Articles Posted in US Court of Appeals for the Third Circuit

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Little Sisters of the Poor, a Roman Catholic congregation serving the elderly poor of all backgrounds, operates homes for the elderly, all of which adhere to the same religious beliefs. A religious nonprofit corporation that operates a Little Sisters home in Pittsburgh sought to intervene in litigation challenging regulations promulgated under the Patient Protection and Affordable Care Act, 42 U.S.C. 300gg-13(a)(4). That litigation was instituted by the Commonwealth of Pennsylvania, challenging interim final rules, providing for “religious” and “moral “ exemptions to the Act's "contraceptive mandate" for “entities, and individuals, with sincerely held religious beliefs objecting to contraceptive or sterilization coverage,” including “for-profit entities that are not closely-held.” The Third Circuit reversed the denial of their motion. Little Sisters’ interest in the regulations is neither novel nor isolated; it has been involved in Affordable Care Act litigation for years. Little Sisters’ interest in preserving the religious exemption is concrete and capable of definition; the relationships among the organization's various homes indicate a unique interest compared to other religious objectors who might wish to intervene. Those interests are significantly protectable. Little Sisters have demonstrated that they may be “practically disadvantaged by the disposition of the action” and have established that their interests are not adequately represented by the federal government. View "Commonwealth of Pennsylvania v. President United States" on Justia Law

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In 2015, former Virgin Islands Senator James was charged with wire fraud, 18 U.S.C. 1343, and federal programs embezzlement, 18 U.S.C. 666(a)(1)(A), stemming from his use of legislative funds to ostensibly obtain historical documents from Denmark related to the Fireburn, an 1878 St. Croix uprising. The indictment specified: obtaining cash advances from the Legislature but retaining a portion of those funds for his personal use; double-billing for expenses for which he had already received a cash advance; submitting invoices and receiving funds for translation work that was never done; and submitting invoices and receiving funds for translation work that was completed before his election to the Legislature. James, who argued that he was engaged in legislative fact-finding, moved to dismiss the indictment on legislative immunity grounds. The district court denied the motion, stating that James’ actions were not legislative acts worthy of statutory protection under the Organic Act of the Virgin Islands. The Third Circuit affirmed. Under 48 U.S.C. 1572(d) legislators are protected from being “held to answer before any tribunal other than the legislature for any speech or debate in the legislature." The conduct underlying the government’s allegations concerning James is clearly not legislative conduct protected by section 1572(d). View "United States v. James" on Justia Law

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Migliaro purchased a Standard Flood Insurance Policy (SFIP) under the National Flood Insurance Program, 42 U.S.C. 4011(a), from Fidelity for his property, which sustained flood damage in October 2012's Hurricane Sandy. Fidelity’s adjuster recommended a payment of $90,499.11, which Fidelity paid. Five months later, Migliaro submitted a proof of loss, claiming an additional $236,702.57. On July 15, 2013, Fidelity sent Migliaro a letter titled “Rejection of Proof of Loss,” stating: This is not a denial of your claim. Your field adjuster provided you with an estimate and Proof of Loss regarding covered damages. If there are additional covered damages identified, please forward documentation and they will be considered. Migliaro did not provide additional documentation or submit a second proof of loss but filed suit. Migliaro's July 2015 complaint was dismissed as untimely. Because SFIP claims are ultimately paid by the government, SFIPs are identical and state: You may not sue ... unless you have complied with all the requirements of the policy. If you do sue, you must start the suit within one year after the date of the written denial of all or part of the claim. The Third Circuit affirmed. Although the rejection of a proof of loss is not per se a denial of the claim, it does constitute a denial if the policyholder treats it as such by filing suit against the carrier. View "Migliaro v. Fidelity National Indemnity Insurance Co." on Justia Law

