Supreme Court Rules Against HHS in Hospital Medicare Reimbursement Case

Author HeadshotBy George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law

On June 15, 2022, the U.S. Supreme Court said the federal government improperly cut more than $1 billion a year in Medicare reimbursements to hospitals.  This came in a ruling that limits regulators’ power to control what the program pays for certain drugs.  In this case, the Supreme Court justices sided unanimously with a group of hospitals suing over drug reimbursement rates for facilities that serve low-income communities. In writing for the court, Justice Brett Kavanaugh said the U.S. Department of Health and Human Services (HHS) improperly calculated reimbursement rates using a methodology Congress authorized for use only in limited circumstances.

Were the Reimbursement Cuts Unlawful?

The Supreme Court overturned a lower court’s 2020 decision that HHS had the authority to reduce the yearly Medicare reimbursement rates for a group of hospitals serving low income communities. Click here to view the July 31, 2020 decision.

The high court found the U.S. Court of Appeals for the District of Columbia Circuit erred in 2020 when it allowed the HHS to reduce Medicare payments, by roughly $1.6 billion, for outpatient drugs that had helped subsidize the operations of the hospitals.  The Supreme Court’s decision did not extend so far as to undermine HHS authority, but only stated how the agency acted unlawfully in accordance with its varying rates for hospitals under the 340B Drug Pricing Program.

“In short, the statute allows HHS to set reimbursement rates based on average price and affords the agency discretion to ‘adjust’ the price up or down. But unless HHS conducts a survey of hospitals’ acquisition costs, HHS may not vary the reimbursement rates by hospital group,” Justice Kavanaugh wrote in the ruling.


Regulating Reimbursement Rates Under the 340B Program.

Under Medicare, health care providers get reimbursed by the government for expenses, including medications used in hospital outpatient departments. Previously, hospitals had been getting reimbursed at a rate based on the average price of the drugs. However, in 2018, the HHS, under then-President Donald Trump, cut payments for outpatient drugs by 28.5% to hospitals receiving money under the 340B program.

The department found that reimbursements were too high because these hospitals obtain the drugs from manufacturers at a deep discount, an issue that also resulted in excessive patient co-payments. Additionally, the resulting cut dealt “a crushing blow to providers that were already operating on razor-thin  margins and to the vulnerable populations they serve,” the hospitals told the justices in a court filing.

Justice Brett Kavanaugh wrote for the court that “absent a survey of hospitals’ acquisition costs,” the HHS “may not vary the reimbursement rates for 340B hospitals. The HHS’s 2018 and 2019 reimbursement rates for 340B hospitals were therefore contrary to the statute and unlawful.”

Click here to read the Supreme Court’s Opinion in the case, American Hospital Association v. Becerra, 20-1114.

Don’t Wait Until It’s Too Late; Consult with a Health Law Attorney Experienced in Medicare and Medicaid Issues Now.

The attorneys of The Health Law Firm represent healthcare providers in Medicare audits, Medcaid audits and RAC audits throughout Florida and across the U.S. They also represent physicians, medical groups, nursing homes, home health agencies, pharmacies, hospitals and other healthcare providers and institutions in Medicare and Medicaid investigations, audits, recovery actions and termination from the Medicare or Medicaid Program.

For more information please visit our website at www.TheHealthLawFirm.com or call (407) 331-6620 or toll-free at (888) 331-6620.


Sources:

Stohr, Greg. “Supreme Court Sides With Hospitals on Medicare Reimbursement.” Bloomberg Law. (June 15, 2022). Web.

Chung, Andrew. “U.S. Supreme Court faults Medicare cuts to hospitals for outpatient drugs.” Reuters. (June 15, 2022). Web.

Gresko, Jessica. “High court rules against government on drug reimbursement.” Associated Press. (June 15, 2022). Web.


About the Author: George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law is an attorney with The Health Law Firm, which has a national practice. Its main office is in Orlando, Florida, area. www.TheHealthLawFirm.com The Health Law Firm, 1101 Douglas Avenue, Suite 1000, Altamonte Springs, Florida 32714, Phone: (407) 331-6620 or Toll-Free: (888) 331-6620.

KeyWords:  Legal representation for Medicare Medicaid audit, Medicare Medicaid audit defense attorney, legal representation for healthcare professionals, complex health care litigation attorney, legal representation for Medicare Medicaid reimbursement demand, Medicare Medicaid defense lawyer, legal representation for Medicare Medicaid defense, complex civil health care litigation attorney, legal representation for complex medical litigation, representation for healthcare business litigation matters, Medicare Medicaid hearing attorney, legal representation for physicians and health care professionals, attorney for physician suits against insurers, complex medical business litigation against health insurers, formal Medicare administrative hearing lawyer, Health law defense lawyer, legal representation of health care professionals, Medicare Medicaid overpayment demand defense lawyer, Legal representation for Medicare Medicaid administrative hearing
Florida Agency for Health Care Administration (AHCA) formal hearing defense attorney, legal representation for Medicare Medicaid revocation termination hearings, medical license investigation representation defense attorney, representation for Florida Department of Health (DOH) investigations and hearings, reviews of The Health Law Firm, reviews of The Health Law Firm. The Health Law Firm attorney reviews, The Health Law Firm attorney reviews

“The Health Law Firm” is a registered fictitious business name of and a registered service mark of The Health Law Firm, P.A., a Florida professional service corporation, since 1999.
Copyright © 2022 The Health Law Firm. All rights reserved.

