Latest 5 Cases This Week: United States v. Chalhoub (6th Cir.), Kreizenbbeck v. Secretary of Health and Human Services (Fed. Cir.), Dignity Health ...

Senate Secrecy: Can the Votes of Senators on President Trump’s Impeachment be Withheld from the Voting Public?

VIKRAM DAVID AMAR, JASON MAZZONE

Illinois law dean Vikram David Amar and professor Jason Mazzone evaluate the suggestion made by some that the votes of senators on President Trump’s impeachment can and should be private. Amar and Mazzone argue that while the text of the Constitution alone does not foreclose secrecy, structural, prudential, and logistical considerations strongly disfavor a secret vote on the matter.

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United States v. Chalhoub

Court: US Court of Appeals for the Sixth Circuit

Docket: 18-6180

Opinion Date: January 7, 2020

Judge: Nalbandian

Areas of Law: Criminal Law, Health Law, Public Benefits

A jury convicted Dr. Chalhoub of defrauding health care benefit programs under 18 U.S.C. 1347. A Kentucky cardiologist, Chalhoub implanted permanent pacemakers in patients who did not need the devices or the tests that he ordered before and after surgery. On appeal, Chalhoub claimed that the district court repeatedly admitted evidence unduly prejudicial to him—and to which he could not effectively respond. The Sixth Circuit affirmed, acknowledging that “some of the government’s tactics here leave something to be desired.” Noting Chaloub’s failure to cross-examine, the court rejected a due process challenge to the admission of testimony by a doctor who claimed to have examined 20 of former Chaloub’s patients but could not name those patients. Chalhoub was not denied a right to be heard and the government did not base its case solely on allegations about those 20 victims. Chalhoub argued that he was severely prejudiced by testimony that he misbilled insurers for other unspecified procedures, but he did not seek clarification or additional information at trial. The court upheld the admission of testimony about Chaloub’s income and expenditures and testimony about his installation of a pacemaker in a former patient.

Kreizenbbeck v. Secretary of Health and Human Services

Court: US Court of Appeals for the Federal Circuit

Docket: 19-1423

Opinion Date: January 6, 2020

Judge: Jimmie V. Reyna

Areas of Law: Health Law, Medical Malpractice, Public Benefits

The Kreizenbecks sought compensation under the National Vaccine Injury Act, 42 U.S.C. 300aa-1–34, alleging that vaccinations administered to their son aggravated an underlying mitochondrial disorder and caused him to suffer immune system dysfunction and other medical problems. They submitted 1,500 pages of medical records, medical literature, Mrs. Kreizenbeck's affidavit, and reports from three medical experts. The government submitted reports from three experts. The Special Master determined that “a ruling on the papers was preferable to a hearing,” expressed “serious misgivings about the claims’ substantive validity,” and explained that if the parties proceeded to a hearing, he was unlikely to compensate the Kreizenbecks for costs. The Kreizenbecks chose to forgo a hearing but objected to a ruling on the record. The Master allowed the parties to submit final briefs, then determined that nothing in the record and expert reports suggested that the outcome would be different after a hearing. He found the government’s mitochondrial expert “reliable and persuasive,” the Kreizenbecks’ expert reports “conclusory or unsubstantiated” and Mrs. Kreizenbeck’s affidavit uncorroborated and inconsistent with the medical records. The Kreizenbecks did not dispute the substance of the claim denial but challenged the dismissal of their petition on the written record. The Claims Court affirmed, finding that the Master provided ample opportunity to support the claims with written material. The Federal Circuit affirmed, noting the Master’s broad discretion to rule on the record and rejecting a due process argument based on evaluating the credibility of the experts and Mrs. Kreizenbeck without live testimony or cross-examination.

Dignity Health v. Local Initiative Health Care Authority of Los Angeles County

Court: California Courts of Appeal

Docket: B288886(Second Appellate District)

Opinion Date: January 9, 2020

Judge: Bendix

Areas of Law: Government & Administrative Law, Health Law

The Court of Appeal affirmed the trial court's grant of summary judgment for defendant, a managed care health plan that provides health coverage to low-income individuals under Medi-Cal. The court held that the legislative history of Welfare and Institutions Code section 14105.28, along with the statement of legislative intent within the statute itself, indicate that the Legislature intended the APR-DRG (All Patient Refined Diagnosis Related Group) rates to apply to out-of-network inpatient poststabilization services under Medi-Cal. Consistent with the legislature's intent, the court interpreted the phrase "managed care inpatient days" to refer to services provided pursuant to a managed care contract, that is, in-network services.

Commonwealth v. Stirlacci

Court: Massachusetts Supreme Judicial Court

Docket: SJC-12735

Opinion Date: January 8, 2020

Judge: Barbara A. Lenk

Areas of Law: Drugs & Biotech, Health Law, Insurance Law

In this case involving the indictments of Dr. Frank Stirlacci and his office manager, Jessica Miller, for violations of the Controlled Substances Act and for submitting false health care claims to insurance providers, the Supreme Judicial Court affirmed in part and reversed in part the superior court's judgment dismissing several of the indictments, holding that there was sufficient evidence to indict Shirlacci on twenty-six counts of improper prescribing and to indict both defendants on twenty of the twenty-two counts of submitting false health care claims. The charges against Defendants included twenty-six counts each of improper prescribing, twenty counts each of uttering a false prescription, and twenty-two charges each of submitting a false health care claim. The trial judge dismissed the indictments for improper prescribing and uttering false prescriptions and dismissed six of the indictments against each defendant for submitting false health care claims. The Supreme Judicial Court reversed in part, holding (1) the evidence was sufficient to indict Stirlacci on all counts of improper prescribing, but Miller's status as a nonpractitioner precluded her indictment on improper prescribing; (2) there was insufficient evidence to indict either defendant for uttering false prescriptions; and (3) there was sufficient evidence to indict both defendants on twenty counts of submitting false health care claims.

Willner v. South County Hospital

Court: Rhode Island Supreme Court

Docket: 19-63

Opinion Date: January 7, 2020

Judge: Maureen McKenna Goldberg

Areas of Law: Health Law, Trusts & Estates

The Supreme Court affirmed the judgment of the superior court in favor of South County Hospital, Home & Hospice Care of Rhode Island and Emmy Mahoney, M.D. (collectively, Defendants), and dismissing all claims alleged by Plaintiff individually and on behalf of the Guardianship of Joyce C. Willner, holding that the trial justice did not err in dismissing the claims. Plaintiff filed an eight-count complaint against Defendants, individually and as guardian of Joyce Willner, his mother. The trial judge granted Defendants' motions to dismiss and motions for summary judgment, dismissing all claims. The Supreme Court affirmed, holding that the trial justice did not err in (1) dismissing the claims alleged by Plaintiff on behalf of the guardianship because Joyce had no right to be represented by Plaintiff, who was not authorized to practice law; and (2) denying Plaintiff's request to appoint a guardian ad litem.