Justia Civil Procedure Opinion Summaries
Articles Posted in Health Law
Best Rest Motel, Inc. v. Sequoia Insurance Co.
This appeal from summary judgment in favor of Sequoia Insurance Company (Sequoia) was one of thousands of cases nationwide involving a claim for business interruption coverage arising out of the COVID-19 pandemic. The outcome here turned on whether there was evidence creating a triable issue that the insured, Best Rest Motel, Inc. (Best Rest), sustained lost business income “due to the necessary ‘suspension’ ” of its operations “caused by direct physical loss of or damage” to the insured property. Best Rest contended its case fell directly within the exception discussed by the Court of Appeal in Inns-by-the-Sea v. California Mut. Ins. Co., 71 Cal.App.5th 688 (2021). Though the Court found Inns might undermine, if not entirely foreclose Best Rest’s case, the Court limited its holding by positing in dicta a “hypothetical scenario” where “an invisible airborne agent would cause a policyholder to suspend operations because of direct physical damage to property.” Here, the Court determined Best Rest's argument failed because the record contained no evidence creating a triable issue that the hotel “could have otherwise been operating” but for the presence of COVID-19 on the premises. Best Rest’s own evidence established the exact opposite was true: its vice president and operating partner testified that the phones were “ringing off the hook[ ]” with cancellations—not because of COVID-19 in the hotel, but because of government shut down orders and travel restrictions that shuttered tourism. Accordingly, the Court affirmed summary judgment in the insurance company's favor because there was no evidence creating a triable issue that COVID-19 in the hotel caused the claimed lost income. View "Best Rest Motel, Inc. v. Sequoia Insurance Co." on Justia Law
Mobile Infirmary Association v. Quest Diagnostics Clinical Laboratories, Inc.
Mobile Infirmary Association d/b/a Mobile Infirmary Medical Center ("Mobile Infirmary") appealed the grant of summary judgment in favor of Quest Diagnostics Clinical Laboratories, Inc. ("Quest"). Quest and Mobile Infirmary entered into a Laboratory Management Agreement ("the LMA"), in which Quest agreed to manage Mobile Infirmary's onsite clinical laboratory facilities and to provide clinical testing services used by Mobile Infirmary's medical staff to diagnose and treat patients. The LMA also contained indemnity provisions. In 2015, James Ward went to Mobile Infirmary's emergency room after suffering weakness, dizziness, loss of fluids, a mild cough, and severe body aches. Ward was eventually diagnosed with diabetic ketoacidosis. When his condition did not improve, Ward was moved into the intensive-care unit, at which point his doctor ordered him to undergo glucose finger-sticks and a basic metabolic panel every four hours to help monitor his serum glucose, kidney function, acid/base status, and electrolytes. According to Mobile Infirmary, those basic metabolic panels were supposed to be performed by Quest, but they were allegedly canceled by one of Quest's employees. At some point, he suffered an "anoxic brain injury" and later died "as a result of multisystem organ failure secondary to severe sepsis and septic shock." Ingrid Mia Ward ("Mia"), Ward's wife and the personal representative of his estate, commenced a wrongful-death action against Mobile Infirmary and other defendants responsible for Ward's treatment and care. Quest was not named as a party to Mia's action. Mobile Infirmary informed Quest of the action and, as the case progressed, apprised Quest of the status of the proceedings, including its negotiations with Mia for potential settlement of the lawsuit. Mia and Mobile Infirmary ultimately settled the wrongful-death action. Before Mia's claims against Mobile Infirmary were dismissed pursuant to a joint motion of those parties, Mobile Infirmary filed a third-party complaint against Quest in which it sought contractual and equitable indemnity related to its defense and settlement of Mia's action. Quest filed a motion to dismiss, which the trial court granted in part by dismissing Mobile Infirmary's equitable- indemnity claim. The Alabama Supreme Court found that nowhere in the LMA did the parties expressly agree or clearly provide a formula that, in the event there was a claim that arises out of partial liability or concurrent acts by both parties, indemnification will be required for a proportionate share. Accordingly, judgment was affirmed. View "Mobile Infirmary Association v. Quest Diagnostics Clinical Laboratories, Inc." on Justia Law
In the Matter of the Necessity for the Hospitalization of: Tonja P.