2022-08-24T00:34:03-04:00August 24th, 2022|Categories: Health Facilities Law Blog|Tags: , , , , , , , , , , , , , , , , , , , , , , , , |0 Comments

COVID Uninsured Provider Relief Fund Expected To Run Out of Money Soon If Congress Doesn’t Act

Attorney and Author HeadshotBy George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law

In 2020, the U.S. Department of Health and Human Services (HHS) created the “Provider Relief Fund” (PRF) to help support healthcare providers in the battle against the COVID-19 pandemic. The federal program has served as a lifeline to frontline healthcare workers who’ve experienced revenue losses and increased demand for their services during the pandemic.

To date, it has allocated more than $178 billion in payments to over 410,000 providers across the United States. Click here to learn more.

COVID-19 Uninsured Relief Fund.

Let’s start with some good news: Under the COVID-19 relief funding, HHS created the “uninsured relief fund.” This program provides claims reimbursement to health care providers for testing, treating, diagnosis, and administering vaccines to uninsured individuals for COVID-19. It has paid out more than $17 billion throughout the pandemic. It has paid out more than $17 billion throughout the pandemic.

Of the $17 billion, HHS has distributed nearly $10 billion for testing, more than $6 billion reimbursed for treatment, and the remainder covered vaccinations. Read more on the statistics here.

Running Out of Money.

Now for the bad news: According to an HHS spokesperson, there’s only $7.6 billion left, and the money will run out in the coming months. Congress isn’t currently considering making more funding available, meaning providers and patients are likely to have soon to bear the costs themselves.

Therefore, many hospitals and healthcare organizations urge Congress to replenish the PRF. “One of the most helpful and patient-oriented uses of the PRF was to help those people who for whatever reasons are uninsured and suffer from COVID-19,” said Federation of American Hospitals CEO Chip Kahn. “It meant that no one should have any reluctance to go to the hospital if they have COVID but no insurance.”

Additionally, on February 9, 2022, the American Hospital Association released a statement urging readers to contact lawmakers to get Congress to provide another $25 billion for the PRF in the government funding package. Read the AHA’s action alert here.

As we approach nearly two years since HHS declared COVID-19 a national public health emergency, PRF has been a lifeline to hospitals, health systems, and medical professionals. It has been helping to keep doors open during the pandemic to continue providing essential care to patients and communities. However, if the program runs out of money and Congress doesn’t appropriate more, hospitals could be left footing the bill, which will hurt both providers and patients in the end.

Read one of my previous blogs on a similar case regarding a Florida Dentist’s COVID-19 Business Interruption Insurance Claim to learn even more.

Contact Health Law Attorneys Experienced in Representing Health Care Professionals and Providers.

At the Health Law Firm, we provide legal services for all health care providers and professionals. This includes physicians, nurses, dentists, psychologists, psychiatrists, mental health counselors, home health agencies, hospitals, ambulatory surgical centers, pain management clinics, nursing homes, and any other healthcare provider. It also includes medical students, resident physicians, and fellows, as well as medical school professors and clinical staff. We represent health facilities, individuals, groups, and institutions in contracts, sales, mergers, and acquisitions. The lawyers of The Health Law Firm are experienced in complex litigation and both formal and informal administrative hearings. We also represent physicians accused of wrongdoing, patient complaints, and in Department of Health investigations.

To contact The Health Law Firm, please call our office at (407) 331-6620 or toll-free at (888) 331-6620 and visit our website at www.ThehealthLawFirm.com.

Sources:

Hellmann, Jessie. “HHS running out of money to pay providers for treating uninsured COVID-19 patients.” Modern Healthcare. (February 8, 2022). Web.

HRSA. “Covid Uninsured Claim.” Health Resources & Services Administration. (February 2022). Web.

About the Author: George F. Indest III, J.D., M.P.A., LL.M., is Board Certified by The Florida Bar in Health Law; he is the President and Managing Partner of The Health Law Firm, which has a national practice. Its main office is in Orlando, Florida, area. www.TheHealthLawFirm.com The Health Law Firm, 1101 Douglas Ave. Suite 1000, Altamonte Springs, FL 32714, Phone: (407) 331-6620 or Toll-Free: (888) 331-6620.

“The Health Law Firm” is a registered fictitious business name of and a registered service mark of The Health Law Firm, P.A., a Florida professional service corporation, since 1999.
Copyright © 2022 The Health Law Firm. All rights reserved.

