Justia Government & Administrative Law Opinion Summaries

Articles Posted in US Court of Appeals for the Sixth Circuit
by
General’s clinicians perform services in long-term care facilities. General bills Medicare under 42 U.S.C. 1395. A Centers for Medicare and Medicaid Services (CMS) contractor, AdvanceMed, initiated audits in 2002 after the CMS fraud unit received complaints about General’s billing practices. In 2004 AdvanceMed initiated an audit of General’s physicians without providing any notice to General. AdvanceMed sent records requests to physicians at 12 General facilities, covering 382 claims involving 278 patients in 2002-2004. General was not notified of these requests. AdvanceMed did not request any records from General. AdvanceMed determined that 35 of the 382 claims were allowed as billed; 33 claims were allowed at different levels than billed. The remaining 314 claims were denied: 3 did not meet policy guidelines, 73 had no documentation to support the services, and 238 were medically unnecessary. General learned of this audit when it received a letter in 2007, indicating that General had been overpaid by $16,778.80; the overpayment was extrapolated to a universe of 41,818 claims. The total amount of overpayment demanded was $1,836,646.56. The Appeals Council determined and the Sixth Circuit affirmed that no remedy should be granted because the lack of notice was inconsequential and did not prevent General from ably and thoroughly arguing the principal issues resulting from the audit, the validity of the sampling methodology, and the coverage of the reviewed claims. The addition of more medical records would not have materially impacted its findings. View "General Medicine, P.C. v. Azar" on Justia Law

by
In a consolidated putative class action based on the Flint Water Crisis, the defendants include government officials from the State of Michigan, the City of Flint, state agencies, and private engineering companies. While government officials like former Governor Snyder and former Treasurer Dillon have been litigating the issue of qualified immunity, discovery against private parties has proceeded. In 2019, the district court granted the government officials’ motions to dismiss claims alleging 42 U.S.C. 1983 equal-protection violations, section 1985(3) conspiracy, Michigan’s Elliott Larsen Civil Rights Act, section 1983 state-created danger, and gross negligence. The court denied motions to dismiss plaintiffs’ section 1983 bodily-integrity claim on the bases of qualified and absolute immunity,. The court entered a comprehensive case management order. Snyder and Dillon claimed that they cannot be deposed as non-party fact witnesses with respect to other defendants, arguing that they are immune from all discovery until they have exhausted every opportunity for appeal from the denial of their motions to dismiss based on qualified immunity. The Sixth Circuit denied Snyder’s and Dillon’s request for a stay of non-party depositions pending resolution of their appeal from the order denying their request for a protective order, and dismissed, for lack of jurisdiction, their appeal from the denial of a protective order. View "Waid v. Earley" on Justia Law

by
Lake manufactures steel-framed buildings. In June 2016, in Akron, two Lake employees were working atop the steel frame of a partially completed building, 28 feet above the ground. The employees were wearing safety harnesses that, if anchored to the building, would prevent them from falling; they had chosen to remain unanchored while they worked with a crane to place bundles of steel decking. An OSHA compliance officer cited their failure to anchor their harnesses as a violation of OSHA’s fall-protection regulations. The on-site foreman disagreed, asserting that those workers were “connectors.” An ALJ upheld the citation, reasoning that the workers were only “placing” the decking bundles, rather than “placing and connecting” them, 29 C.F.R. 1926.751. OSHA’s regulations generally require ironworkers to use fall protection whenever working above a height of 15 feet, but there is an exception to that rule for “connectors,” who are specially trained to work with incoming loads from hoisting equipment and need to remain unencumbered to escape collapses and incoming steel. A “connector,” is defined as “an employee who, working with hoisting equipment, is placing and connecting structural members and/or components.” The Sixth Circuit granted Lake’s petition for review. The court agreed with the Commission’s interpretation of the regulation but concluded on this record that Lake lacked fair notice of that interpretation. View "Lake Building Products, Inc. v. Secretary of Labor" on Justia Law

