Justia Civil Procedure Opinion Summaries

George BouSamra, M.D., along with his colleague, Ehab Morcos, M.D., were members of Westmoreland County Cardiology (WCC), a private cardiology practice. BouSamra and Morcos were interventional cardiologists. Westmoreland Regional Hospital was operated by Excela Health (Excela). As of 2006, approximately 90% of the interventional cardiology procedures at Westmoreland Regional Hospital were performed by WCC. As a result, most of the income Excela realized from interventional cardiology procedures at Westmoreland Regional Hospital stemmed from WCC’s procedures. In 2007, Excela acquired Latrobe Cardiology (Latrobe). Although Latrobe was a cardiology practice, it did not employ interventional cardiologists. Instead, Latrobe referred its patients requiring interventional cardiac procedures to other cardiologist groups, including WCC. Because WCC and Latrobe competed for patients, some animosity existed between the practices. In February 2010, Robert Rogalski (Rogalski) was appointed CEO of Excela, at which point he became aware of the acrimonious relationship between WCC and Latrobe. Seeking to control the market for interventional cardiology in Westmoreland County, Rogalski began negotiating with WCC intending to bring WCC into Excela’s network. The negotiations were ultimately unsuccessful, and in April 2010, WCC rejected any further negotiations. In June 2010, Excela engaged Mercer Health & Benefits, LLC (Mercer) to review whether physicians at Westmoreland Regional Hospital, including BouSamra, were performing medically unnecessary stenting. The results of the study were critical of BouSamra’s work, and concluded that he had performed medically unnecessary interventional cardiology procedures. While Mercer was completing its peer review but prior to another peer review, Excela contracted with an outside public relations consultant to assist Excela in managing the anticipated publicity stemming from the results of the peer review studies. BouSamra initiated this action seeking damages for, among other things, defamation and interference with prospective and actual contractual relations. As the matter continued through the phases of litigation, the parties disagreed as to the scope of discoverable materials. The issue raised before the Pennsylvania Supreme Court was whether Excela Health waived the attorney work product doctrine or the attorney-client privilege by forwarding an email from outside counsel to its public relations and crisis management consultant. The Court concluded the work product doctrine was not waived by disclosure unless the alleged work product was disclosed to an adversary or disclosed in a manner which significantly increased the likelihood an adversary or anticipated adversary would obtain it. This matter was remanded back to the trial court for fact finding and application of the newly articulated work product waiver analysis. View "BouSamra v. Excela Health" on Justia Law

Hoag, a Newport Beach acute care hospital whose patients include beneficiaries of California’s Medi-Cal program, was audited by the California Department of Health Care Services. Hoag’s cost report for fiscal year 2009 included $2,413,623 in audit reimbursement reductions mandated by Assembly Bill (AB) 5 and AB 1183. Hoag filed an administrative appeal that was a blanket challenge to the legality of those assembly bills and the legality of the reimbursement reductions based upon them. Over 18 months later, Hoag submitted a second administrative appeal regarding an alleged $620,903 calculation error that it requested be “incorporated” into the open administrative appeal. Hoag alleged that if its global challenge failed, the $2,413,623 reduction should not include $620,903 stemming from an erroneous calculation of Medi-Cal days subject to the reductions required by the assembly bills. The Department’s Office of Administrative Hearings and Appeals dismissed the administrative appeal of the alleged calculation error as untimely. The court of appeal affirmed. Hoag’s legal challenge to the Medi-Cal audit reduction is a separate issue from its challenge to the alleged calculation error and was, therefore, untimely. View "Hoag Memorial Hospital Presbyterian v. Kent" on Justia Law

The Medical Board of California sought the medical records of three minors for whom Dr. Kennedy provided vaccination exemptions. After Kennedy refused to produce the records, the Director superior court granted a petition under Government Code section 11187 and ordered Kennedy to produce the records. The court denied Kennedy’s request to stay the order while he pursued appellate review. The court of appeal denied Kennedy’s petition for a writ of supersedeas, rejecting Kennedy’s argument under Code of Civil Procedure section 917.2, which operates automatically to stay an order directing “the assignment or delivery of personal property, including documents,” if the appellant posts an undertaking. The automatic stay provisions apply to civil actions but do not ordinarily apply to a special proceeding. The underlying petition to enforce an administrative subpoena is a special proceeding because it is “established by statute” and commenced independently of a pending action by petition. The court noted that its interpretation is consistent with federal law. An automatic stay would impede the Board’s discharge of its duty to “protect the public against incompetent, impaired, or negligent physicians.” Kennedy has not shown a discretionary stay is warranted; it is likely that the court acted within its discretion in finding the Board’s interest in obtaining records of vaccination exemptions outweighed the patients’ privacy rights, given that the Board must keep the records confidential during its investigation. View "Kennedy v. Super. Court" on Justia Law

