabilitation Hospital of San Juan, Inc." on Justia Law

Two state forensic chemists in Massachusetts tampered with drug evidence and falsified test results, affecting tens of thousands of drug cases. The Massachusetts Supreme Judicial Court (SJC) vacated over 30,000 criminal cases due to this misconduct. The SJC ruled that under the Fourteenth Amendment, affected individuals were entitled to the repayment of most funds collected due to their vacated convictions but not the automatic return of forfeited property. Instead, individuals had to file motions for relief from judgment under Rule 60(b) of the Massachusetts Rules of Civil Procedure.The plaintiffs, whose criminal convictions were vacated, sought a federal court order for the automatic return of their forfeited property and related relief. The Commonwealth defendants moved to dismiss the complaint, arguing that the claims were barred by the Eleventh Amendment, which prohibits suits in federal court against a state by its own citizens. The United States District Court for the District of Massachusetts dismissed the complaint in part, ruling that it could not order the automatic return of forfeited property but allowed other claims to proceed under the Ex parte Young exception to the Eleventh Amendment.The United States Court of Appeals for the First Circuit reviewed the case and concluded that the Eleventh Amendment bars all the relief sought by the plaintiffs. The court held that the plaintiffs' claims focused on a past wrong, and the Ex parte Young exception applies only to prospective relief against ongoing violations of federal law. Additionally, the state officials sued lacked the authority to enforce or change the state court procedures. The court reversed the district court's partial denial of the motion to dismiss and remanded with instructions to dismiss the case in full. View "Cotto v. Campbell" on Justia Law

The First Circuit declined enforcement of the National Labor Relations Board’s (NLRB) order requiring 1199 SEIU United Healthcare Workers East (the Union) and Good Samaritan Medical Center to reinstate Camille Legley with back pay and rescind a workplace civility policy, holding that there was not substantial evidence on the record as a whole that Legley was discharged because of his protected conduct.Legley, a probationary employee hired by Good Samaritan, questioned a union delegate’s alleged remark during an orientation training that he had to join the Union in order to work at Good Samaritan. Good Samaritan terminated Legley’s employment the following day, claiming that Legley’s conduct had violated its civility policy. The NLRB found that the Union caused Good Samaritan to discharge Legally because of his protected conduct. In denying enforcement of the NLRB’s order the First Circuit held that the NLRB’s decision ignored a portion of the record and could not survive review under the substantial evidence standard. View "Good Samaritan Medical Center v. National Labor Relations Board" on Justia Law

In this immigration case, the First Circuit vacated the order of the Board of Immigration Appeals (BIA) upholding the decision of the Immigration Judge (IJ) denying Petitioner’s applications for asylum, withholding of removal, and protection under the Convention Against Torture (CAT). In his petition for review, Petitioner, a native of Guatemala, argued that he presented sufficient evidence to establish both past persecution and a well-founded fear of future persecution and that he could not reasonably relocate within Guatemala. The First Circuit granted the petition for review and remanded for further proceedings, holding (1) there was significant evidence in the record supporting a conclusion that relocation would be unreasonable; and (2) given the limited analysis on this issue by the IJ and the BIA, remand was proper for the BIA to consider it fully. View "Garcia-Cruz v. Sessions" on Justia Law

Petitioner, a citizen of Guatemala, petitioned for review of a decision of the Board of Immigration Appeals (BIA) denying his requests for asylum, withholding of removal, and protection under the Convention Against Torture (CAT). The BIA affirmed the decision of the Immigration Judge (IJ), concluding (1) the level of mistreatment Petitioner suffered did not rise to the level that could qualify as persecution to be entitled to a grant of asylum, and (2) Petitioner could not meet the requirements for withholding of removal and for protection under the CAT. The First Circuit denied Petitioner’s petition for review, holding (1) Petitioner failed to provide the court with a basis for reversing the BIA’s ruling denying his application for asylum; and (2) Petitioner failed to offer any basis on which to conclude that he could satisfy the requirements for withholding for removal or for protection under the CAT. View "Morales-Morales v. Sessions" on Justia Law

The First Circuit held that the five-day grace period outlined in 20 C.F.R. 422.210(c) does not apply to final decisions on remand where the individual does not file any written exceptions to the administrative law judge's decision and the Appeals Council does not assume jurisdiction of the case.Plaintiff applied for Title II disability benefits with the Social Security Administration. On remand, an ALJ issued a partially favorable decision on Plaintiff’s claim. Plaintiff did not file any written exceptions to the ALJ’s decision, and the Appeals Council did not review the ALJ’s decision. Therefore, the ALJ’s decision became the final decision of the Commissioner of Social Security. Plaintiff then filed a civil action challenging the ALJ’s decision on remand. The Commissioner moved to dismiss Plaintiff’s claim as untimely. The district court ruled against Plaintiff and dismissed her complaint for being untimely filed. Plaintiff appealed, asking the First Circuit to hold that the five-day grace period outlined in section 422.210(c) applies to final decisions on remand. The First Circuit declined Plaintiff’s request, holding that Plaintiff cannot apply the five-day grace period under section 422.210(c) to save her civil claim from being untimely. View "Walker-Butler v. Berryhill" on Justia Law

The Court of Appeals for the First Circuit held that aliens who are subject to reinstated orders of removal may not apply for asylum, even though they may be entitled to withholding of removal. In reaching this conclusion, the First Circuit ruled that certain provisions of the Illegal Immigration Reform and Immigrant Responsibility Act of 1996 did not entitle Petitioner, a citizen of Guatemala who was subject to a reinstated order of removal, to seek asylum. The First Circuit affirmed the decisions of the immigration judge (IJ) and Board of Immigration Appeals (BIA) that determined that Petitioner could not apply for asylum even where the IJ determined that he was entitled to withholding of removal based on the persecution he would face in Guatemala. View "Garcia-Garcia v. Sessions" on Justia Law

Pan Am Railways, Inc. brought charges of dishonesty and insubordination and threats of dismissal against Jason Raye, an injured employee who had filed a complaint with the Occupational Safety and Health Administration (OSHA) under the Federal Railroad Safety Act (FRSA). Raye then filed an amended complaint to OSHA accusing Pan Am of violating the FRSA for filing his original OSHA complaint. OSHA concluded that Pan Am had unlawfully retaliated against Raye for bringing charges after Raye had filed his original OSHA complaint. An administrative law judge (ALJ) rejected Pan Am’s affirmative defense and awarded $250,000 in punitive damages, the maximum amount that the FRSA allows. The Department of Labor’s Administrative Review Board affirmed. The First Circuit denied Pan Am’s petition for review, holding (1) the ALJ did not err in rejecting Pan Am’s affirmative defense that it would have charged Raye with dishonesty even absent his protected activity; and (2) there was no abuse of discretion in the ALJ’s punitive damages award. View "Pan Am Railways, Inc. v. U.S. Department of Labor" on Justia Law