Justia Civil Procedure Opinion Summaries

In 2006, the Washington legislature enacted legislation establishing a state health technology assessment program. Part of that legislation formed the Health Technology Clinical Committee ("HTCC") as an independent committee to judge selected medical technology and procedures by their safety, efficacy, cost-effectiveness, and health outcomes. In 2010, the HTCC began its review of a controversial procedure - femoroacetabular impingement (FAI) syndrome hip surgery. Michael Murray sustained a hip injury while at work in August 2009. L&I allowed his claim and provided medical treatment. Murray's physician, Dr. James Bruckner, asked the Washington Department of Labor and Industries ("L&I") to authorize surgery regarding Murray's hip condition, FAI syndrome. L&I denied payment for FAI surgery because the HTCC disallowed coverage for that procedure. Dr. Bruckner performed the surgery on Murray without authorization from L&I. The FAI surgery purportedly successfully rehabilitated Murray's hip injury. Murray appealed L&I's decision denying payment for the surgery to the Board of Industrial Insurance Appeals (Board or BIIA), which affirmed L&I. Murray appealed to the superior court, which affirmed the Board. Murray appealed to the Court of Appeals, which affirmed the superior court. Murray then petitioned the Washington Supreme Court, which reversed. The Supreme Court "harmonized" the HTCC legislation with the Industrial Insurance Act, and in doing so, determined that applying L&I's Medical Aid Rules, HTCC determinations were one of several sources of information L&I used to make medical coverage decisions. "While HTCC determinations are given considerable weight, the Medical Aid Rules do not afford such determinations preclusive effect. Under Medical Aid Rules, L&I, not the HTCC, remains responsible for medical treatment coverage decisions. Accordingly, such Department medical coverage decisions are then subject to review before the BIIA and in superior court, pursuant to chapter 51.52 RCW." Murray's reimbursement claim to L&I was remanded for further proceedings. View "Murray v. Dep't of Labor & Indus." on Justia Law

The Supreme Court dismissed this appeal after the district court administratively dismissed a negligence action for failure to timely submit a proposed scheduling order and then granted a motion to reinstate the case, holding that the district court’s reinstatement order was not a final, appealable order.On appeal, Appellants argued that the district erred when it applied the local rules regarding reinstatement of cases instead of Neb. Rev. Stat. 25-201.01 to decide whether to reinstate the case. The Supreme Court dismissed the appeal, holding that the order vacating dismissal and reinstating the case put the parties back in approximately the same litigation posture as before the action was dismissed, and there was no reason to disrupt the progression of the case by entertaining an interlocutory appeal. View "Fidler v. Life Care Centers of America" on Justia Law

In 2015, the California Governor issued a proclamation convening a special session of the Legislature for certain specified purposes, including to “[i]mprove the efficiency and efficacy of the health care system, reduce the cost of providing health care services, and improve the health of Californians.” Pertinent to this appeal, the Legislature enacted the End of Life Option act, which legalized physician-assisted suicide for the terminally ill. During a special session, the Legislature passed the Act. Plaintiffs were five individual physicians along with a professional organization that promoted ethical standards in the medical profession (collectively the Ahn parties), who asserted causes of action for violations of due process, of equal protection, and of California constitutional limitations on the power of the Legislature to act in special session. In February 2018, the Ahn parties filed a motion for judgment on the pleadings. After hearing argument, the trial court ruled that it would grant the motion, without leave to amend. On May 24, 2018, the trial court entered judgment in favor of the Ahn parties, and enjoined enforcement of the Act. Days later, three nonparties5 (collectively the Fairchild parties) filed an ex parte application to vacate the judgment, which was denied. The State filed a petition for writ of mandate to the Court of Appeal along with a request for an immediate stay. The Court granted a temporary stay, during which the Fairchild parties filed an appeal of the judgment, contending that, as a result of the denial of their ex parte application to vacate the judgment, they had standing to appeal and, in that appeal, to challenge the judgment on the merits. The Ahn parties disputed this. The issue this case presented for the Court of Appeal’s review was not whether the Fairchild parties are parties to the appeal, but only whether they were parties to this writ proceeding. Admittedly, the State’s writ petition did not name the Fairchild parties, nor did the Fairchild parties formally move to intervene. “However, a person can become a party to an action, even if not named in the complaint, by appearing and participating without any objection by the other parties. We see no reason why this principle should not also apply to a writ proceeding. This is not to say that they are necessarily proper parties.” The Court ultimately concluded the Ahn parties lacked standing on any of the theories they asserted in this appeal. The Court was unclear whether, on remand, they would be able to amend their complaint so as to allege standing, whether the trial court will grant them leave to do so, or whether they will be able to prove up their amended allegations. “It is possible (though by no means certain) that we will see this case again; if so, however, at least we will be sure that the constitutional issue is properly presented.” The Court issued a writ of mandate to direct the superior court to vacate its order granting the motion for judgment on the pleadings and to vacate the judgment. View "California v. Superior Court (Ahn)" on Justia Law

