Justia Government & Administrative Law Opinion Summaries

Defendant was convicted of conspiracy and substantive health care fraud for fraudulently billing Medicare and Medicaid for millions of dollars for visits to nursing home patients that he never made. He challenged the convictions, sentence, restitution amount, and forfeiture amount on appeal.The co-conspirator pleaded guilty to conspiracy and agreed to cooperate with the government. Part of his plea agreement addressed his compensation during the conspiracy. Defendant contends that the district court erred in quashing his subpoena of the co-conspirator’s attorney. The court ruled that any erroneous exclusion of the attorney’s testimony was harmless beyond a reasonable doubt because his testimony would not have impeached the co-conspirator. He further argues that the district court erred in limiting how many character witnesses he could present. The court found that the district court did not err because defendant overstates the importance of character witness testimony in this case. He was not on trial for being uncaring or uncompassionate but for lying and billing Medicare for services he did not provide.Additionally, defendant contends that the district court improperly limited part of his counsel’s closing argument when he was discussing whether defendant had made a profit. The court found that the government does not have to prove a defendant profited to establish the elements of fraud. The court also found that the district court did not err in calculating the loss amount used to determine defendant's sentence or the amount of restitution ordered. View "USA v. Douglas Moss" on Justia Law

Plaintiffs were involved in a motor vehicle accident involving a vehicle operated by a USPS employee; through counsel, Plaintiffs submitted a “claim for damage, injury, or death." Subsequently, Plaintiffs retained a new law firm (Pawlowski), and provided notice to the USPS. On September 27, 2018, Plaintiffs filed a Federal Tort Claims Act action against the government and the USPS employee. On October 16, 2018, a copy of the complaint and summons in the first FTCA action was delivered to the government. Another law firm (“Youngblood”), filed the first FTCA action complaint.On October 22, 2018, the USPS mailed a certified letter denying Plaintiffs’ administrative claims to Pawlowski, indicating Plaintiffs had until April 22, 2019 to file suit against the government. Neither Pawlowski nor Youngblood provided the USPS notice of any change in representation. On August 30, 2019, Plaintiffs filed their second FTCA complaint. On March 4, 2020, the government moved for summary judgment, arguing Plaintiffs’ claims were time-barred.Plaintiffs contend that the government failed to comply with the plain language of 39 C.F.R. Sec. 912.9(a) when the USPS sent the denial letter to Pawlowski. Further that the district court erred in finding they were not entitled to equitable tolling.The court ruled that the USPS mailed the denial letter to the legal representative who Plaintiffs most recently identified, thus complying with the regulation. Further, the court held that Plaintiffs failed to demonstrate entitlement to equitable tolling. The court affirmed the district court’s order granting summary judgment for the government. View "Robert Wayne Dotson, et al. v. USA" on Justia Law

Heather operated a health-coaching business called Constitution Nutrition. She started her business in California, which did not require a license. After moving to Florida in 2015, she continued to run her business—meeting online with most of her clients and meeting in person with two clients who lived in Florida. She described herself as a “holistic health coach” and not as a dietician. Heather tailored her health coaching to each client, which included dietary advice. After a complaint was filed against her and she paid $500.00 in fines and $254.09 in investigatory fees, Heather sued, claiming that Florida’s Dietetics and Nutrition Practice Act, which requires a license to practice as a dietician or nutritionist, violated her First Amendment free speech rights to communicate her opinions and advice on diet and nutrition to her clients. The district court granted the Florida Department of Health summary judgment.The Eleventh Circuit affirmed, after considering the Supreme Court’s decision in National Institute of Family & Life Advocates v. Becerra (2018). The Act “is a professional regulation with a merely incidental effect on protected speech,” and is constitutional under the First Amendment. View "Del Castillo v. Secretary, Florida Department of Health" on Justia Law

