(United States Fifth Circuit) - Affirmed a judgment in favor of a medical supplier in its lawsuit against a health insurance company that refused to pay for covered services. The supplier, which provides equipment and staffing to doctors who perform surgery in their own offices, prevailed in a jury trial.

(United States Fifth Circuit) - Petition denied. A company's petition for review of an administrative law judge's finding of violations and imposition of a monetary penalty against a poultry processing plant following a worker injury was upheld.

(United States Supreme Court) - Held that an inventor's sale of an invention to a third party who is obligated to keep the invention confidential can qualify as prior art for purposes of determining the patentability of the invention. The dispute here involved two pharmaceutical companies that disagreed about whether a certain drug was under patent; one of the companies wanted to market a generic version of it. Justice Thomas delivered the unanimous opinion.

(United States Seventh Circuit) - Plaintiff, an abortion care provider, sought a license from the State of Indiana to operate a clinic. Plaintiff made two unsuccessful license applications over a two-year period before resorting to the federal courts. The district court granted Plaintiff preliminary relief based on the likelihood that it would be successful at trial. Indiana appealed seeking a stay on the relief. Appellate ordered that Indiana should treat Plaintiff as though it were provisionally licensed while the litigation proceeds.

(United States Supreme Court) - In an insurance class action arising in the context of the Federal Employees Health Benefits Act of 1959 (FEHBA) authorization of the Office of Personnel Management (OPM) to contract with private carriers for federal employees' health insurance, 5 U.S.C. section 8902(a) and (d), the Missouri Supreme Court's decision, preventing federal employee insurance carries from seeking subrogation and reimbursement if there is a conflicting state law, is reversed where, because contractual subrogation and reimbursement prescriptions plainly 'relate to . . . payments with respect to benefits,' section 8902(m)(1), they override state laws barring subrogation and reimbursement.

(United States Federal Circuit) - In this insurance law claim a health insurer contends that the US failed to satisfy its payment obligation under a federal health insurance pool program. The Court of Federal Claims entered judgement for the insurer. The Court of Appeals reversed the judgment stating that Congress suspended the governments obligation and that subsequent regulation did not create a contract promising full payment.

(United States Ninth Circuit) - Held that a 2015 Nevada statute designed to protect construction general contractors from certain claims was not preempted by ERISA. A group of labor unions brought this action seeking a declaratory judgment that Nevada's SB 223, limiting general contractors' vicarious liability for their subcontractors' unpaid labor debts, was preempted by ERISA. Finding no preemption, the Ninth Circuit vacated the entry of summary judgment for the unions.

(California Court of Appeal) - Held that a general building contractor did not file a timely court challenge to a citation issued by government inspectors who found a safety violation at a job site. Affirmed dismissal of the contractor's petition for a writ of mandate.

(United States Fifth Circuit) - Held that a university-affiliated medical practice must return $8 million to the federal agency that administers Medicare. The medical practice's test of a new care management model (a Medicare demonstration project) did not achieve the expected cost savings. Upheld an administrative order.

(United States Supreme Court) - Held that the U.S. Department of Health and Human Services neglected its statutory notice-and-comment obligations when it revealed a new policy that dramatically -- and retroactively -- reduced Medicare payments to hospitals serving low-income patients. Concluded that the new policy must be vacated. Justice Gorsuch delivered the opinion of the 7-1 Court (Justice Kavanaugh did not participate).

(California Court of Appeal) - Affirmed. Plaintiff sued medical providers for birth injuries that were paid for through Medi-Cal. The Department of Health Care Services put a lien on the monies recovered from the medical providers. Plaintiff sought to remove lien. Court held that Medi-Cal was entitled to repayment and upheld the lien.

(MD Court of Appeals) - No. 19, Sept. Term, 2019

(United States Second Circuit) - Vacated and remanded. Plaintiff, who is profoundly deaf, appeals from dismissal on summary judgment her claim that a hospital violated the Rehabilitation Act by failing to provide an ASL interpreter. The panel concluded that material issues of fact preclude summary judgment.

(United States Seventh Circuit) - Plaintiff, an abortion care provider, sought a license from the State of Indiana to operate a clinic. Plaintiff made two unsuccessful license applications over a two-year period before resorting to the federal courts. The district court granted Plaintiff preliminary relief based on the likelihood that it would be successful at trial. Indiana appealed seeking a stay on the relief. Appellate ordered that Indiana should treat Plaintiff as though it were provisionally licensed while the litigation proceeds.

(United States Seventh Circuit) - In a suit arising out of alleged fraud by officers of a corporation acquired by defendant, a preliminary injunction preventing defendant from proceeding with an arbitration hearing on the fraud claims is affirmed where the merger agreement between the two companies did not mandate arbitration of the types of claims defendant asserted against plaintiffs.

(United States Second Circuit) - In antitrust dispute arising from a action by plaintiff seeking to prevent defendant-healthcare providers from merging, summary judgment in favor of defendants is affirmed where the district court's conclusion, that the market definition the plaintiff alleged as the basis of its claims is legally deficient, is a discretionary prerogative devoid of abuse.

(California Court of Appeal) - Affirmed. Plaintiff appealed from order of the probate court denying their request that special needs trust be distributed to them rather than Department of Health Care Services. Appeals court found Department was entitled to reimbursement for Medi-Cal expenses.