A woman who suffered from schizophrenia appealed court orders authorizing her involuntary commitment and administration of psychotropic medication. She argued the superior court erred by relying on a cursory report from the court visitor and by failing to make specific findings that involuntary medication was in her best interests. She also contended it was error to commit her to a psychiatric hospital instead of to a less restrictive facility. Finding no reversible error, the Alaska Supreme Court affirmed the superior court’s orders. View "In the Matter of the Necessity for the Hospitalization of: Tonja P." on Justia Law
Wash. Food Indus. Ass’n v. City of Seattle
Six months after United States and global health authorities declared COVID-19 a public health emergency, the city of Seattle (City) passed an ordinance (Seattle Ordinance 126094) authorizing hazard pay for certain workers who delivered food to consumers’ homes. By that time, Governor Inslee had issued stay-at-home orders requiring Washingtonians to leave home only for the most essential of trips. Among some of the conditions in the ordinance were that food delivery network companies could not reduce workers’ compensation or otherwise limit their earning capacity as a result of the ordinance, and they were prohibited from reducing the areas of the City they served or to pass on the cost of the premium pay to customers’ charges for groceries. The Washington Food Industry Association and Maplebear Inc., d/b/a Instacart, challenged the ordinance, seeking a declaration invalidating the ordinance on statutory and state and federal constitutional grounds. The trial court dismissed the statutory claim under chapter 82.84 RCW but permitted all remaining claims to proceed. After review of the limited record, the Washington Supreme Court affirmed in part and reversed in part: (1) affirming dismissal of the 82.84 RCW claim; (2) reversing dismissal of the equal protection claim; and (3) reversing the trial court’s dismissal of the privileges and immunities claim. The Court affirmed in all other respects and remanded for further proceedings. View "Wash. Food Indus. Ass'n v. City of Seattle" on Justia Law
Hudak v. Elmcroft of Sagamore Hills
In May 2020, Koballa died of COVID-19. Hudak, the executrix of Koballa’s estate, sued, asserting negligence and related state-law claims against Elmcroft, an assisted-living facility. Elmcroft removed the case to federal court under the general removal statute, 28 U.S.C. 1441(a), and the federal-officer removal statute, 28 U.S.C. 1442(a)(1), based on arguments it made under the Public Readiness and Emergency Preparedness Act (PREP), 42 U.S.C. 247d-6d.The district court found that the PREP Act did not provide grounds for removal under either removal statute and remanded the case to state court for lack of subject-matter jurisdiction. The Sixth Circuit affirmed. Hudak does not allege that Elmcroft engaged in willful misconduct in the administration or use of a covered COVID-19 countermeasure, so the PREP Act does not “provide[] the exclusive cause of action for the claims” and does not completely preempt Hudak’s state-law claims. Hudak’s state-law claims do not arise under federal law and could not be removed. Elmcroft is not a "federal officer"; it operated a facility that came under significant federal regulation as part of the federal government’s COVID-19 response but did not have an agreement with the federal government, did not produce a good or perform a service on behalf of the government, and has not shown that the federal government exercised control over its operations to such a degree that the government acted as Elmcroft’s superior. View "Hudak v. Elmcroft of Sagamore Hills" on Justia Law
Howard Center v. AFSCME Local 1674, et al.
Employer Howard Center appealed a trial court order that confirmed an arbitration award in favor of grievant Daniel Peyser and AFSCME Local 1674. In May 2019, employer expressed concern over grievant’s billing practices, specifically, his submission of billing paperwork in May for services provided in April. Employer told grievant that it was considering disciplining him for “dishonesty and unethical action” concerning the backdated bills. Grievant brought two billing notes from patient records to show that other employees engaged in the same billing practices. Employer did not reprimand grievant for the billing practices. In August 2019, however, employer informed grievant that he breached employer’s confidentiality policy by sharing the billing notes with his union representative at the June meeting. Employer issued a written reprimand to grievant. The reprimand stated that sharing client records without redacting confidential information violated protocols and state and federal regulations, and that grievant knew or should have known of these standards. Employer also explained that it was required to report the breach to state and federal authorities and to those individuals whose records were disclosed. Grievant filed a grievance under the terms of his collective-bargaining agreement, arguing in part that employer lacked just cause to discipline him. In an October 2020 decision, the arbitrator sustained the grievance. Employer then filed an action in the civil division seeking to modify or vacate the arbitrator’s award, arguing in relevant part that the arbitrator manifestly disregarded the law in sustaining the grievance. Employer asked the Vermont Supreme Court to adopt “manifest disregard” of the law as a basis for setting aside the arbitration award and to conclude that the arbitrator violated that standard here. The Supreme Court did not decide whether to adopt the manifest-disregard standard because, assuming arguendo it applied, employer failed to show that its requirements were satisfied. The Court therefore affirmed. View "Howard Center v. AFSCME Local 1674, et al." on Justia Law
Medicaid & Medicare Advantage Products Ass’n of Puerto Rico, Inc. v. Emanuelli-Hernandez
The First Circuit affirmed the judgment of the district court determining that Act 90, passed by the Legislative Assembly of Puerto Rico in 2019, was preempted by federal law, holding that the district court did not err.Act 90 requires that Medicare Advantage plans compensate Puerto Rico healthcare providers in Puerto Rico at the same rate as providers are compensated under traditional Medicare. Plaintiffs, several entities that managed Medicare Advantage plans, filed suit seeking a declaratory judgment and an injunction barring the "mandated price provision," arguing that the Medicare Advantage Act preempted the challenged provision and that provision was unconstitutional. The district court ruled in favor of Plaintiffs. The First Circuit affirmed, holding that Act 90's mandated price provision was preempted by federal law. View "Medicaid & Medicare Advantage Products Ass'n of Puerto Rico, Inc. v. Emanuelli-Hernandez" on Justia Law
McGovern v. BHC Fremont Hospital, Inc.