Enacted after the Exxon Valdez oil spill, the Oil Pollution Act of 1990 (OPA), creates a comprehensive remedial scheme that governs—and apportions liability for—oil-removal costs. OPA holds oil spillers strictly liable upfront for oil-removal expenses and allows them, if they meet certain requirements, to avail themselves of one of three liability defenses and to seek contribution from other culpable parties. The M/V SAVAGE VOYAGER was transporting oil through a Mississippi waterway when an accident at a boat lift— operated by the U.S. Army Corps of Engineers—caused a rupture in the SAVAGE VOYAGER’s hull, through which thousands of gallons of oil poured into the river.The owners of the vessel sued the United States, not under the OPA, but under the common-law admiralty regime. They cited the Suits in Admiralty Act (SAA), a 1920 law by which Congress generally waived sovereign immunity for most admiralty claims. The interplay between the OPA and the SAA was an issue of first impression in the federal courts. The Eleventh Circuit affirmed the dismissal of the vessel owner’s claims for removal costs. OPA authorizes no claim against the government for oil-removal damages and OPA’s comprehensive remedial scheme displaced the SAA’s more general sovereign-immunity waiver. View "Savage Services Corp. v. United States" on Justia Law

Norton operated a pressure washer on a Tampa Convention Center dock that had no guardrails or barricades and was surrounded on three sides by water. Norton fell into the bay while working and drowned. He was wearing rubber boots and was not wearing a personal flotation device. During an investigation, an OSHA officer did not identify any incidents of employees falling off the dock before Norton’s accident, but did learn that two employees who had pressure washed the same dock voluntarily wore personal flotation devices. OSHA issued a citation to C&W for its failure to provide and require the use of a personal flotation device and proposed a $12,675 penalty.Eleventh Circuit precedents required proof either that the use of personal flotation devices was an industry custom or that C&W had “clear actual knowledge that personal protective equipment was necessary under the circumstances.” OSHA did not present any evidence of industry custom. An ALJ concluded that C&W had “clear actual knowledge" that personal protective equipment was necessary, given “an open and obvious hazard.” The Eleventh Circuit vacated the citation. The Commission misapplied the standard for actual knowledge in the absence of industry custom. A finding that C&W had actual knowledge of the requirement to provide and require the use of personal flotation devices for employees when they pressure washed the dock was not supported by substantial evidence. View "C&W Facility Services, Inc. v. Secretary of Labor" on Justia Law

Because the Eleventh Circuit previously determined that the Government does not have to formally intervene before filing a motion to settle a qui tam action, and because the reasoning is the same for dismissals, the court held that the Government does not have to formally intervene before moving to dismiss a qui tam case even though it had earlier declined to intervene. The court also concluded that decisions to dismiss are within the province of the Executive Branch subject only to limits imposed by the Federal Rules of Civil Procedure, a statute, or the Constitution.The court affirmed the district court's dismissal of the case. Here, when relators filed their initial complaint, the United States declined to intervene. Relators then filed an amended complaint adding additional defendants, some of which were Government employees in their individual and official capacities. The United States subsequently filed a motion to dismiss without first filing a motion to intervene in the case. View "United States v. McAvoy" on Justia Law

In this qui tam action, after the jury found that Pinellas violated the False Claims Act and that the United States sustained damages, the district court trebled the damages and imposed statutory minimum penalties of $1,177,000 ($5,500 for each of the 214 violations).The Eleventh Circuit affirmed in part and reversed in part. The court upheld the district court's admission of Exhibit 24 where Pinellas failed to argue that the admission of the evidence constituted plain error. The court concluded that there was sufficient evidence for the jury to have found that, had Medicare known of Pinellas's misrepresentations, it would not have paid the refiled reimbursement claims. Furthermore, viewed in the light most favorable to the verdict, the evidence on scienter is not overwhelmingly in favor of Pinellas. Therefore, the jury's decision stands. The court also upheld the jury's findings on damages where the court concluded that the proper measure of damages in this case is the difference between what the United States paid and what it would have paid had Pinellas' claims been truthful. The court rejected the remaining challenges to the jury's verdict. The court further concluded that the monetary award imposed does not violate the Excessive Fines Clause. Finally, the court dismissed Pinellas' appeal as to the allocation of the monetary award between Ms. Yates and the United States. View "Yates v. Pinellas Hematology & Oncology, P.A." on Justia Law

