Justia Government & Administrative Law Opinion Summaries

Steven M. Camburn, a former sales specialist for Novartis Pharmaceuticals Corporation, filed a qui tam action under the False Claims Act (FCA) and equivalent state and municipal laws. Camburn alleged that Novartis violated the Anti-Kickback Statute (AKS) by offering remuneration to physicians to induce them to prescribe its drug Gilenya, which treats multiple sclerosis. He claimed that Novartis used its peer-to-peer speaker program and other forms of illicit remuneration to influence physicians' prescribing practices.The United States District Court for the Southern District of New York dismissed Camburn's Third Amended Complaint (TAC) with prejudice, concluding that he had not pleaded his allegations with the particularity required under Rule 9(b) to support a strong inference of an AKS-based FCA violation. The court found that Camburn's allegations did not adequately demonstrate the existence of a kickback scheme.The United States Court of Appeals for the Second Circuit reviewed the case and held that a plaintiff states an AKS violation if they allege with particularity that at least one purpose of the purported scheme was to induce fraudulent conduct. The court found that Camburn had adequately pleaded certain categories of factual allegations that gave rise to a strong inference of an AKS violation. Specifically, Camburn sufficiently alleged that Novartis held sham speaker events with no legitimate attendees, excessively compensated physician speakers for canceled events, and selected and retained speakers to incentivize prescription-writing.The Second Circuit affirmed the district court's dismissal in part but vacated the judgment and remanded the case in part. The court instructed the district court to evaluate whether Camburn had stated all the elements of an FCA claim with respect to the adequately pleaded AKS violations and to assess the adequacy of Camburn's claims under state and municipal law. View "Camburn v. Novartis Pharmaceuticals Corporation" on Justia Law

Dr. Judith Robinson, a former employee of HealthNet, a federally qualified health center in Indiana, brought a qui tam action against HealthNet, alleging fraudulent billing practices, including improper Medicaid billing for ultrasound readings. She claimed that HealthNet billed Medicaid for face-to-face encounters that did not occur. Dr. Robinson initially filed a suit in 2013 (Robinson I), which was settled in 2017, excluding the wrap-around claims. These claims were dismissed without prejudice, allowing for future litigation.In 2019, Dr. Robinson filed a new suit (Robinson II) to address the wrap-around claims. The United States declined to intervene, but Indiana did. Indiana moved to dismiss all claims except for the wrap-around claims from October 18, 2013, to February 28, 2015, as the rest were time-barred. The district court dismissed Count III of Dr. Robinson's complaint, which sought to enforce an alleged oral settlement agreement, due to lack of standing, as Dr. Robinson failed to provide competent proof of the agreement's existence.The United States Court of Appeals for the Seventh Circuit reviewed the case. The court affirmed the district court's dismissal of Count III, agreeing that Dr. Robinson lacked standing because she did not demonstrate any breach of the alleged oral agreement by HealthNet. The court also upheld the district court's approval of the settlement between Indiana and HealthNet, finding it fair, adequate, and reasonable. The court noted that the reduction in the relator’s share was due to Dr. Robinson's own actions, including the failure to obtain a tolling agreement, which led to many claims being time-barred. The court also agreed with the application of the Federal Medical Assistance Percentage (FMAP) in calculating the settlement amount. View "Robinson v. Healthnet, Inc." on Justia Law

The case involves a dispute between the Government Oversight Committee of the 131st Maine Legislature and the Maine Department of Health and Human Services (DHHS) over access to confidential records related to the deaths of four children in 2021. The DHHS refused to provide the records, citing confidentiality laws. The Committee then filed an action in the Superior Court (Kennebec County) to compel the DHHS to comply with its subpoena. The Superior Court denied the Committee’s request, and the Committee appealed.The Superior Court (Kennebec County) ruled that the Committee did not have the statutory authority to access the confidential records and denied the motion to compel. The Committee then appealed the decision to the Maine Supreme Judicial Court.The Maine Supreme Judicial Court affirmed the Superior Court’s judgment. The Court held that the Committee does not have the statutory authority to access confidential records under the OPEGA statute, which limits the Committee’s access to public information and records. The Court also found that the statutory exception in 22 M.R.S. § 4008(3)(D) does not apply to the Committee, as it is not considered a “legislative official with responsibility for child protection services.” Additionally, the Court rejected the Committee’s argument that it has inherent legislative power to compel the disclosure of confidential information via subpoena, as this power is limited by the Committee’s statutorily prescribed duties and the nature of the information it may receive. View "Government Oversight Committee v. Department of Health and Human Services" on Justia Law