In November 2015, while hospitalized at Fremont, an acute psychiatric facility, McGovern was assaulted by another patient. In March 2016, McGovern’s attorney sent Fremont a letter, requesting that Fremont preserve evidence, and stating that counsel would be gathering more information and would present Fremont’s insurance carrier with a pre-litigation demand. It requested that Fremont place its carrier on notice. On October 27, 2016, McGovern’s counsel sent Fremont a Notice of Intent to Commence Action For Medical Negligence Pursuant to Code of Civil Procedure 364, which requires that a plaintiff give a healthcare provider 90 days’ notice before commencing an action for professional negligence. Subsection (d) tolls the limitations period for 90 days if the notice is served on the defendant within the last 90 days of the applicable statute of limitations. which expired on November 7, 2016, in McGovern's case.McGovern filed suit on January 20, 2017. The trial court granted Fremont summary adjudication, finding that the March letter constituted a section 364 notice. so the complaint was not timely filed, and McGovern failed to establish a triable issue of fact as to neglect under Welfare & Institutions Code 15610.57. The court of appeal reversed. The March letter lacked the requisite elements for section 364 compliance and was not a notice of intent. McGovern’s professional negligence causes of action are not time-barred, The court also reversed an order quashing a subpoena for the assailant’s mental health records. View "McGovern v. BHC Fremont Hospital, Inc." on Justia Law
Yale New Haven Hosp. v. Becerra
Yale New Haven Hospital (“YNHH”) receives federal funds under the Medicare Act. As part of the statutory formula for determining appropriate funding, the Medicare Act directs the Secretary of Health and Human Services (the “Secretary”) to “estimate” the “amount of uncompensated care” that each hospital will provide to indigent patients in a given federal fiscal year (“FFY”). Here, YNHH contended that the Secretary failed to conduct adequate notice-and-comment rulemaking before choosing to use only YNHH’s historical data – and not that of a hospital that had recently merged into YNHH – to estimate YNHH’s amount of uncompensated care for FFY 2014. The Secretary moved to dismiss for lack of subject-matter jurisdiction under 42 U.S.C Section 1395ww(r)(3), which prohibits “judicial review” of “[a]ny estimate of the Secretary.” The district court denied the Secretary’s motion, reasoning that section 1395ww(r)(3) applies only to substantive challenges to estimates, but not to procedural challenges like YNHH’s. The district court subsequently granted summary judgment in favor of YNHH.
The Secretary appealed, disputing (1) the district court’s ruling that it had jurisdiction to consider YNHH’s procedural challenge, and alternatively (2) the district court’s merits ruling that the Secretary’s estimate was procedurally unlawful.
The Second Circuit reversed the district court’s denial of the Secretary’s motion to dismiss YNHH’s procedural challenge for lack of subject-matter jurisdiction; vacated, for lack of subject-matter jurisdiction, the district court’s grant of summary judgment for YNHH on its procedural challenge; REMAND the case to the district court with instructions to dismiss the remainder of YNHH’s action for lack of subject-matter jurisdiction; and dismissed YNHH’s cross-appeal disputing the district court’s chosen remedy. View "Yale New Haven Hosp. v. Becerra" on Justia Law
North Carolina Insurance Guaranty Association v. Xavier Becerra
The North Carolina Insurance Guaranty Association (“Appellant”) to the Center for Medicare and Medicaid Services (“CMS”) sought an advisory opinion about whether Appellant is required to reimburse Medicare for certain medical bills that Medicare pays on behalf of insured individuals. CMS declined to issue the requested opinion. Dissatisfied with this response, Appellant filed this action against Alex M. Azar, II, in his official capacity as Secretary of the United States Department of Health and Human Services (“HHS”), HHS, and CMS (collectively, “Appellees”).
In this appeal, Appellant challenges the district court’s determination that Appellant lacked standing to bring this action because it failed to plausibly allege that it suffered an injury-in-fact. Additionally, Appellant challenges the district court’s conclusion that it did not possess jurisdiction over the action because Appellant failed to exhaust its administrative remedies.
The Fourth Circuit affirmed the dismissal of Appellant’s complaint. The court concluded that the district court properly determined that it did not have jurisdiction over this case because 42 U.S.C. Section 405(h) precludes federal question jurisdiction for claims against the United States or its agents if such claims arise under the Medicare Act. The court further wrote that the existence of the administrative appeal is fatal to Appellant’s claim that it is completely precluded from seeking review of its argument that it is not a primary plan through the administrative process. Additionally, the court agreed with the district court that the ordinary exceptions to the exhaustion requirement are inapplicable here, particularly in light of the Supreme Court’s guidance in Illinois Council. View "North Carolina Insurance Guaranty Association v. Xavier Becerra" on Justia Law