Articles Posted in Health Law

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Altapointe Health Systems, Inc., and Altapointe Healthcare Management, LLC (collectively referred to as "Altapointe"), petitioned for a writ of mandamus to direct the Mobile Circuit Court to vacate its order compelling Altapointe to respond to certain discovery requests and to enter a protective order in its favor in an action pending against it. Jim Avnet, as father and next friend of Hunter Avnet, sued Altapointe. Altapointe operated group homes for adults suffering from mental illness. Avnet asserted that Hunter, a resident at one of Altapointe's group homes, was assaulted by another resident with a blunt object, and was stabbed multiple times with a kitchen knife. Avnet asserted various claims of negligence and wantonness against Altapointe, including claims that Altapointe failed to comply with various unspecified regulations and guidelines designed to protect Hunter's safety and that Altapointe was negligent or wanton in hiring, training, and supervising its employees. Along with his complaint, Avnet served Altapointe with written discovery requests. Avnet's discovery requests sought the total amount of Altapointe's liability-insurance coverage limits; information regarding prior claims or lawsuits against Altapointe alleging personal injury or assault at the home; information concerning whether Altapointe was aware of any previous "aggressive acts" by the resident; and information and documents regarding Altapointe's own investigation of the incident. Altapointe objected to Avnet's discovery requests, contending that the information and documents requested were protected by certain discovery privileges. The Alabama Supreme Court concluded Altapointe offered sufficient evidence demonstrating that it was entitled to the quality-assurance privilege provided in 22-21-8, Ala. Code 1975 as to Avnet's request for information and documents relating to Altapointe's own investigation of the incident. Accordingly, the petition for writ of mandamus was granted as to that request. As to the remaining requests, however, Altapointe did not sufficiently establish that the discovery protections of the AMLA or the psychotherapist-patient privilege applied. Thus, as to those requests, the petition was denied. View "Ex parte Altapointe Health Systems, Inc." on Justia Law

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Plaintiffs Managed Health Care Administration, Inc. ("MHCA"), and Alabama Psychiatric Services, P.C. ("APS") appealed the denial of their motion to compel Blue Cross and Blue Shield of Alabama ("Blue Cross") to arbitrate their claims. In 1986, Blue Cross contracted with APS, a subsidiary of MHCA, to provide mental-health services to Blue Cross's insureds. In 1991, Blue Cross's contract with APS was transferred to MHCA. In 1995, Blue Cross and MHCA entered into a new contract in which MHCA agreed to provide or arrange for mental-health services to Blue Cross's insureds. In 2006, Blue Cross and MHCA entered into yet another contract in which MHCA agreed to provide or arrange for mental-health services to Blue Cross's insureds. In late 2012, Blue Cross decided to replace MHCA, as its behavioral health benefits management vendor, with New Directions Behavioral Health, L.L.C. In 2013, Blue Cross and New Directions Behavioral Health, L.L.C. ("New Directions"), entered into a contract in which New Directions agreed to "arrange for the provision of all Covered Services to Members in accordance with the terms and conditions set forth in this Agreement," which gave New Directions authority to delegate certain services to third parties. pursuant to the authority granted it under the Blue Cross-New Directions 2013 contract and at the request of Blue Cross, New Directions entered into a contract which MHCA in which New Directions sub-delegated to MHCA certain of New Directions' obligations under the Blue Cross-New Directions 2013 contract. A disagreement arose concerning the amount of compensation MHCA was to receive for its services. In 2015, the plaintiffs sued Blue Cross and several fictitiously named defendants alleging fraudulent misrepresentation, fraudulent suppression, breach of an implied contract, and promissory estoppel, claims pertaining to plaintiffs' 2006 contract and for payments of delegated duties. After review, the Alabama Supreme Court concluded plaintiffs demonstrated they had a right to arbitration. The circuit court erred in denying the plaintiffs' motion to compel arbitration, and the Court reversed the circuit court's judgment denying the plaintiffs' motion to compel arbitration in its entirety. View "Managed Health Care Administration, Inc. v. Blue Cross & Blue Shield of Alabama" on Justia Law