CKY, Inc. entered into a fixed-price construction contract with the United States Army Corps of Engineers (Corps) in October 2012. CKY encountered unexpected conditions, including heavy rainfall and undisclosed culverts, which led to additional expenses. CKY sought compensation for these expenses, but the Corps denied the requests. CKY then filed a claim under the Contract Disputes Act, seeking $1,146,226 for the additional costs incurred. The Armed Services Board of Contract Appeals (Board) ruled in favor of CKY regarding the undisclosed culverts but denied compensation for other claims.The Board awarded CKY $185,000 plus interest for the expenses related to the undisclosed culverts. CKY then applied for attorney’s fees and expenses under the Equal Access to Justice Act (EAJA). The Board granted the application, concluding that the government’s position regarding the undisclosed culverts was not substantially justified. The Board limited its substantial-justification inquiry to the government’s litigation position on the specific claim where CKY prevailed.The United States Court of Appeals for the Federal Circuit reviewed the case. The court held that the Board erred by categorically narrowing its substantial-justification inquiry to the government’s litigation position and to the specific claim on which CKY prevailed. The court emphasized that the substantial-justification inquiry should consider both the agency’s pre-litigation conduct and its litigation position, and should treat the case as an inclusive whole rather than focusing on individual claims. The court vacated the Board’s decision and remanded the case for reconsideration without the categorical limitations previously applied. View "In Re SECRETARY OF THE ARMY " on Justia Law

A California corporation, China Unicom (Americas) Operations Limited (CUA), was authorized to provide domestic and international telecommunications services under certificates issued by the Federal Communications Commission (FCC) pursuant to § 214 of the Communications Act of 1934. In 2020, the FCC ordered CUA to show cause why its certificates should not be revoked due to national security concerns related to its Chinese government ownership. CUA responded, but the FCC found the responses inadequate and initiated revocation proceedings.The FCC's International, Wireline Competition, and Enforcement Bureaus issued an order to show cause, citing national security concerns and CUA's lack of candor. CUA argued against the revocation, claiming the FCC lacked authority and that it was entitled to a formal hearing. The FCC, however, found CUA's responses insufficient and proceeded with revocation based on national security risks and CUA's lack of trustworthiness.The United States Court of Appeals for the Ninth Circuit reviewed the case. The court held that the FCC has the authority to revoke § 214 certificates based on national security concerns and that the FCC's decision was supported by substantial evidence. The court found that CUA's ultimate Chinese government ownership and the overlap of its board members with the Chinese Communist Party posed significant national security risks. Additionally, the court upheld the FCC's finding that CUA demonstrated a lack of candor and trustworthiness in its dealings with the FCC.The court also rejected CUA's procedural arguments, concluding that the FCC followed appropriate procedures and that a formal evidentiary hearing was not required. The Ninth Circuit denied CUA's petition for review, affirming the FCC's revocation of CUA's § 214 certificates. View "CHINA UNICOM (AMERICAS) OPERA V. FCC" on Justia Law

The petitioners, including The Gazette and the Invisible Institute, sought records from the Colorado Peace Officer Standards and Training Board (POST) regarding peace officer demographics, certification, and decertification. They argued that these records should be disclosed under the Colorado Open Records Act (CORA). POST countered that the records were criminal justice records governed by the Colorado Criminal Justice Records Act (CCJRA), which allows the custodian discretion in disclosing records.The Denver District Court agreed with POST, concluding that POST is a criminal justice agency under the CCJRA and that the requested records were criminal justice records. The court found that POST's activities, such as conducting criminal background checks and investigating officers, qualified it as a criminal justice agency. The court held that the custodian did not abuse her discretion in partially denying the records requests due to concerns about officer safety and ongoing investigations.The Colorado Court of Appeals affirmed the district court's decision, albeit on slightly different grounds. The appellate court concluded that POST is a criminal justice agency because it collects and stores arrest and criminal records information when it revokes a peace officer's certification.The Supreme Court of Colorado reviewed the case and affirmed the judgment of the court of appeals. The court held that POST qualifies as a criminal justice agency because it performs activities directly related to the detection or investigation of crime. This includes conducting criminal investigations into officers and applicants suspected of criminal offenses. Consequently, the CCJRA governs the records requested by the petitioners, allowing the custodian discretion in their disclosure. View "The Gazette v. Bourgerie" on Justia Law

Port City Air Leasing, Inc. (Port City) leases land and buildings at Pease International Tradeport for aircraft-related services. Pease Aviation Partners LLC, doing business as Million Air Portsmouth (Million Air), proposed to lease adjacent land to build a similar facility and applied for a permit to dredge and fill wetlands to construct an access road. The New Hampshire Department of Environmental Services (DES) issued the permit in June 2022. Port City filed an administrative appeal with the New Hampshire Wetlands Council (Council), arguing that the permit issuance was unlawful and unreasonable. Million Air intervened and moved to dismiss the appeal, claiming Port City lacked standing.The Hearing Officer ruled that Port City lacked standing because it was not a "person aggrieved" under RSA 482-A:10, I, which includes the applicant and those entitled to notice by mail under RSA 482-A:8 and RSA 482-A:9. The Hearing Officer determined that Port City was not an "abutting landowner" entitled to notice. Port City's motion for reconsideration and rehearing was denied, leading to this appeal.The Supreme Court of New Hampshire reviewed the case and affirmed the Council's decision. The court held that Port City is not a "landowner" under RSA 482-A:9 because its lease does not grant interests equivalent to fee ownership. Consequently, Port City is not a "person aggrieved" with standing to appeal under RSA 482-A:10, I. The court also rejected Port City's due process claims, concluding that the absence of an administrative remedy does not violate its state or federal due process rights, as Port City still has potential legal remedies for any injuries. The court affirmed the dismissal of Port City's appeal. View "Appeal of Port City Air Leasing, Inc." on Justia Law