In November 2021, the Secretary of Health and Human Services issued an interim rule that requires facilities that provide health care to Medicare and Medicaid beneficiaries to ensure that their staff, unless exempt for medical or religious reasons, are fully vaccinated against COVID-19, 86 Fed. Reg. 61,555. Under the rule, covered staff must request an exemption or receive their first dose of a two-dose vaccine or a single-dose vaccine by December 6, 2021. Florida unsuccessfully sought a preliminary injunction to bar the interim rule’s enforcement.The Eleventh Circuit upheld the denial of the motion, first deciding not to apply the mootness doctrine and to exercise jurisdiction despite another district court’s issuance of a nationwide injunction. Florida failed to demonstrate a substantial likelihood that it will prevail on the merits, that it will suffer irreparable injury absent an injunction, or that the balance of the equities favors an injunction. The Secretary has express statutory authority to require facilities voluntarily participating in the Medicare or Medicaid programs to meet health and safety standards to protect patients. The Secretary provided a detailed explanation for why there was good cause for dispensing with the notice-and-comment requirement. Ample evidence supports the Secretary’s determination that facility staff vaccination will provide important protection for patients. View "State of Florida v. Department of Health and Human Services" on Justia Law

Liver-transplant candidates and transplant hospitals challenged HHS's adoption of a new policy for allocating donated livers. In 2019, the Eleventh Circuit held that the plaintiffs had not shown a substantial likelihood of success on the merits of their claim that the Secretary failed to follow procedures under 42 C.F.R. 121.4(b) during the new liver-allocation policy's development. Section 121.4(b) does not require the Secretary to refer the new liver allocation policy to an Advisory Committee on Organ Transplantation or to publish the new policy in the Federal Register for public comment. The court remanded for the district court to consider the remaining Administrative Procedure Act and Fifth Amendment claims.The district court ordered limited discovery on remand. The defendants ultimately produced requested communications between its top-level personnel and outside policymakers that, according to the plaintiffs, exposed “bad faith and improper behavior.” The district court ultimately excluded the documents from the administrative record for the APA claim, while noting that the documents included “colorable evidence of animosity and even some measure of regional bias.” The hospitals moved to unseal the documents. In 2021, the Eleventh Circuit affirmed an order unsealing the documents. The documents here are “plainly judicial records” and the appellants have not shown good cause to keep them sealed. View "Callahan v. United Network for Organ Sharing" on Justia Law

In 2008, following a diagnosis of multiple sclerosis (MS), Karantsalis sued the city under the Americans with Disabilities Act (ADA) and the Rehabilitation Act of 1973 by failing to make its facilities and infrastructure accessible to individuals with disabilities. He later voluntarily dismissed the lawsuit, believing that he lacked constitutional standing because his symptoms were mild and did not prevent him from accessing and using the city’s programs or services. By 2019, Karantsalis’s MS and his symptoms had progressed dramatically: he had started falling, developed a limp, and needed a disabled parking permit. His neurologist had prescribed a wheelchair.He again sued the city under the ADA and Rehabilitation Act alleging the sidewalks, municipal gymnasium, and parking at public facilities were inaccessible. The district court dismissed the case with prejudice, holding that it was barred by the four-year statute of limitations, which was triggered before or during 2008 when Karantsalis became aware of his MS diagnosis. The Eleventh Circuit reversed. From the face of his complaint, Karantsalis’s injury did not occur until at least 2017. Karantsalis could not have sued before he lost his mobility and his ready access to and use of the city’s public services. View "Karantsalis v. City of Miami Springs" on Justia Law