Justia Civil Procedure Opinion Summaries

Relators filed suit against medical laboratory businesses in 2007 in state court, alleging that the labs had submitted false claims to the Commonwealth for Medicaid reimbursement. Defendants removed to federal court. After the Commonwealth entered into a settlement agreement with defendants, the district court awarded relators a share of the settlement proceeds. Relators appealed, contending that the district court's award was insufficient under state law. The court vacated and remanded to the state court, concluding that the district court lacked subject matter jurisdiction over the qui tam action. In this case, by the plain terms of the complaint, relators could have prevailed on their state law claims by proving that defendants contravened the Commonwealth’s Medicaid regulations, without showing any violation of federal law. View "Commonwealth of Virginia ex rel. Hunter Labs. v. Commonwealth of Virginia" on Justia Law

Sneed, who served on active duty 1964-1968, suffered service-connected disabilities. In 2001, Sneed suffered a spinal cord contusion from a fall, leaving him quadriplegic. In 2003, he died of smoke inhalation while living in a home for paralyzed veterans. His widow sought dependency and indemnity compensation, 38 U.S.C. 1310, alleging that Sneed’s service-connected spondylosis and spinal stenosis contributed to quadriplegia and that his service-connected PTSD and hearing loss prevented him from exiting during the fire. The Board of Veterans’ Appeals affirmed denial,mailing notice on April 5. Sneed’s notice of appeal was due 120 days after that mailing. On April 13, Sneed contacted attorney Eagle, requesting representation. According to Sneed, at the request of Eagle’s secretary, she transmitted case materials to and had oral communications with that office. On August 2, Sneed received a letter from Eagle, stating that the claim “does not meet the criteria,” declining representation, and stating that notice of appeal was due "no later than August 5.” The correct deadline was August 3. Several lawyers declined her case. Sneed filed notice on September 1, explaining her circumstances. The Veterans Court dismissed the appeal as untimely. On remand, Sneed argued attorney abandonment, warranting equitable tolling. The Veterans Court held, and the Federal Circuit affirmed, that equitable tolling was not warranted absent an agreement between Eagle and Sneed and that Sneed did not act diligently. View "Sneed v. McDonald" on Justia Law

In 2012, Illinois enacted legislation requiring prior approval for reimbursement for more than four prescriptions for one Medicaid patient within a 30‐day period. 305 ILCS 5/5‐5.12(j). Ciarpaglini is an Illinois Medicaid recipient and suffers from chronic conditions, including bipolar disorder, attention deficit hyperactivity disorder, panic disorder, and generalized anxiety disorder. Doctors have prescribed at least seven medications to manage these conditions. Ciarpaglini alleges that after the prior‐approval requirement took effect, he could not, at least at times, obtain medications he needed and that he has contemplated committing suicide, committing petty crimes so that he would be jailed, or checking himself into hospitals just to get medications. He challenged the requirement under federal Medicaid law, the Americans with Disabilities Act, the Rehabilitation Act, and the Constitution. Illinois subsequently moved Ciarpaglini from the general fee‐for‐service Medicaid program to a new managed care program, under which the requirement does not apply. The district court dismissed the matter as moot. The Seventh Circuit remanded, finding insufficient evidence to determine whether the claims were moot, given Ciarpaglini’s stated desire to move to another county and the lack of information about whether the change in his program was individual or part of a change in policy. View "Ciarpaglini v. Norwood" on Justia Law