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The Alabama Supreme Court granted Alfa Mutual Insurance Company's petition for a writ of certiorari with respect to the issue whether University of South Alabama Medical Center Hospital's (USA) hospital lien was impaired and the amount of damages recoverable by USA from Alfa for that impairment. The Court reversed the Court of Civil Appeals insofar as it affirmed the circuit court's ruling that the amount of damages recoverable from Alfa was an amount equal to the entirety of USA's reasonable charges, irrespective of the amount that was otherwise owed by Alfa under the terms of its policy, and remanded for further proceedings. View "Ex parte Alfa Mutual Insurance Company." on Justia Law

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Melissa Bain, in her capacity as the personal representative of the estate of her deceased husband Christopher Heath ("Heath"), appealed the grant of summary judgment in favor of Colbert County Northwest Alabama Health Care Authority d/b/a Helen Keller Hospital ("HKH"). Dr. Preston Wigfall was the emergency-room physician working at the hospital on the night Heath was taken to the emergency room. Dr. Wigfall ordered certain tests to be run, but he was unable to determine from the results of those tests the cause of Heath's symptoms. Heath was discharged approximately six hours after his arrival with an "unspecified" diagnosis with instructions to follow up with his primary-care physician. Approximately 20 days after his visit to the emergency room at the hospital, Heath died when a 45-millimeter ascending aortic aneurysm dissected. Bain, in her capacity as the personal representative of Heath's estate, filed a medical-malpractice action against HKH and several other defendants, arguing that that the emergency-department nurses at the hospital and Dr. Wigfall breached the applicable standards of care when they treated Heath; that Dr. Wigfall, at all relevant times, was acting within the line and scope of his duties and employment as an actual or apparent agent or employee of HKH; and that HKH was vicariously liable for the actions of its nurses and Dr. Wigfall. After review, the Supreme Court concluded Bain failed to demonstrate that the trial court erred in entering a summary judgment in favor of HKH as to all of Bain's claims and affirmed the circuit court's judgment. View "Bain v. Colbert County Northwest Alabama Health Care Authority" on Justia Law

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Genesis Pittman, D.M.D., P.C. ("Pittman, P.C."), petitioned the Supreme Court for a writ of mandamus directing the Jefferson Circuit Court to vacate its order setting aside a prior summary judgment entered in favor of Pittman, P.C. In August 2014, respondent Debra Blackmon filed a pro se action against Pittman, P.C., alleging negligence and dental malpractice. Blackmon further alleged that she suffered an allergic reaction necessitating emergency medical treatment as well as a related fall resulting in physical injury after treatment from Pittman. Blackmon apparently failed, in accordance with the trial court's scheduling order, to timely disclose the identity of an expert witness she had retained. After the expiration of the disclosure deadline, Pittman, P.C., filed a motion requesting a summary judgment in its favor on the primary ground that, based on the above-described failure to identify an expert, Blackmon could not prove her case. Blackmon, who had, by that time, retained legal counsel, filed a response in opposition that included her own affidavit testimony and medical records. After a hearing, the trial court, entered a summary judgment in favor of Pittman, P.C., as to all counts against it. Blackmon filed a postjudgment motion to alter, amend, or vacate the summary judgment in favor of Pittman, P.C. The trial court scheduled Blackmon's motion for, and ultimately conducted a hearing in May 2016. According to Pittman, P.C., however, by the time of the hearing, Blackmon's motion had been denied by operation of law in April 2016. On May 6, 2016 –- 110 days after the filing of Blackmon's postjudgment motion –- the trial court entered an order purporting to grant Blackmon's postjudgment motion. In response, Pittman, P.C., applied for mandamus relief, contending, in part, that the trial court lacked jurisdiction to grant Blackmon's motion. The Supreme Court concluded that Pittman, P.C. demonstrated a clear legal right to the requested relief and issued the writ. View "Ex parte Genesis Pittman, D.M.D., P.C., et al." on Justia Law

