Justia Government & Administrative Law Opinion Summaries

Southern Farm Bureau Life Insurance Company (“Farm Bureau”) issued a term life insurance policy to S.M. S.M.’s husband, Plaintiff, who was the policy’s primary beneficiary. Farm Bureau received a notification from the Post Office indicating that S.M.’s address had changed. Farm Bureau sent its semiannual bill to S.M. at her South Carolina address, informing her that her payment was due on November 23, 2016. S.M. did not pay the bill. Plaintiff sued Farm Bureau in federal district court, seeking the policy’s coverage amount as well as excess damages for alleged unfair and deceptive trade practices on the part of Farm Bureau. He argued that Farm Bureau had not complied with a statutory notice requirement prior to canceling the insurance policy for nonpayment and he was therefore entitled to the policy’s benefits. The parties filed cross-motions for summary judgment, and the district court granted summary judgment to Farm Bureau.   The Fourth Circuit affirmed finding that Farm Bureau complied with the statute’s notice requirement. The court wrote that a literal interpretation of the statute’s language—referring to a notice being sent to the “last known post-office address in this State”—would not put S.M. on notice at all. Rather it would have Farm Bureau send “notice” to an address where it knows she no longer resides. Additionally, there is substance in Farm Bureau’s argument that a rigidly literal reading of the words “in this State” would require insurers to implement burdensome and nonsensical notice policies. View "Robert Whitmire v. Southern Farm Bureau Life Insurance Company" on Justia Law

The United States Government seized $69,940.50 in cash from Plaintiff’s car. Plaintiff and his girlfriend challenged the seizure, claiming that the cash was not subject to forfeiture. To forfeit the seized cash, the Government bore the burden of establishing a connection between the cash and the illegal activity—in this case, illegal drug trafficking. The district court, in granting summary judgment, found that the facts painted a picture that definitively established that the cash was drug money.   The Fourth Circuit reversed finding that the record is unclear regarding whether a reasonable jury might well decide that the painting of these facts shows the cash came from drug trafficking. The court explained that summary judgment in a forfeiture proceeding is like summary judgment in any other civil case. Applying those standards correctly ensures that the Government must prove its case before depriving citizens of their private property based on an allegation of wrongdoing. Here, the Government has the burden of proof. The Government lacks any direct evidence of a drug transaction or involvement in the drug trade beyond Plaintiff’s possession of a single marijuana blunt and medical marijuana cards. The Government would have the court rely on its own inferences from its circumstantial evidence, which the court may not do. View "US v. Dereck McClellan" on Justia Law

Genesis Healthcare was a healthcare provider participating in the federal “340B Program,” which was designed to provide drugs to qualified persons at discounted prices. Under the Program, the Secretary of the Department of Health and Human Services (“HHS”) enters into agreements with drug manufacturers to sell drugs at discounted prices to entities such as Genesis Healthcare, which could, in turn, sell the drugs to their patients at discounted prices. After Genesis Healthcare purchased the covered drugs from the manufacturers, it dispensed them to patients through its wholly owned pharmacies or contract pharmacies. After the Health Resources and Services Administration (“HRSA”) conducted an audit of Genesis Healthcare in June 2017 for Program compliance, HRSA removed Genesis Healthcare from the 340B Program. The audit report found, among other things, that Genesis Healthcare dispensed 340B drugs to individuals who were ineligible because they were not “patients” of Genesis Healthcare. HRSA rejected Genesis Healthcare’s challenges; Genesis Healthcare, in turn, filed suit seeking a declaration it did not violate the requirements of the Program, and injunctive relief requiring HRSA to reinstate it into the Program and to retract any notifications that HRSA had provided to manufacturers stating that Genesis Healthcare was ineligible under the Program. In response to the lawsuit, HRSA ultimately: (1) notified Genesis Healthcare by letter that it “ha[d] voided” all audit findings and that Genesis Healthcare “ha[d] no further obligations or responsibilities in regard to the audit” and (2) filed a motion to dismiss Genesis Healthcare’s action as moot based on the letter. The district court granted HRSA’s motion, finding that the action was moot. The Fourth Circuit reversed the district court's finding the case was moot: Genesis Healthcare continued to be governed by a definition of “patient” that, Genesis maintained, was illegal and harmful to it. Therefore, there remained a live controversy between the parties. View "Genesis HealthCare, Inc. v. Becerra" on Justia Law