Fresenius Medical Care Holdings, Inc., and Fresenius USA, Inc., operated dialysis treatment clinics throughout the United States, including Mississippi. Fresenius also manufactured and sold dialysis products, including GranuFlo, a product administered to patients being treated for end-stage renal disease. GranuFlo was an acid concentrate mixed with bicarbonate and water to create a dialysis fluid. In 2014, the State of Mississippi brought a civil action against Fresenius, alleging that it had engaged in unfair and deceptive trade practices in connection with GranuFlo in violation of the Mississippi Consumer Protection Act. At issue before the Mississippi Supreme Court in this appeal were a batch of discovery disputes arising between the State and Fresenius brought on interlocutory appeal. The State filed a motion to compel discovery against Fresenius and requested a privilege log. Fresenius provided the State with a privilege log similar to the logs produced in other GranuFlo litigation pending elsewhere. Although the State had objected, Fresenius did not log each individual email and email attachment; rather, Fresenius logged “families” or aggregates of documents. The chancery court granted the State’s motion to compel and ordered Fresenius to produce a “full and complete privilege log” to the State. Fresenius produced a second amended privilege log to the State, continuing to use the family logging method. The State filed a second motion to compel, seeking: (1) all emails and email attachments not separately identified on Fresenius’s July 1, 2016, privilege log; (2) withheld documents referred to as attorney notifications (nurses’ memoranda sent to doctors and in-house counsel); and (3) withheld documents referred to as public comment advice (public relations documents). The chancery court ordered Fresenius to produce all emails and email attachments that were responsive to the State’s discovery requests, that had not been produced, and that had not been separately identified on Fresenius’s July 1, 2016, privilege log. The chancery court also ordered Fresenius to submit attorney notifications and public relations documents for in camera review, later ordering production of the notifications. Fresenius appealed these orders. The Mississippi Supreme Court reversed the chancery court's order with respect to the public relations documents; the Court affirmed in all other respects. View "Fresenius Medical Care Holdings, Inc. v. Hood" on Justia Law

Patsy Wood, administratix of Patricia Peoples’s estate and a wrongful death beneficiary, as well as Sandra Kay Madison and Samuel Peoples, Peoples’s other children and wrongful death beneficiaries, sued Lakeland Nursing and its employees, primarily the nurses involved in caring for Peoples, for negligence. Lakeland Nursing and Nurses Brittany Spann, Mary McGowan, Patricia Rhodes, and Barbara Scott (collectively “the Nurses”) filed motions to dismiss, arguing that Wood did not comply with the presuit notice requirements provided in Mississippi Code Section 15-1-36(15) (Rev. 2012). Peoples, a resident at Lakeland Nursing and Rehabilitation Center, LLC, fell on September 12, 2011, and died from her injuries. Her children sued Lakeland Nursing and the Nurses for negligence. The issue this interlocutory appeal presented for the Mississippi Supreme Court's review centered on whether Patsy Wood gave proper presuit notice to the Nurses pursuant to Mississippi Code Section 15-1-36(15), such that the circuit court correctly denied the Nurses’ motions to dismiss. Finding that Wood failed to do so, the Supreme Court reversed the trial court’s denial of the Nurses’ motion to dismiss, and remanded for further proceedings. View "Spann v. Wood" on Justia Law

In 2017, R.M. and C.W., were committed to the South Mississippi State Hospital (SMSH) to be treated for mental illness. As required under the commitment statute, both R.M. and C.W. were evaluated by court-appointed physicians, one a medical doctor, the other a psychologist. In the cases of both individuals, the evaluating physicians were the same two physicians. And in both cases, the physicians’ recommendations were the same: the medical doctor found that both individuals were, to some degree, mentally ill and thus needed treatment; the psychologist found that both individuals were not mentally ill and did not need treatment. The issue this case presented for the Mississippi Supreme Court’s review centered on whether Mississippi Code Section 41-21-77 allows a director of a state hospital independently to override a commitment order of a chancery court for treatment of mental illness. The Court held it does not. Because this statutory question came to the Court by way of a citation of contempt, this case also required the Court to review the citation of contempt to determine whether the chancery court’s classification of the contempt was correct and whether correct procedures were followed in the finding of contempt. To this, the Court found the chancery court erred in its contempt determination. Accordingly, the Court reversed the chancery court’s contempt finding, remanded the case for an entry of an order of recusal, and otherwise ordered further proceedings. View "In the Matter of C. W." on Justia Law