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John Boman appealed the grant of summary judgment in favor of the City of Gadsden. Boman worked as a Gadsden police officer from 1965 until he retired in 1991. Following his retirement, Boman elected to pay for retiree health coverage through a group plan offered by Gadsden to retired employees. This retired-employee-benefit plan was also administered by Blue Cross and provided substantially similar benefits to those Boman received as an active employee. In 2000, however, Gadsden elected to join an employee-health-insurance-benefit plan ("the plan") administered by the State Employees' Insurance Board ("the SEIB"). When Boman turned 65 in 2011, he was receiving medical care for congestive heart failure and severe osteoarthritis of the spine. After his 65th birthday, Blue Cross began denying his claims for medical treatment based on the failure to provide Blue Cross with a "record of the Medicare payment." However, Boman had no Medicare credits. Boman was hired before March 31, 1986, and, although Gadsden did begin participation in the Medicare program in 2006, Boman's employee group had not opted to obtain Medicare coverage before Boman retired. Consequently, Boman never paid Medicare taxes and did not claim to have Medicare coverage. The SEIB ultimately determined that the plan was the secondary payer to Medicare. Boman sued Gadsden, asserting that it had broken an agreement, made upon his employment, to provide him with lifetime health benefits upon his retirement. Boman also sued the members of the SEIB charged with administering the plan, challenging the SEIB's interpretation of the plan. Finding no reversible error in the grant of summary judgment to Gadsden, the Supreme Court affirmed. View "Boman v. City of Gadsden" on Justia Law

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The Alabama State Health Planning and Development Agency ("SHPDA") granted HealthSouth of Alabama, LLC ("HealthSouth") a certificate of need ("CON") allowing HealthSouth to operate 17 inpatient physical-rehabilitation beds in Shelby County. In a separate proceeding, SHPDA granted another CON to HealthSouth allowing it to operate an additional 17 inpatient physical-rehabilitation beds in Shelby County. Shelby Ridge Acquisition Corporation d/b/a Shelby Ridge Rehabilitation Hospital ("Shelby Ridge") opposed HealthSouth's CON applications, and, after SHPDA issued the CONs to HealthSouth, Shelby Ridge appealed SHPDA's decision. The circuit court reversed one of SHPDA's decisions but affirmed the other. HealthSouth, SHPDA, and Shelby Ridge appealed separately to the Court of Civil Appeals, which consolidated the appeals and concluded that SHPDA had erred by granting the CONs to HealthSouth. HealthSouth and SHPDA separately petitioned the Supreme Court for review, which was granted. While the appeals were pending, the parties resolved their disputes; the parties agreed that HealthSouth should have been allowed to build the planned 34-bed physical-rehabilitation hospital in Shelby County. The parties also agreed that the Court of Civil Appeals wrongly decided the appeals before it insofar as HealthSouth's CON applications were concerned. The Supreme Court agreed that the Court of Civil Appeals erred. "It is sufficient to note that the pivotal error of that court's opinion is the characterization as 'key' and determinative two of the many considerations to be evaluated and balanced by SHPDA in considering CON applications." The Supreme Court reversed the Court of Civil Appeals and rendered judgment in favor of HealthSouth and SHPDA. The Supreme Court also remanded the cases to the Court of Civil Appeals with instructions that that court remand the cases to the circuit court so the parties could implement the resolution they reached. View "Ex parte Alabama State Health Planning and Development Agency." on Justia Law