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Migliaro purchased a Standard Flood Insurance Policy (SFIP) under the National Flood Insurance Program, 42 U.S.C. 4011(a), from Fidelity for his property, which sustained flood damage in October 2012's Hurricane Sandy. Fidelity’s adjuster recommended a payment of $90,499.11, which Fidelity paid. Five months later, Migliaro submitted a proof of loss, claiming an additional $236,702.57. On July 15, 2013, Fidelity sent Migliaro a letter titled “Rejection of Proof of Loss,” stating: This is not a denial of your claim. Your field adjuster provided you with an estimate and Proof of Loss regarding covered damages. If there are additional covered damages identified, please forward documentation and they will be considered. Migliaro did not provide additional documentation or submit a second proof of loss but filed suit. Migliaro's July 2015 complaint was dismissed as untimely. Because SFIP claims are ultimately paid by the government, SFIPs are identical and state: You may not sue ... unless you have complied with all the requirements of the policy. If you do sue, you must start the suit within one year after the date of the written denial of all or part of the claim. The Third Circuit affirmed. Although the rejection of a proof of loss is not per se a denial of the claim, it does constitute a denial if the policyholder treats it as such by filing suit against the carrier. View "Migliaro v. Fidelity National Indemnity Insurance Co." on Justia Law

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Private indirect purchasers of prescription Flonase filed a class action, alleging that GSK had filed sham petitions with the FDA to delay the introduction of generic Flonase and force them to pay more for Flonase than they would have if the generic version were available. Those plaintiffs moved for final approval of settlement after the court certified the class and approved the notice to settlement class members. Louisiana, an indirect Flonase purchaser, qualified as a potential class member but did not receive the notice; it only received a Class Action Fairness Act (CAFA) Notice, for “the appropriate State official of each State in which a class member resides,” 28 U.S.C. 1715(b) The settlement “permanently enjoined” all members of the settlement class, including Louisiana, from bringing released claims against GSK, even in state court. In an ancillary suit, GSK moved to enforce the settlement against the Louisiana Attorney General. The Third Circuit affirmed denial of the request, finding that under the Eleventh Amendment “a State retains the autonomy to choose ‘not merely whether it may be sued, but where it may be sued.'" Although some of Louisiana’s claims fall within the settlement, the state did not waive its sovereign immunity. Receipt of the CAFA Notice was insufficient to unequivocally demonstrate that the state was aware that it was a class member and voluntarily chose to have its claims resolved. View "In re: Flonase Antitrust Litigation" on Justia Law

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The Delaware Companies challenged Delaware’s right to audit whether funds paid for stored-value gift cards issued by their Ohio-based subsidiaries are held by the Companies and subject to escheatment. Their argument relied on Supreme Court precedent establishing priority among states competing to escheat abandoned property, giving first place to the state where the property owner was last known to reside. If that residence cannot be identified or if that state has disclaimed its interest, second in line is the state where the holder of the abandoned property is incorporated; any other state is preempted from escheating the property. The Companies argued that money left unclaimed by owners of the stored-value cards is held by the Ohio Subsidiaries, so Delaware can have no legitimate escheatment claim and must be barred from auditing the Companies in connection with the gift cards. The Third Circuit held that private parties can invoke federal common law to challenge a state’s authority to escheat property but agreed that dismissal was proper. “The notion that the State cannot conduct any inquiry into abandoned property to verify a Delaware corporation’s representations regarding abandoned property lacks merit” and, to the extent the Companies challenged the scope or means of the audit, the claim is not ripe, since Delaware has taken no formal steps to compel an audit. View "Marathon Petroleum Corp v. Secretary of Finance for the State of Delaware" on Justia Law

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Caremark is a pharmacy benefit manager. In 2006, Caremark employees identified approximately 4,500 Prescription Drug Events (PPDEs) under Medicare Part D that had been authorized for payment by Caremark, but not yet submitted to the Centers for Medicare and Medicaid Services (CMS), due to the lack of a compatible Prescriber ID. Caremark then used a dummy Prescriber ID for those PDEs and programmed that dummy Prescriber ID into its system. Thereafter, when any claim with a missing or incorrectly formatted Prescriber ID was processed, the system would default to the dummy, which allowed Caremark to submit for payment PDEs without trigging CMS error codes. Spay, a pharmacy auditor, discovered the use of “dummy” Prescriber IDs while auditing a Caremark client. That client dropped all issues identified in the audit, collected no recovery from Caremark, and did not pay Spay. Spay filed a qui tam lawsuit, asserting violations of the False Claims Act because the inaccurate PDEs were used to support reimbursement requests. The government declined to intervene. The court granted Caremark summary judgment, finding that Caremark had established sufficient government knowledge to preclude finding the required element of scienter, noting that several courts have adopted the government knowledge inference doctrine. The Third Circuit affirmed, declining to adopt that doctrine but stating that the misrepresentations were not material to the government’s decision to pay the underlying claims. View "Spay v. CVS Caremark Corp" on Justia Law