The Supreme Court affirmed the decision of the court of appeals granting Waukesha County's motion to dismiss the appeal brought by Ms. L. challenging the circuit court's judgment extending Ms. L's commitment, holding that all three issues brought by Ms. L. on appeal were moot but that the Court would address two of those three issues.Specifically, the Court held (1) the circuit court still had personal jurisdiction over Ms. L. when it conducted the extension hearing and entered the extension order, and the County's notice did not fail any due process requirements; (2) the circuit court properly entered default against Ms. L. for failing to appear at an extension hearing; and (3) Ms. L.'s issue that there was insufficient evidence to support the circuit court's entry of the extension order was moot. View "Waukesha County v. S.L.L." on Justia Law

The longstanding dispute between UPMC; UPE, a/k/a Highmark Health and Highmark, Inc. (collectively, “Highmark”); and the Commonwealth of Pennsylvania's Office of the Attorney General (“OAG”) is again before the Pennsylvania Supreme Court. This time, the issue centered on the parties’ rights and obligations under a pair of Consent Decrees that, since 2014, governed the relationship between UPMC and Highmark with regard to the provision and financing of certain healthcare services to their respective insurance subscribers. The Consent Decrees were scheduled to terminate on June 30, 2019. Following the Supreme Court's decision in "Shapiro I," on February 7, 2019, OAG filed a four-count petition at Commonwealth Court to Modify Consent Decrees (“Petition”), thus commencing the underlying litigation. OAG argued the Commonwealth Court erred in concluding that Shapiro I controlled this case, and in so doing, misapplied the applicable principles of contract law. Highmark argued the Commonwealth Court erred in imposing a “materiality” limitation upon the Modification Provision, observing that nothing therein precluded modification of “unambiguous” and “material” terms of the Consent Decrees, as the Supreme Court characterized the termination date in Shapiro I. UPMC counters that OAG’s proposed use of the Modification Provision is contrary to the parties’ intent, in that the intent of the Consent Decrees, UPMC contends, was to establish a five-year transition period for UPMC and Highmark to wind down their contractual relationships, and thereby to minimize disturbance to the health care industry and to avoid sudden disruption of health care consumers’ expectations. The Supreme Court agreed with OAG and Highmark that the Commonwealth Court erred in concluding this case was controlled by Shapiro I. Further, the Court determined OAG and Highmark have set forth a plausible construction of the Modification Provision. The Court remanded this matter back to the Commonwealth Court to interpret the contested provision, and to reconsider the question of extension of the Consent Decrees. View "Pennsylvania v. UPMC, et al." on Justia Law

Plaintiff Elizabeth Lawson alleged she incurred damages as the result of an emergency room nurse informing a police officer that she was intoxicated, had driven to the hospital, and was intending to drive home. The trial court granted defendant Central Vermont Medical Center (CVMC) summary judgment based on its determination that nothing in the record supported an inference that the nurse’s disclosure of the information was for any reason other than her good-faith concern for plaintiff’s and the public’s safety. In this opinion, the Vermont Supreme Court recognized a common-law private right of action for damages based on a medical provider’s unjustified disclosure to third persons of information obtained during treatment. Like the trial court, however, the Supreme Court concluded CVMC was entitled to judgment as a matter of law because, viewing the material facts most favorably to plaintiff and applying the relevant law adopted here, no reasonable factfinder could have determined the disclosure was for any purpose other than to mitigate the threat of imminent and serious harm to plaintiff and the public. Accordingly, the Supreme Court affirmed the trial court’s judgment. View "Lawson v. Central Vermont Medical Center" on Justia Law

Putnam County Memorial Hospital ("Putnam") appealed a circuit court denial of its motion to set aside a default judgment entered in favor of TruBridge, LLC ("TruBridge"), and Evident, LLC ("Evident"). In September 2015, Putnam entered into a "Master Services Agreement" with TruBridge ("the MSA agreement") and a license and support agreement with Evident ("the LSA agreement"). In the MSA agreement, TruBridge agreed to provide accounts-receivable management services for Putnam for five years. The MSA agreement provided that TruBridge would receive 5.65 percent of the "cash collections," as that term is defined in the MSA agreement, to be paid monthly, for its account and billing services. In the LSA agreement, Evident agreed to provide Putnam with Evident's electronic health-records system as well as maintenance and support for that system. According to Putnam, starting in 2016, Putnam entered into a series of agreements with Hospital Partners, Inc. ("HPI"), in which HPI agreed to manage and control the operations of the hospital and its facilities. TruBridge and Evident alleged that at that time, Putnam began entering patient information and billing services through a different computer system than the one provided by Evident pursuant to the LSA agreement and used by TruBridge for accounts receivable pursuant to the MSA agreement. When a TruBridge manager contacted Putnam to inquire about this drop in new-patient admissions into their system, Putnam claimed to have almost no new patients and that it was barely surviving. TruBridge and Evident alleged Putnam was deliberately false and that Putnam was, in fact, simply entering new patients into a different system. Putnam did not enter an appearance in the lawsuit brought by TruBridge and Evident for breach of contract. The circuit court entered a default judgment. Putnam's motion to set aside the judgment was denied. The Alabama Supreme Court concluded Putnam met its evidentiary threshold to trigger the statutory requirement the circuit court reconsider its motion to set aside and for reconsideration relating to the default judgment. Therefore, the Court reversed the circuit court and remanded for further proceedings. View "Putnam County Memorial Hospital v. TruBridge, LLC, and Evident, LLC" on Justia Law