The Louisiana Supreme Court granted certiorari to determine whether the Sledge Jeansonne Louisiana Insurance Fraud Prevention Act, and the Louisiana Unfair Trade Practice and Consumer Protection Act, could be applied retroactively to defendant’s criminal misconduct which occurred prior to the effective dates of these statutes. Defendant Lynn Foret, a medical doctor who specialized in orthopedic surgery, pled guilty in federal court to one count of health care fraud, for criminal acts that occurred between 2003 and 2009. The trial court granted Dr. Foret’s declinatory exceptions, dismissing with prejudice, the State's action for penalties under the Sledge Jeansonne Act and dismissed with prejudice causes of action under the Louisiana Unfair Trade Practices Act. The court of appeal affirmed the trial court’s rulings, finding that the conduct regulated by the substantive statute was the underlying fraud, rather than the subsequent guilty plea. Therefore, even though the State's cause of action could not have accrued until Dr. Foret pled guilty, application of the Acts nonetheless attached new consequences to his criminal misconduct, which occurred before the Acts became effective. One judge on the appellate panel dissented, reasoning the plain language of the Sledge Jeansonne Act demonstrated it was the guilty plea that gave the State Attorney General the authority to act, not the criminal activity, and because the guilty plea was entered after the effective date of the statute, its application herein would be prospective, not retroactive. The State appealed to the Supreme Court, arguing that the Sledge Jeansonne Act was not an impermissible retroactive application of the law. After review, the Supreme Court held that both the Sledge Jeansonne Act and Louisiana Unfair Trade Practice and Consumer Protection Act operated prospectively only, applying to causes of action arising after the effective date of each Act. The Court affirmed the court ofappeal ruling finding that the statutes at issue could not be retroactively applied to this defendant’s past criminal conduct. View "Louisiana v. Foret" on Justia Law

In 2011, Bogina sued under the False Claims Act, 31 U.S.C. 3729, seeking compensation for exposing fraud allegedly perpetrated against the federal government and several state governments. Defendants included a major supplier of medical equipment to institutions reimbursed by Medicare and other federal programs and its customer, a chain of nursing homes. The district judge dismissed the federal claims as being too similar to those in a prior suit and relinquished jurisdiction over the state claims. The Seventh Circuit affirmed, finding differences between this suit and an earlier suit “unimpressive” and stating that it did not matter that the alleged fraud continued. View "Bogina v. Medline Indus., Inc." on Justia Law

Carter served in the Army, 1965-1967. In 1989, he sought disability benefits for an injury to his back. The VA denied his claim. He sought to reopen in 2005, filing new evidence that he had aggravated the injury during his service. In 2006, the VA reopened, but denied the claim. The Board of Appeals affirmed in 2009. While appeal was pending, Carter changed counsel. He filed Form 21-22a in March 2010, naming a private attorney in place of Disabled American Veterans. New counsel requested a copy of Carter’s claim file. In June 2010, new counsel and the government jointly requested partial vacatur of the 2009 decision; the Veterans Court remanded the case with instructions. The Board sent a letter to Carter and Disabled American Veterans, stating that additional evidence must be submitted within 90 days (November 4, 2010). Counsel did not receive the letter. On December 13, 2010, the VA sent new counsel Carter’s file, nearly nine months after her requested. She did not immediately read the file and did not see the letter. In February 2011, without hearing from Carter, the Board again denied his claim. Carter’s attorney received a copy of the decision in December 2011. The Veterans Court affirmed. The Federal Circuit vacated. The Veterans Court incorrectly understood the law governing this notice defect. View "Carter v. McDonald" on Justia Law

Scott served on active duty in 1972. In 1999, Scott tested positive for hepatitis C. He applied for disability benefits in 2005, alleging that he contracted hepatitis C in service from air-gun inoculations. The VA denied service connection. Scott was incarcerated during his appeal. The VA acknowledged Scott’s request for a video conference hearing, and requested the date on which he was expected to be released. Scott responded “January 13, 2017,” and “next parole review date is scheduled for March of 2009.” The VA notified Scott that his hearing was scheduled for March 14, 2008. Scott, still incarcerated, failed to appear. On March 23, Scott requested a rescheduled hearing. The Board of Veterans’ Appeals found that Scott had “not shown good cause,” with no mention of Scott’s incarceration. The Board denied Scott’s claim for service connection, noting that Scott “failed to report for his scheduled hearing.” Before the Veterans Court, Scott, then represented by counsel, did not raise the hearing issue. The Veterans Court vacated based on an inadequate medical examination. In 2011, the VA continued the denial without mentioning the hearing issue. Scott submitted a re-certification of appeal form which checked “YES” in answer to “WAS HEARING REQUESTED?” Scott did not raise the hearing issue with the Board, which affirmed, noting that Scott “has not renewed his request” for a hearing. Before the Veterans Court, in 2013, Scott raised the hearing issue for the first time since March 23, 2008. That court affirmed, stating that raising the hearing issue “amounts to … undesirable piecemeal litigation” for no compelling reason. The Federal Circuit affirmed. The obligation to read filings in a liberal manner does not require the Board or the Veterans Court to search the record and address procedural arguments when the veteran fails to raise them. View "Scott v. McDonald" on Justia Law

