Table of Contents | Houston Aquarium, Inc. v. Occupational Safety and Health Review Commission Government & Administrative Law, Health Law, Labor & Employment Law US Court of Appeals for the Fifth Circuit | Schmitt v. Kaiser Foundation Health Plan of Washington Health Law, Insurance Law US Court of Appeals for the Ninth Circuit | MSP Recovery Claims, Series LLC v. QBE Holdings, Inc. Civil Procedure, Health Law US Court of Appeals for the Eleventh Circuit | Williams v. St. Alphonsus Medical Center Civil Procedure, Contracts, Health Law Idaho Supreme Court - Civil | In re Involuntary Commitment of M. Civil Rights, Constitutional Law, Health Law Maine Supreme Judicial Court |
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Health Law Opinions | Houston Aquarium, Inc. v. Occupational Safety and Health Review Commission | Court: US Court of Appeals for the Fifth Circuit Docket: 19-60245 Opinion Date: July 15, 2020 Judge: Stephen Andrew Higginson Areas of Law: Government & Administrative Law, Health Law, Labor & Employment Law | The Fifth Circuit reversed the Commission's decision affirming the application of OSHA's commercial diving safety regulations to the dives its staff members perform to feed animals housed at the Aquarium and to clean the facility's tanks. A majority of the Commission panel affirmed the ALJ's determination that feeding and cleaning dives did not fall within the "scientific diving" exemption to the commercial standard. The court held that the ALJ did not err in crediting the compliance officer's testimony about the Commercial Diving Operations (CDO) standard as lay opinion testimony; even if the compliance officer testified to some matters that fell outside the realm of lay opinion testimony, the admission of the testimony was harmless; and the Aquarium's witnesses were properly treated as lay witnesses. Under a plain reading of the entire definition of "scientific diving," as well as the regulation guidelines and regulatory history, the court held that the activities performed during the feeding and cleaning dives fall within the plain text of the exemption. In this case, the Aquarium has shown that feeding and cleaning dives are a necessary component of its scientific research. | | Schmitt v. Kaiser Foundation Health Plan of Washington | Court: US Court of Appeals for the Ninth Circuit Docket: 18-35846 Opinion Date: July 14, 2020 Judge: Nguyen Areas of Law: Health Law, Insurance Law | Plaintiffs, who have hearing loss severe enough to qualify them as disabled, filed suit claiming that Kaiser's health insurance plan's categorical exclusion of most hearing loss treatment discriminates against hearing disabled people in violation of Section 1557 of the Patient Protection and Affordable Care Act (ACA). The district court ruled that Kaiser's plans do not exclude benefits based on disability because the plans treat individuals with hearing loss alike, regardless of whether their hearing loss is disabling. The Ninth Circuit agreed with the district court that plaintiffs have failed to state a plausible discrimination claim. The panel explained that the ACA specifically prohibits discrimination in plan benefit design, and a categorical exclusion of treatment for hearing loss would raise an inference of discrimination against hearing disabled people notwithstanding that it would also adversely affect individuals with non-disabling hearing loss. However, the exclusion in this case is not categorical. The panel stated that, while Kaiser's coverage of cochlear implants is inadequate to serve plaintiffs' health needs, it may adequately serve the needs of hearing disabled people as a group. Therefore, the panel affirmed the district court's dismissal of the second amended complaint. The panel reversed the district court's dismissal without leave to amend and remanded. | | MSP Recovery Claims, Series LLC v. QBE Holdings, Inc. | Court: US Court of Appeals for the Eleventh Circuit Docket: 19-11759 Opinion Date: July 15, 2020 Judge: Martin Areas of Law: Civil Procedure, Health Law | The Eleventh Circuit affirmed the district court's dismissal based on lack of standing of this action for damages under the Medicare Secondary Payer Act and remanded with instructions for the district court to dismiss the complaint with prejudice. The court held that the Addendum (but not the Nunc Pro Tunc Assignment) is impermissible parol evidence; although the Nunc Pro Tunc Assignment could create standing on the basis of retroactive assignment of claims, plaintiffs did not receive any rights under it; and the court declined to consider whether the Recovery Agreement by itself equitably assigned plaintiffs HFHP's rights under the Act because plaintiffs did not assert this argument before the district court. | | Williams v. St. Alphonsus Medical Center | Court: Idaho Supreme Court - Civil Docket: 46741 Opinion Date: July 15, 2020 Judge: Bevan Areas of Law: Civil Procedure, Contracts, Health Law | Appellants-patients Nathaniel Valencia and Emily Williams were self-pay patients who received emergency medical services at Saint Alphonsus Medical Center—Nampa, Inc. (“Saint Alphonsus”) in 2015. During their respective visits, Patients agreed to pay for “all charges incurred” for services rendered to them. Patients were billed in accordance with Saint Alphonsus’ “chargemaster” rates. Patients sought declaratory relief requesting the district court to rule Saint Alphonsus was only entitled to bill and seek collection of the reasonable value of the treatment provided to self-pay patients. Saint Alphonsus moved the district court to dismiss the complaint pursuant to Idaho Rule of Civil Procedure 12(b)(6). The district court treated the motion to dismiss as a motion for summary judgment pursuant to I.R.C.P. 12(d). Ultimately, the district court granted summary judgment for Saint Alphonsus, and Patients timely appealed. Finding no reversible error, the Idaho Supreme Court affirmed. | | In re Involuntary Commitment of M. | Court: Maine Supreme Judicial Court Citation: 2020 ME 99 Opinion Date: July 16, 2020 Judge: Horton Areas of Law: Civil Rights, Constitutional Law, Health Law | The Supreme Judicial Court affirmed the order of the district court committing M. to involuntary hospitalization for up to 120 days, holding that the evidence was sufficient to support the court's decision to order M.'s involuntary hospitalization. The district court authorized M.'s hospitalization for up to 120 days, and the superior court affirmed. On appeal, M. argued that she was denied due process and a fair appeal because there was no verbatim transcript of her commitment hearing and that the record contained insufficient evidence to support the court's findings. The Supreme Judicial Court affirmed, holding (1) the opportunities afforded to M. to supplement the incomplete transcript were sufficient to satisfy due process; and (2) there was sufficient evidence to support the district court's decision. | |
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