Air Evac EMS, Inc., is an emergency air ambulance provider. Because the company's services are expensive, it markets and sells what it characterizes as a "debt cancellation program." Under this program, West Virginia residents pay a sum of money annually and any amount due on their bill in excess of what is covered by insurance will be canceled by the company.Through a series of communications and actions taken by West Virginia, Air Evac determined that the state was favoring a competitor. Air Evac brought several suits in district court. This one alleges that the Airline Deregulation Act preempts the West Virginia Insurance Commissioner from taking any enforcement efforts. Following this case, Air Evac brought another case against the Commissioner that remains pending at the time of this appeal.The district court determined that the abstention doctrine applied, however, because the case presented "extraordinary circumstances," the court determined that abstention was not appropriate.The Fourth Circuit affirmed. Under Younger v. Harris, 401 U.S. 37 (1971), federal courts should abstain from exercising jurisdiction to consider matters related to ongoing state criminal proceedings as well as quasi-criminal proceedings if the state proceeding is ongoing, implicates important state interests and provides an adequate opportunity to raise constitutional challenges. The Fourth Circuit determined that the district court properly analyzed the abstention factors. Thus, the district court did not abuse its discretion. View "Air Evac EMS, Inc. v. Allan McVey" on Justia Law

Plaintiff filed suit against the Iredell-Statesville School District Board of Education (“ISSD”) and several individual defendants, alleging federal constitutional and statutory claims, as well as state law claims for negligence and negligent inflection of emotional distress arising from school officials’ mistreatment of her son.  Some of the defendants timely moved to dismiss, asserting that the state law negligence claims against them in their individual capacities were barred by public official immunity under North Carolina law.   The district court granted their motion in part and dismissed all federal claims against the appellants. But as for the state law negligence claims, it denied the school officials’ motion to dismiss. It concluded that the school officials were not entitled to public official immunity for a breach of a ministerial duty to report child abuse.   The Fourth Circuit affirmed the district court’s dismissal of Plaintiff’s negligence claims. The court reasoned that the school officials’ actions at issue here were discretionary. What to do when faced with allegations of a teacher mistreating her student is not a decision that can be made automatically, without regard to the administrator’s judgment.  Further, Plaintiff’s claim was against public officials, in their individual capacities, for state law negligence. For such claims, North Carolina law dictates that the plaintiff may only pierce public official immunity by “showing that the defendant-official’s tortious conduct falls within one of the immunity exceptions. Plaintiff has not satisfied this obligation because she did not allege malice, or any other piercing exception, in the amended complaint. View "R.A. v. Brady Johnson" on Justia Law

Plaintiff, a North Carolina attorney, believed he uncovered fraud perpetrated by forty-five adult care homes upon the United States and the State of North Carolina. According to Plaintiff, Defendants violated a North Carolina Medicaid billing regulation, and did so knowingly, as evidenced by the clarity of the regulation and by the fact Defendants did not ask the regulators for advice. The district court granted Defendants’ motion for summary judgment, holding that Plaintiff failed to proffer evidence showing “that the bills submitted by Defendants to North Carolina Medicaid for PCS reimbursement were materially false or made with the requisite scienter.”   The Fourth Circuit affirmed the district court’s decision. The court held that no reasonable juror could find Defendants acted with the requisite scienter on Plaintiff’s evidence. The court explained that The False Claims Act (“FCA”) imposes civil liability on “any person who . . . knowingly presents, or causes to be presented” to the Federal Government “a false or fraudulent claim for payment or approval.” The Act’s scienter requirement defines “knowingly” to mean that a person “has actual knowledge of the information,” “acts in deliberate ignorance of the truth or falsity of the information,” or “acts in reckless disregard of the truth or falsity of the information.” Here, Plaintiff failed to identify any evidence that Defendants knew, or even suspected, that their interpretation of the relevant policy and the guidance from NC Medicaid was incorrect. Nor did Plaintiff identify any evidence that Defendants attempted to avoid discovering how the regulation applied to adult care homes. View "US ex rel. Stephen Gugenheim v. Meridian Senior Living, LLC" on Justia Law