In this dispute over who was the first-to-file relator in a case brought under the False Claims Act (FCA), 31 U.S.C. 3729 et seq., the First Circuit reversed the judgment of the district court ruling that the first-to-file rule was jurisdictional, holding, for the first time in this circuit, that the first-to-file rule is not jurisdictional and that the Court had jurisdiction over Mark McGuire's crossclaim.The FCA's first-to-file rule prohibits relators other than the first to file from bringing a related action based on the facts underlying the pending action. In this case, the government successfully intervened in several qui tam suits against Millennium Health. Millennium settled with the government, setting aside fifteen percent of the settlement proceeds as a relator's share. McGuire brought a crossclaim for declaratory judgment that he was the first to file and was thus entitled to the fifteen-percent share. The district court dismissed the crossclaim for lack of subject-matter jurisdiction, finding that the first-to-file rule was jurisdictional. The First Circuit reversed, holding (1) the first-to-file rule is not jurisdictional, and therefore, the district court had subject-matter jurisdiction over McGuire's crossclaim; and (2) McGuire was the first-to-file relator and has stated a claim that he is entitled to the relator's share of the settlement. View "McGuire v. Estate of Robert Cunningham" on Justia Law

Acting as the personal representative of his father’s estate, plaintiff Dennis Sloan brought a medical negligence action against defendants Providence Health System-Oregon and Apogee Medical Group, P.C. Plaintiff claimed defendants were negligent in their care of plaintiff’s father because they failed to diagnose and treat the father's rib fractures and internal bleeding. On November 3, the father, then 85 years old, came to Providence’s hospital after falling at home and was initially treated at the emergency room. He was later admitted to the hospital, where he was treated by Apogee’s doctors. On November 7, Apogee’s doctors discharged Sloan to a skilled nursing facility, Three Fountains. On November 17, Sloan’s condition worsened significantly. Two days later, Three Fountains returned Sloan to the hospital. At the hospital, Sloan was found to have multiple displaced rib fractures and bleeding in his right chest cavity, which had caused his right lung to collapse. Later that same day, Sloan died of respiratory failure due to the bleeding in his chest cavity and the collapse of his lung. Plaintiff claimed the trial court erred in refusing to give his requested jury instruction concerning a tortfeasor’s liability for the subsequent conduct of another. The Court of Appeals agreed and reversed the trial court’s judgment in part and remanded the case to the trial court for a new trial. On defendant’s petition, the Oregon Supreme Court granted review of the appellate court's judgment, and finding no reversible error, affirmed the Court of Appeals decision, which reversed the trial court’s judgment in part. The case was remanded for a new trial. View "Sloan v. Providence Health System-Oregon" on Justia Law

Blue Valley Hospital, Inc., (“BVH”) appealed a district court’s dismissal of its action for lack of subject matter jurisdiction. The Department of Health and Human Services (“HHS”) and the Centers for Medicare and Medicaid Services (“CMS”) terminated BVH’s Medicare certification. The next day, BVH sought an administrative appeal before the HHS Departmental Appeals Board and brought this action. In this action, BVH sought an injunction to stay the termination of its Medicare certification and provider contracts pending its administrative appeal. The district court dismissed, holding the Medicare Act required BVH exhaust its administrative appeals before subject matter jurisdiction vested in the district court. BVH acknowledged that it did not exhaust administrative appeals with the Secretary of HHS prior to bringing this action, but argued: (1) the district court had federal question jurisdiction arising from BVH’s constitutional due process claim; (2) BVH’s due process claim presents a colorable and collateral constitutional claim for which jurisdictional exhaustion requirements are waived under Mathews v. Eldridge, 424 U.S. 319 (1976); and (3) the exhaustion requirements foreclosed the possibility of any judicial review and thus cannot deny jurisdiction under Bowen v. Michigan Academy of Family Physicians, 476 U.S. 667 (1986). The Tenth Circuit disagreed and affirmed dismissal. View "Blue Valley Hospital v. Azar" on Justia Law