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Jeffrey Ware, Ph.D., was a University of Pennsylvania neuroscientist, studying the effects of radiation on biological organisms with the goal of better understanding how radiation affects astronauts while in orbit. Ware used cesium-137 irradiators to track the effects of low-level radiation on mice and rats. In 2010, Ware suffered a rare form of brain cancer, gliosarcoma. His widow, Boyer, claims gliosarcoma is associated with radiation exposure but produced no expert reports and that Ware’s cancer specifically resulted from radiation exposure that UPenn failed to properly monitor, protect against or warn of. Ware underwent chemotherapy and radiation at the University’s hospital. Boyer alleges that Ware was not given appropriate information about these treatments; that, given the advanced stage of his disease, they provided little benefit; and that a UPenn doctor enrolled Ware in a research study to investigate the effects of chemotherapy and radiation on brain cancer patients without his knowing consent. The Third Circuit affirmed the application of the Price-Anderson Act, 42 U.S.C. 2011, and its remedy-limiting provisions to Boyer's suit. The Act gives federal courts jurisdiction to resolve a broad set of claims involving liability for physical harm arising from nuclear radiation. Boyer’s case is within the Act’s reach. View "Estate of Ware v. Hospital of the University of Pennsylvania" on Justia Law

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Tennessee Gas applied to several federal and state agencies seeking approval to build the Orion interstate pipeline project, comprising 12.9 miles of pipeline looping that would transport 135,000 dekatherms of natural gas per day via Pennsylvania. Approximately 99.5% of the new pipeline would run alongside existing pipeline. The Pennsylvania Department of Environmental Protection issued a permit approving the project. Riverkeeper argued that the court lacked jurisdiction to rule on its challenge because PADEP’s order was not final and that PADEP made an erroneous “water dependency” finding and improperly rejected a “compression” alternative to the pipeline project. The Third Circuit concluded that PADEP’s decision was final and upheld the decision on the merits because the agency’s unique interpretation of water dependency was reasonable and worthy of deference. PADEP considered and rejected the compression alternative for reasons that are supported by the record. Where an interstate pipeline project is proposed to be constructed,15 U.S.C. 717f provides “original and exclusive jurisdiction over any civil action for the review of an order or action of a . . . State administrative agency acting pursuant to Federal law to issue . . . any permit, license, concurrence, or approval . . . required under Federal law,” View "Delaware Riverkeeper Network v. Secretary, Pennsylvania Department Environmental Protection" on Justia Law

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Misternovo and his sons (Petitioners) are citizens of Guatemala who first entered the U.S. in 1990, 1998, and 2004, respectively. In 1999, Misternovo filed an application for suspension of deportation or special rule cancellation of removal under the Nicaraguan Adjustment and Central American Relief Act (NACARA) that listed his sons as derivatives. USCIS denied the NACARA application. In 2008, the Department of Homeland Security initiated removal proceedings under 8 U.S.C. 1182(a)(6)(A)(i). The Immigration Judge ruled that Petitioners were removable as charged. Later, in January 2012, Misternovo’s NACARA application received a full merits hearing. An Immigration Judge denied that application, holding that Misternovo had failed to establish that he had timely registered for benefits pursuant to the American Baptist Churches v. Thornburgh settlement agreement; an appeal was dismissed by the BIA. More than two years later, Petitioners filed a motion to reopen based on changed country conditions in Guatemala. The BIA denied the motion. The Third Circuit denied a petition for review. The time bar contained in 8 C.F.R. 1003.2(c) applies to motions to reopen based on a request for withholding of removal under the Convention Against Torture. View "Bamaca-Cifuentes v. Attorney General United States" on Justia Law