Delisle served on active duty in the U.S. Army, 1952-1954, and injured his left knee in a ski accident. After that injury, Delisle also began to experience chronic pain in his other knee. In 1978, the Department of Veterans Affairs granted Delisle’s claim for entitlement to a service connection for his right-knee disorder and assigned a 10 percent disability rating. Despite continued treatment, the condition of Delisle’s right knee continued to deteriorate. In 2009, Delisle unsuccessfully sought an increase to the 10 percent disability rating for his right knee. While appeal to the Board of Veterans Appeals was pending, he underwent the total right-knee replacement. As a result, the VA assigned a 100 percent disability rating for the period from April 7, 2010 to May 31, 2011, and assigned a 60 percent rating, along with a total disability rating based on individual employability for the period following May 31, 2011. Delisle challenged only the determination that he was not entitled to a higher disability rating for the nine months before his surgery. The Board rejected the claim. The Veterans Court affirmed. The Federal Circuit dismissed. The Veterans Court’s determination concerned questions of fact, which are beyond the court’s jurisdiction, 38 U.S.C. 7292(d)(2) View "Delisle v. McDonald" on Justia Law

In the “NOVA” decision, the Federal Circuit approved a plan requiring the Department of Veterans Affairs (VA) to identify and rectify harms caused by wrongful application of former 38 C.F.R. 3.103. The Plan required that the VA notify every claimant who received a final Board decision during the specified period and did not receive full relief. If a claimant had a case outside of the Board’s jurisdiction, but mandate had not issued and the appellate court’s judgment was not final, the VA was obligated to offer to submit a joint motion for remand. If the mandate had issued, the VA was required to offer to submit a joint motion to recall mandate and a joint motion for remand. Smith served in the Army, 1963-1965. In 2000, Smith filed an unsuccessful claim for compensation for post-traumatic stress disorder (PTSD). In 2008, Smith was awarded service connection for PTSD with a 100% disability rating and a 2006 effective date. Smith appealed to the Board, which, in 2011, denied entitlement to an earlier effective date. The Board did not apply the invalid Rule interpretation. The Veterans Court affirmed and, days before the NOVA decision, entered judgment. In 2013, the parties filed a joint motion to recall that judgment. The decision fit the search terms profile under the Plan and triggered the VA’s obligation to offer to submit a joint motion. Smith did not claim that VA failed to comply with 38 C.F.R. 3.103(c)(2) or any prejudice in the conduct of the Board hearing. The Federal Circuit affirmed denial of the motion, stating that neither its decisions nor the Plan preclude appropriate denial. View "Smith v. McDonald" on Justia Law

Kentucky Spirit Health Care Plan, Inc. brought a declaratory judgment action seeking a ruling that it had a right to terminate its Medicaid managed care contract with the Finance and Administration Cabinet prior to the expiration of the contract without penalty. The trial court entered partial summary judgment in favor of the Cabinet. Both parties appealed. While the appeals were pending, the circuit court stayed Kentucky Spirit’s pre-trial discovery efforts relating to its rights under the Medicaid contract until resolution of the partial summary judgment appeals. The Court of Appeals granted Kentucky Spirit’s petition for a writ of prohibition against the circuit court judge prohibiting the judge from enforcing the order imposing the stay of discovery. The Supreme Court vacated the writ and remanded for entry of an order denying Kentucky Spirit’s petition for a writ of prohibition, holding that the circuit court did not abuse its discretion by temporarily staying discovery, as a stay of discovery was appropriate pending resolution of the threshold issues currently on appeal. View "Commonwealth v. Hon. Wingate" on Justia Law