by
In response to the COVID-19 pandemic, the Governor of Tennessee issued “shelter-in-place” orders. On April 8, 2020, the Governor ordered that “[a]ll healthcare professionals and healthcare facilities ... postpone surgical and invasive procedures that are elective and non-urgent,” until April 30 in order to preserve personal protective equipment and prevent community spread of COVID-19 through nonessential patient-provider interactions. Elective and non-urgent procedures were defined as those that can be delayed because they are not required to provide life-sustaining treatment, to prevent death or risk of substantial impairment of a major bodily function, or to prevent rapid deterioration or serious adverse consequences to a patient’s physical condition … as reasonably determined by a licensed medical provider. A Tennessee woman may receive a “medication abortion” within 11 weeks from her last menstrual period or a “procedural abortion” within the first 20 weeks (aspiration or dilation and evacuation), subject to a 48-hour waiting period and in-person visitation requirements. On April 17, the district court enjoined Tennessee from enforcing that ban against doctors performing abortion procedures. The Sixth Circuit affirmed, acknowledging the challenges Tennessee faces in responding to the public health crisis,” but concluding that the “response, in this one respect, unduly curtailed constitutional liberty." The court ordered modification of the injunction so that it prohibits the state from enforcing the ban against plaintiffs to the extent they provide procedural abortions to specific patients, including women who, in the good-faith professional judgment of the provider, will likely be forced to undergo a D&E procedure instead of an aspiration if their procedures are delayed. View "Adams & Boyle, P.C. v. Slatery" on Justia Law

by
The Twenty-first Amendment permits the states to regulate the sales of alcohol within their borders. Michigan is among several states with a three-tier system that forbids alcohol producers (first tier) to sell directly to retailers or consumers. Producers must sell to wholesalers within the state (second tier); those wholesalers sell exclusively to in-state retailers, who sell to consumers. Businesses at each tier must be independently owned; no one may operate more than one tier, Michigan imposes minimum prices and prohibits wholesalers from offering volume discounts or selling on credit. For liquor (not wine and beer), the state is the wholesaler in Michigan. In 2016, Michigan amended its law to allow in-state retailers to deliver directly to consumers using state-licensed “third party facilitators” or common carriers like FedEx or UPS. A wine retailer based in Fort Wayne, Indiana and Michigan wine consumers alleged that the new law violated the Commerce Clause and the Privileges and Immunities Clause. The district court extended delivery rights to out-of-state retailers. Michigan obtained a stay. The Sixth Circuit reversed. The Twenty-first Amendment permits Michigan to treat in-state retailers differently from out-of-state retailers. There is no inherent right to sell intoxicating liquors by retail. Some reduction in consumer choice is inevitable in a three-tier system, which is intended to make it harder to sell alcohol. View "Lebamoff Enterprises, Inc., v. Whitmer" on Justia Law

by
The Office of Personnel Management (OPM), manages the Federal Employees’ Group Life Insurance Act (FEGLIA), 5 U.S.C. 8705(a). Absent a valid beneficiary selection, FEGLIA provides an order of precedence for the proceeds, starting with the policyholder's surviving spouse, followed by the policyholder's descendants. FEGLIA will not follow that order if a “court decree of divorce, annulment, or legal separation, or . . . any court order or court-approved property settlement agreement” “expressly provides” for payment to someone else. The decree, order, or agreement must be “received” by the policyholder’s “employing agency” or OPM before the policyholder’s death. At the time of his death, Miller worked at Tinker Air Force Base and maintained a MetLife policy. Coleman's 27-year marriage to Donna ended in divorce in 2011. Their property settlement agreement states that “[Donna] shall remain the beneficiary of the life insurance policy.” The court ordered Coleman to assign his FEGLI benefits to Donna. Upon Coleman’s death, his only child, Courtenay, was appointed administratrix of his estate. The Air Force informed Courtenay that the court order had not been filed with Coleman’s employing office. Courtenay was paid $172,000 in proceeds and sought a declaration that she is the rightful owner. Citing lack of subject-matter jurisdiction, the district court dismissed the suit. The Sixth Circuit affirmed, noting the lack of a substantial federal question. FEGLIA does not contain an express cause of action for Donna. There is no federal agency involved. View "Miller v. Bruenger" on Justia Law

by
The plaintiffs sued, alleging that, in future elections, the defendants (various officials) will burden their right to vote, dilute their votes, and disenfranchise them in violation of the Equal Protection and Due Process clauses. The plaintiffs cited election administration problems: election workers are poorly trained, sometimes distributing the wrong ballots, sometimes recording the wrong address when registering a voter; failure to recertify the voting machines; failure to follow fair protocols for uploading votes; the use of digital voting machines, vulnerable to hacking and cyberattacks, that do not produce a paper record of each voter’s choices. The Sixth Circuit affirmed the dismissal of the suit. The complaint’s allegations with respect to injury all reference prior system vulnerabilities, previous equipment malfunctions, and past election mistakes; nearly all of the allegations of past harm stem from human error rather than errors caused by the voting machines or hacking. Fear that individual mistakes will recur, generally speaking, does not create a cognizable imminent risk of harm. The plaintiffs do not allege that Shelby County election officials always make these mistakes or that the government entities ordered the election workers to make such mistakes. The plaintiffs have not plausibly shown that there is a substantial risk of vote flipping. Without imminent harm, the individual plaintiffs have no standing to sue. The plaintiffs allege only policies that add risk to the ever-present possibility that an election worker will make a mistake. View "Shelby Advocates for Valid Elections v. Hargett" on Justia Law