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Diversicare Leasing Corp. d/b/a Canterbury Healthcare Facility ("Canterbury") appealed an order denying its motion seeking to compel arbitration of a wrongful-death claim filed by Betty Hubbard, as the personal representative of the estate of Johnathan Hubbard. Johnathan was diagnosed with cerebral palsy when he was six months old, which caused him to be developmentally delayed and to suffer from a seizure disorder. Johnathan could not walk and was confined to a wheelchair his entire life. He could not speak; he could not feed, clean, or dress himself; he had no use of his hands; and he could not otherwise communicate his needs to others. Johnathan spent various periods of his life in residential-care facilities. Betty made all health-care decisions relating to Johnathan's care and executed all documents in furtherance of that care. Betty executed a number of documents upon Johnathan's admission to Canterbury, including the admission agreement and the arbitration agreement made the basis of this appeal. Johnathan was found unresponsive by the Canterbury staff in early 2011, and was transferred to a local hospital. Johnathan was diagnosed with sepsis; he died on February 21, 2011. Betty sued Canterbury asserting a wrongful-death claim. Canterbury moved the trial court to compel arbitration of Betty's wrongful-death claim and to stay the claim pending the arbitration. Betty argued in response to the motion to compel that she lacked the legal authority to bind Johnathan to the arbitration agreement because at the time the agreement was executed Johnathan was incapacitated and was 21 years old and had reached the age of majority, and she did not hold his power of attorney nor had she been appointed his personal representative or guardian by any court. Following a hearing, the trial court entered an order denying Canterbury's motion to compel arbitration and to stay the proceedings. Canterbury appealed. The Supreme Court affirmed, finding that Betty could not be bound to the arbitration agreement in her capacity as the personal representative of Johnathan's estate when she signed the arbitration agreement in what amounts to her capacity as Johnathan's relative or next friend. View "Diversicare Leasing Corp. v. Hubbard" on Justia Law

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In 2011, 74-year-old Garnell Wilcoxon lived alone. He suffered a stroke, awoke on the floor of his bedroom covered in sweat, feeling sore and with no memory of how he got there. Wilcoxon was admitted to the Troy Regional Medical Center for analysis and treatment for approximately one year before he died. Following Wilcoxon's death, Brenda McFarland, one of Wilcoxon's daughters, filed a complaint as the personal representative for Wilcoxon's estate, asserting claims for : (1) medical malpractice; (2) negligence; (3) breach of contract; (4) negligent hiring, training, supervision, and retention; and (5) loss of consortium. In its answer, Troy Health asserted, in part, that McFarland's claims were barred from being litigated in a court of law "by virtue of an arbitration agreement entered into between plaintiff and defendant." Troy Health then moved to compel arbitration, asserting that forms signed by one of Wilcoxon's other daughters, acting as his attorney-in-fact, contained a valid and enforceable arbitration clause. McFarland argued that "Wilcoxon did not have the mental capacity to enter into the contract with [Troy Health,] and he did not have the mental capacity to give legal authority to enter into contracts on his behalf with" relatives who initially helped admit him to Troy Health facilities when he first fell ill. According to McFarland, "[t]he medical records document that Wilcoxon was habitually and/or permanently incompetent." Therefore, McFarland argued, both a 2011 arbitration agreement and a 2012 arbitration agreement were invalid. The circuit court denied Troy Health's motion to compel arbitration. The Supreme Court reversed, finding that McFarland failed to prove that Wilcoxon was mentally incompetent when he executed a 2012 durable power of attorney naming his other daughter as his attorney-in-fact, and also failed to demonstrate that Wilcoxon was "permanently incompetent" before that date, and because there was no other issue concerning the validity of the 2012 arbitration agreement. View "Troy Health and Rehabilitation Center v. McFarland" on Justia Law

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Keith Westphal and Joyce Osborn Wilson filed suit against David Northcutt III, DMD, Bobby R. Wells, DMD, Stephen R. Stricklin, DMD, Thomas T. Willis, DMD, Sam J. Citrano, Jr., DMD, William Chesser, DMD, and Sandra Kay Alexander, RDH, in their official capacities as members of the Alabama Board of Dental Examiners. Westphal and Wilson sought a judgment declaring unconstitutional the portion of the Alabama Dental Practice Act, (Sec. 34-9-1 et seq., Ala. Code 1975) that made it unlawful for anyone other than a duly licensed dentist to perform teeth-whitening services, and sought a permanent injunction forbidding future enforcement of the prohibition in the Act on teeth-whitening services performed by non-dentists. The parties submitted cross-motions for a summary judgment, and the Jefferson Circuit Court entered a summary judgment in favor of the Dental Board. Westphal and Wilson appealed. But finding no reversible error, the Supreme Court affirmed. View "Westphal v. Northcutt III" on Justia Law