Plaintiffs., a Florida-based wine retailer, plus its owner and three North Carolina residents, initiated a 42 U.S.C. Section 1983 action, challenging a North Carolina alcoholic beverage control regime as unconstitutional. More specifically, the Plaintiffs alleged that North Carolina’s regime, which prohibits out-of-state retailers — but not in-state retailers — from shipping wine directly to consumers in North Carolina (the “Retail Wine Importation Bar”), contravenes the Constitution’s dormant Commerce Clause. The Plaintiffs sought declaratory and injunctive relief and named the Chair of the North Carolina Alcoholic Beverage Control Commission as a defendant (“N.C. Commission”). The district court awarded summary judgment to the N.C. Commission.   The Fourth Circuit affirmed the ruling, holding that even though the Retail Wine Importation Bar discriminates against interstate commerce — it is authorized by Section 2 of the 21st Amendment. The court explained that its analysis of North Carolina’s Retail Wine Importation Bar under the Tennessee Wine framework led the court to conclude that, although the Bar discriminates against interstate commerce, it is nevertheless justified on the legitimate non- protectionist ground of preserving North Carolina’s three-tier system. View "B-21 Wines, Inc. v. Hank Bauer" on Justia Law

White Coat Waste Project (“WCW”) tried to run an advertisement denouncing animal experimentation with the Greater Richmond Transit Company (“Richmond Transit”) the ad was denied for being impermissibly “political.” WCW sued, challenging that denial as a violation of its First Amendment rights. Richmond Transit responded that, as a private company, it is not bound by the First Amendment, and even if it were, its policy passes constitutional muster because it only restrains speech in a nonpublic forum.   The district court disagreed on both counts, concluding that Richmond Transit is a state actor subject to constitutional constraints and that its policy violates the First Amendment right to free speech. But the district court granted WCW only partial summary judgment, holding that it could not provide the facial relief WCW sought because public-transit political-advertising bans can sometimes accord with the Constitution.   The Fourth Circuit concluded that the district court correctly identified Richmond Transit as a state actor and held that Richmond Transit’s policy is not “capable of reasoned application” and is therefore unconstitutionally unreasonable. Further, the court held that the district court erred in denying facial relief. Even if another public-transit political-advertising ban may be constitutional, this ban is incapable of reasoned, constitutional application in all circumstances. Thus, it is facially unconstitutional and warrants facial relief. View "White Coat Waste Project v. Greater Richmond Transit Co." on Justia Law

Plaintiff entered the United States in 2014 when he was apprehended by border patrol agents before eventually being released to his older brother (a resident of North Carolina).On or shortly before his eighteenth birthday, Plaintiff filed an application for special immigrant juvenile (SIJ) status with the United States Citizenship and Immigration Services (USCIS). SIJ status provides certain protections against removal under 8 U.S.C. Sec. 1255 and can lead to lawful permanent residency and citizenship. USCIS issued Plaintiff a Notice of Intent to Deny his SIJ application and Plaintiff appealed to the Administrative Appeals Office (AAO), which upheld the denial. Plaintiff then filed a complaint in district court seeking review of the agency’s denial of his SIJ applicationOn rehearing en banc, the court reversed the judgment of the district court and remanded with instructions to grant Plaintiff’s motion to set aside USCIS’s denial of SIJ status. Following his victory before the en banc court, Plaintiff sought to recover attorney’s fees and expenses under the Equal Access to Justice Act (EAJA). The district court denied Plaintiff’s EAJA application, finding the government’s position was “substantially justified.” The Fourth Circuit reasoned that "this was a tough case" involving reasonable arguments on both sides. Thus, the court affirmed the district court’s ruling finding the government’s position was substantially justified. View "Felipe Perez v. Ur Jaddou" on Justia Law

The plaintiffs filed suit in South Carolina state court against fourteen defendants (ten individuals and four agencies), alleging five causes of action. The circuit court reviewed five preserved issues: (1) the applicable statutes of limitations for plaintiffs' claims under the Rehabilitation Act ("RA") and the Americans with Disabilities Act ("ADA"); (2) whether the district court abused its discretion in excluding the witnesses' testimonies; (3) the plaintiffs' assertion that the district court improperly instructed the jury as to the duty owed under the South Carolina Tort Claims Act; (4) whether the district court improperly dismissed plaintiff’s RA claims; and (5) whether the court erred in dismissing plaintiff’s 1983 claims.The circuit court affirmed the district court’s decision to limit the plaintiffs' witness's testimony and further found that the court did not abuse its discretion by limiting the hybrid witness's testimony or by determining whether the defendant’s deposition had any potential to lead to admissible evidence.Further, the court found no error in the district court’s instruction or its' finding that the ADA and RA claims were subject to the South Carolina Human Affairs Law’s one-year statute of limitations. The plaintiffs failed to show reversible error as they neither pleaded nor proved any action or inaction by any individually named defendants that caused them harm. View "Johnny Timpson v. Anderson County Disabilities" on Justia Law