by
Saginaw County has nearly 200,000 residents. A single company, Mobile Medical, has provided the county’s ambulance services since 2009. The county guaranteed Mobile the exclusive right to operate within its borders; Mobile pledged to serve all eight of Saginaw County’s cities and incorporated villages and its 27 rural townships. In 2011, STAT, a competing ambulance company, entered the Saginaw market, providing patient-transport services for an insurer as part of a contract that covered six Michigan counties. A municipality, dissatisfied with Mobile’s response times and fees, hired STAT. When Saginaw County proposed to extend Mobilel’s contract in 2013, STAT objected, arguing that the arrangement violated state law, federal antitrust law, and the Fourteenth Amendment. The county approved Mobile's new contract and enacted an ordinance that codified the exclusivity arrangement but never enforced the ordinance. STAT continued to insist that Michigan law permitted it to offer ambulance services. Saginaw County sought a federal declaratory judgment that Michigan law authorizes the exclusive contract and that it does not violate federal antitrust laws or the U.S. Constitution by prohibiting STAT from operating in the county. The Sixth Circuit affirmed the dismissal of the claim for lack of jurisdiction. The county failed to establish an actual or imminent injury. Federal courts have the power to tell parties what the law is, not what it might be in potential enforcement actions. View "Saginaw County. v. STAT Emergency Medical Services, Inc." on Justia Law

by
Johnson rented her restaurant to a private party. For unknown reasons, individuals unaffiliated with her or the party emerged from a vehicle that night and shot at the restaurant. Police were called during the shooting but never apprehended the shooters. Less than two days later, Saginaw City Manager Morales issued Johnson a notice ordering the suspension of all business activity related to her restaurant under an ordinance that permits such suspensions “in the interest of the public health, morals, safety, or welfare[.]” There was hearing three days later. More than two months after the hearing, Human Resources Director Jordan upheld the suspension. Johnson filed suit with a motion for a temporary restraining order and, alternatively, a motion for a preliminary injunction to prevent Morales from sitting on the appeal panel expected to review Jordan’s decision. The district court denied that motion. The appeal panel, which did not include Morales, held a hearing and affirmed Jordan’s decision upholding the suspension. The Sixth Circuit reversed, in part, the dismissal of Johnson’s burden-shifting, substantive due process, and equal-protection claims. Johnson adequately alleged selective enforcement and pled that the city lacked a rational basis to suspend her license. Johnson has plausibly alleged that the procedures afforded to Johnson fell short of constitutional requirements. View "Johnson v. Morales" on Justia Law

by
FES distributes electricity, buying it from its fossil-fuel and nuclear electricity-generating subsidiaries. FES and a subsidiary filed Chapter 11 bankruptcy. The bankruptcy court enjoined the Federal Energy Regulatory Commission (FERC) from interfering with its plan to reject certain electricity-purchase contracts that FERC had previously approved under the Federal Power Act, 16 U.S.C. 791a or the Public Utilities Regulatory Policies Act, 16 U.S.C. 2601, applying the ordinary business-judgment rule and finding that the contracts were financially burdensome to FES. The counterparties were rendered unsecured creditors to the bankruptcy estate. The Sixth Circuit agreed that the bankruptcy court has jurisdiction to decide whether FES may reject the contracts, but held that the injunction was overly broad (beyond its jurisdiction) and that its standard for deciding rejection was too limited. The public necessity of available and functional bankruptcy relief is generally superior to the necessity of FERC’s having complete or exclusive authority to regulate energy contracts and markets. The bankruptcy court exceeded its authority by enjoining FERC from “initiating or continuing any proceeding” or “interfer[ing] with [its] exclusive jurisdiction,” given that it did not have exclusive jurisdiction. On remand, the bankruptcy court must reconsider and decide the impact of the rejection of these contracts on the public interest—including the consequential impact on consumers and any tangential contract provisions concerning such things as decommissioning, environmental management, and future pension obligations—to ensure that the “equities balance in favor of rejecting the contracts.” View "In re: FirstEnergy Solutions Corp." on Justia Law