This matter stemmed from a lawsuit filed by the State of Mississippi against the defendant pharmacies. The State alleged deceptive trade practices and fraudulent reporting of inflated “usual and customary” prices in the defendant’s reimbursement requests to the Mississippi Department of Medicaid. The State argued that Walgreens, CVS, and Fred’s pharmacies purposefully misrepresented these prices to obtain higher prescription drug reimbursements from the State. Finding that the circuit court was better equipped to preside over this action, the DeSoto County Chancery Court transferred the matter to the DeSoto County Circuit Court in response to the defendants’ request. Aggrieved, the State timely filed an interlocutory appeal disputing the chancellor’s decision to transfer the case. After a thorough review of the parties’ positions, the Mississippi Supreme Court found that though the chancery court properly could have retained the action, the chancellor correctly used his discretion to transfer the case, allowing the issues to proceed in front of a circuit-court jury. As a result, the Supreme Court affirmed the chancellor’s decision. View "Mississippi v. Walgreen Co." on Justia Law

The DEA bars hospitals from hiring, as an employee with “access to controlled substances,” any doctor who “for cause” has surrendered his registration to handle those substances. The DEA enforced this regulation against Doctors McDonald and Woods, who had voluntarily surrendered their registrations while in addiction treatment. They later regained full registrations. The doctors sued to enjoin the DEA from enforcing the regulation against them in the future, arguing that it no longer applied to them once their registrations were restored. The parties settled. Their agreement provides that “[t]he DEA no longer interprets 21 C.F.R. 1301.76(a) as requiring . . . potential employers of doctors with unrestricted DEA registrations to seek waivers.” The Sixth Circuit denied the government’s motion to keep the agreement under seal, noting “a strong presumption in favor of openness as to court records.” The government did not identify information too sensitive to remain public. Public interest is particularly strong where the information pertains to an agency’s interpretation of a regulation. Other doctors would no doubt be interested. View "Woods v. United States Drug Enforcement Administration" on Justia Law

This case was one in a longstanding dispute between major health services providers operating in Western Pennsylvania: UPE, a/k/a Highmark Health and Highmark, Inc. (collectively, Highmark) and UPMC (University of Pittsburgh Medical Center). Highmark and UPMC separately entered into Consent Decrees with the Commonwealth's Office of Attorney General (OAG). In this case, an issue arose concerning the obligations imposed by the Consent Decrees relative to UMPC's attempt to terminate ten hospital Medicare Acute Care Provider Agreements it had with Highmark. Pertinent here, UPMC's Consent Decree required it to treat Highmark's Medicare Advantage Plan consumers as in-network through the end date of the Consent Decree. UPMC allowed Provider Agreements with Highmark to renew annually in satisfaction of its in-network obligation. UPMC informed Highmark in accordance with the notice provisions, it would terminate the Provider Agreements on December 31, 2018, but would nonetheless continue to comply with all terms and obligations of those agreements through June 30, 2019, pursuant to the Decree runout provision. Highmark filed for an injunction and to hold UPMC in contempt. The Commonwealth granted OAG's petition to enforce, rejecting UPMC's contention that the six-month runout provision of the Provider Agreements satisfied its obligation to remain in "contract" with Highmark. The Pennsylvania Supreme Court reversed, finding the runout provision of the Provider Agreement satisfied UPMC's obligation to contract for in-network access to its facilities for Highmark's MA Plan subscribers through June 30, 2019. View "Pennsylvania v. UPMC, et al" on Justia Law

This case was a qui tam action alleging violations of the False Claims Act (“FCA”) involving fraudulent reimbursements under the Medicare Act. Plaintiff Gerald Polukoff, M.D., was a doctor who worked with Defendant Sherman Sorensen, M.D. After observing some of Sorensen’s medical practices, Polukoff brought this FCA action, on behalf of the United States, against Sorensen and the two hospitals where Sorensen worked (collectively, “Defendants”). Polukoff alleged Sorensen performed thousands of unnecessary heart surgeries and received reimbursement through the Medicare Act by fraudulently certifying that the surgeries were medically necessary. Polukoff further alleged the hospitals where Sorensen worked were complicit in and profited from Sorensen’s fraud. The district court granted Defendants’ motions to dismiss, reasoning that a medical judgment could not be false under the FCA. The Tenth Circuit reversed and remanded, holding that a doctor’s certification to the government that a procedure is “reasonable and necessary” is “false” under the FCA if the procedure was not reasonable and necessary under the government’s definition of the phrase. View "Polukoff v. St. Mark's Hospital" on Justia Law