(United States Federal Circuit) - Affirming the denial of attorney fees and costs to a man who sued claiming that he developed Guillain-Barre Syndrome as the result of a flu vaccination because the Court of Federal Claims correctly concluded that there was no reasonable basis for the claim.

(California Court of Appeal) - Affirming the trial court's conclusion that Monsanto and others failed to state a claim in a suit where they averred that Proposition 65's reliance on the International Agency for Research on Cancer's determinations about which chemicals cause cancer improperly granted a foreign entity authority over domestic affairs.

(United States Federal Circuit) - Affirming the dismissal of a declaratory judgment action filed against the producer of several antiviral drugs used in the treatment of AIDS by an organization providing medical care to AIDS sufferers seeking to have patents declared invalid because the action failed to meet the requirements of the Declaratory Judgment Act.

(United States Federal Circuit) - Affirmed that vaccinations given to an infant did not cause him to develop a seizure condition. The parents of an infant who developed an illness called Dravet syndrome after being vaccinated sued the Secretary of Health and Human Services for compensation under the National Childhood Vaccine Injury Act of 1986. Agreeing with the findings of the U.S. Court of Federal Claims, the Federal Circuit held in a 2-1 decision that the parents failed to show that the infant's injuries were caused by his vaccinations.

(United States Second Circuit) - Held that it was proper to remand to New York state court a case in which a labor union health plan sought disclosure of a patent dispute settlement agreement between pharmaceutical companies and the generic manufacturer of the EpiPen. Affirmed the district court's remand order, in this special proceeding under New York law seeking pre‐action disclosure.

(United States Supreme Court) - Held that an inventor's sale of an invention to a third party who is obligated to keep the invention confidential can qualify as prior art for purposes of determining the patentability of the invention. The dispute here involved two pharmaceutical companies that disagreed about whether a certain drug was under patent; one of the companies wanted to market a generic version of it. Justice Thomas delivered the unanimous opinion.

(United States Ninth Circuit) - Reversed the denial of class certification in an action where a healthcare company was accused of unlawfully sending unsolicited faxed advertisements in violation of the U.S. Telephone Consumer Protection Act. The district court denied the motion for class certification on the ground that individual issues would predominate over issues common to the putative class. On an interlocutory appeal, the Ninth Circuit disagreed and remanded for further proceedings.

(California Court of Appeal) - Affirmed order denying petition to compel arbitration. Plaintiffs attempted to enforce arbitration in an action for elder abuse and wrongful death at a skilled nursing facility. The trial court determined that the successor in interest was bound by the agreement to arbitrate, but the children of the decedent were not so bound. The trial court denied the petition to arbitrate to prevent inconsistent findings if both arbitration and litigation proceeded concurrently. The appeals court agreed.

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(US 4th Circuit) - No. 19-1369

(United States Third Circuit) - Affirmed that a broker-dealer was required to arbitrate a customer's claim. The broker-dealer had placed a contractual clause in its agreement with an institutional customer stating that the customer must bring any claims arising out of their agreement in a particular federal court. Splitting from several other circuits on the enforceability of such forum-selection clauses, the Third Circuit held that the clause was unenforceable because it would circumvent Financial Industry Regulatory Authority (FINRA) Rule 12200. The panel therefore affirmed an order compelling the broker-dealer to submit to FINRA arbitration.

(United States Third Circuit) - Reinstated a claim that a debt collector violated the Fair Debt Collection Practices Act by leaving telephone voice messages that did not use its true name. The plaintiffs filed a class-action complaint alleging that the debt collector left pre-recorded messages on their phone that did not state the caller's correct name. Reversing the district court, the Third Circuit held that they stated a plausible claim for relief under the statute's true-name provision, though the panel affirmed the dismissal of their other causes of action.

(United States Seventh Circuit) - Affirmed in part and reversed in part. A company that was unaware of a debt discharge in bankruptcy was not liable for continuing to attempt to collect on its debt, but one company who was notified and proceeded in state court could be held liable for actions taken by counsel on its behalf.

(US 8th Circuit) - No. 18-3574

(United States Second Circuit) - Vacated and remanded. Plaintiff, who is profoundly deaf, appeals from dismissal on summary judgment her claim that a hospital violated the Rehabilitation Act by failing to provide an ASL interpreter. The panel concluded that material issues of fact preclude summary judgment.

(United States Fifth Circuit) - In a healthcare antitrust case, affirmed a protective order that said certain confidential business documents belonging to a non-party health insurer should be unsealed (but redacted) if and when they are filed on the public docket. The non-party sought stronger confidentiality protections.

From my wonderful Marquette colleague, professor in social and cultural sciences, Alexandra Crampton, who argues that the very metaphors we use make us less likely to succeed in staying healthy:  As the Covid-19 virus circulates, so have war metaphors. UN and national leaders are using a familiar rallying cry to justify their moral authority, calls … Continue reading Make Health, Not War: In Search of Long-Term Survival →

(United States First Circuit) - Reinstated a lawsuit alleging that a health insurance company improperly denied coverage for in-patient mental health services. After several unsuccessful administrative appeals, the insured sued the insurance company under ERISA, claiming that all of her time spent at a mental health residential treatment facility was medically necessary and thus should have been covered under an employer-provided healthcare plan. On appeal, the First Circuit vacated an order granting summary judgment for the insurance company, holding that the district court should have allowed the insured to supplement the administrative record.

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