The case involves Lori Ann Wiley, who, along with Charles Wallace Hanson, engaged in a verbal altercation at a Kern High School District (KHSD) high school. The incident began when a school employee blocked a handicap parking spot they intended to use. Wiley later submitted a written complaint about the incident to the school. Subsequently, KHSD police officer Michael Whiting recommended various misdemeanor charges against Wiley, leading to her being cited and a prosecutor filing a criminal complaint with three misdemeanor charges. After a mistrial, the court dismissed Wiley’s charges in the interest of justice.Wiley sued KHSD police officers Edward Komin, Michael Whiting, Luis Peña, and Steven Alvidrez, alleging violations of her First Amendment rights, malicious prosecution, and abuse of process. She brought causes of action under 42 U.S.C. section 1983, the Bane Act, and common law torts for intentional infliction of emotional distress and negligence. The trial court sustained the defendants’ demurrer to Wiley’s causes of action in the second amended complaint on multiple grounds without leave to amend and granted a motion to strike Wiley’s punitive damages allegations without leave to amend.The California Court of Appeal, Fifth Appellate District, reviewed the case. The court affirmed the trial court’s decision in part and reversed it in part. The appellate court held that Wiley failed to adequately plead her claims under section 1983 for malicious/retaliatory prosecution and abuse of process, as well as her claims under the Bane Act. The court also found that the defendants were entitled to qualified immunity and that Wiley did not sufficiently allege facts to support her claims for intentional infliction of emotional distress and negligence. However, the court granted Wiley leave to amend her section 1983 claim but denied leave to amend her other causes of action. The court affirmed the trial court’s order granting the motion to strike without leave to amend. View "Wiley v. Kern High School District" on Justia Law

Chesla A. Scott challenged the Idaho Department of Labor's service of three determination notices, claiming she did not receive them while temporarily working out-of-state. The Department mailed the notices to her last known address, and Scott missed the fourteen-day appeal period. When she attempted to appeal, the Department's Appeals Examiner dismissed her appeal as untimely. Scott argued that the Department's service by mail did not meet constitutional due process requirements.The Appeals Examiner conducted a hearing and concluded that Scott's appeal was untimely under Idaho Code section 72-1368(3) and (5). The Idaho Industrial Commission affirmed this decision, denying Scott's request for a new hearing and conducting a de novo review of the record. The Commission also concluded that Scott had not timely filed her appeal.Scott appealed to the Idaho Supreme Court, arguing that the Department's service by mail was constitutionally inadequate. The Court reviewed whether Scott exhausted her administrative remedies and preserved her constitutional challenge. The Court held that Scott had exhausted her administrative remedies and preserved her due process claim, allowing it to be reviewed.The Idaho Supreme Court affirmed the Commission's decision, holding that the Department's mailing of the determination notices was reasonable under all the circumstances and did not violate due process. The Court found that the Department's method of service was reasonably calculated to provide notice, and Scott's failure to receive the notices was not due to any fault of the Department. The Court did not award attorney fees to either party but awarded costs to the Department. View "Scott v. Home Depot USA, Inc." on Justia Law

Troy Olhausen, a former Senior Vice President of Business Development and Marketing at Arriva Medical, LLC, filed a qui tam action under the False Claims Act against his former employers, Arriva, Alere, Inc., and Abbott Laboratories, Inc. He alleged that the defendants submitted fraudulent claims to the Center for Medicare and Medicaid Services (CMS) for reimbursement. Specifically, Olhausen claimed that Arriva submitted claims without obtaining required assignment-of-benefits signatures and failed to disclose or accredit certain call-center locations that processed claims.The United States District Court for the Southern District of Florida dismissed Olhausen’s third amended complaint, holding that he failed to plead with the particularity required under Federal Rule of Civil Procedure 9(b) that any fraudulent claims were actually submitted to the government. The district court found that Olhausen did not provide sufficient details to establish that false claims had been submitted, as he did not work in the billing department and lacked firsthand knowledge of the claim submissions.On appeal, the United States Court of Appeals for the Eleventh Circuit reviewed the case. The court concluded that Olhausen adequately pled with particularity that allegedly false claims were submitted under Count II, which involved claims for heating pads that lacked assignment-of-benefits signatures. The court found that the internal audit allegations provided sufficient indicia of reliability to satisfy Rule 9(b). However, the court upheld the dismissal of Count IV, which alleged that Arriva failed to disclose or accredit certain call-center locations, as Olhausen did not adequately allege that any claims involving these locations were actually submitted. Consequently, the court vacated the dismissal of Counts II and VI (conspiracy) and remanded them for further proceedings, while affirming the dismissal of Count IV. View "Olhausen v. Arriva Medical, LLC" on Justia Law