Florida’s Protecting DNA Privacy Act: How Will It Affect Healthcare Providers?

By George F. Indest III, J.D., M.P.A., LL.M., is Board Certified by The Florida Bar in Health Law

On June 29, 2021, Florida Gov. Ron DeSantis signed into law HB 833, known as the “Protecting DNA Privacy Act,” which took effect in Florida October 1, 2021. Under the act, collecting or submitting another person’s DNA sample for analysis without his or her express consent now constitutes a second-degree felony in the state of Florida.  It amends Section 760.40, Florida Statutes, with the criminal penalties being set forth in Section 817.5655, Florida Statutes.

The new law clarifies the extent to which individuals own their genetic information. It also creates new crimes for the unlawful collection, retention, analysis, disclosure, or sale of an individual’s DNA sample and the results of a DNA analysis.  The act also has important implications for secondary uses of data by health care providers and others that perform genetic testing and analyze genetic information.


What is Genetic/DNA Privacy Law?

The use and accessibility of genetic testing, primarily through direct-to-consumer options (companies such as 23andMe and Ancestry.com ), has significantly increased in recent years, which has resulted in growing concerns about the privacy of genetic information and its use by third parties.

The Florida Legislature has focused on strengthening the protections surrounding genetic information. In 2020, it amended Florida law to limit the use of genetic information by life insurance companies for specific insurance purposes, including underwriting. Click here to read the final bill analysis for the act.


The Impact on Healthcare Professionals.

The new law will have the biggest impact on physicians who employ DNA testing in their practices. Physicians who collect or submit a patient’s DNA sample for DNA analysis will have to first obtain the patient’s express consent to do so.

“Express consent” is defined as “authorization by the person whose DNA is to be extracted or analyzed, or such person’s legal guardian or authorized representative, evidenced by an affirmative action demonstrating an intentional decision after the person receives a clear and prominent disclosure regarding the manner of collection, use, retention, maintenance, or disclosure of a DNA sample or results of a DNA analysis for specified purposes.”

This means that physicians who wish to have a patient’s DNA analyzed for a specified purpose need first to explain how the DNA sample will be collected, used, retained, and maintained and how the results of the DNA analysis will be used. This information ideally will be outlined in a formal, written document that the patient will sign. In addition, the legislation allows physicians to obtain a single express consent for every instance of a specified purpose or use.

What This Means For You.

Any healthcare professional engaged in such activities should consider reevaluating their consent processes to determine whether they obtain appropriate consent for all uses of de-identified results of DNA analysis. To learn more, click here.

Click here to view HB 833 in full.

Click here to review Section 760.40, Florida Statutes.

Click Here to review Section 817.5655, Florida Statutes, containing the criminal penalties.


Contact Health Law Attorneys Experienced in Representing Health Care Professionals and Providers.

At the Health Law Firm, we provide legal services for all health care providers and professionals. This includes physicians, nurses, dentists, psychologists, psychiatrists, mental health counselors, home health agencies, hospitals, ambulatory surgical centers, pain management clinics, nursing homes, and any other healthcare provider. It also includes medical students, resident physicians, and fellows, as well as medical school professors and clinical staff. We represent health facilities, individuals, groups, and institutions in contracts, sales, mergers, and acquisitions. The lawyers of The Health Law Firm are experienced in complex litigation and both formal and informal administrative hearings. We also represent physicians accused of wrongdoing, patient complaints, and in Department of Health investigations.

To contact The Health Law Firm, please call our office at (407) 331-6620 or toll-free at (888) 331-6620 and visit our website at www.TheHealthLawFirm.com.


Sources:

Peloquin, David. “What Fla. DNA Privacy Law Means For Health Providers.” Law360. (October 4, 2021). Web.

“How the new DNA privacy law could affect your practice.” Florida Society of Clinical Oncology. (September 20, 2021). Web.

About the Author:  George F. Indest III, J.D., M.P.A., LL.M., is Board Certified by The Florida Bar in Health Law; he is the President and Managing Partner of The Health Law Firm, which has a national practice. Its main office is in Orlando, Florida, area. www.TheHealthLawFirm.com The Health Law Firm, 1101 Douglas Avenue, Suite 1000, Altamonte Springs, Florida 32714, Phone: (407) 331-6620 Toll-Free: (888) 331-6620.

“The Health Law Firm” is a registered fictitious business name of and a registered service mark of The Health Law Firm, P.A., a Florida professional service corporation, since 1999.  Copyright © 2022 The Health Law Firm. All rights reserved.

COVID-19 Provider Relief Fund Expected To Run Out of Money If Congress Doesn’t Act Soon

Attorney and Author HeadshotBy George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law

In 2020, the U.S. Department of Health and Human Services (HHS) created the “Provider Relief Fund” (PRF) to help support healthcare providers in the battle against the COVID-19 pandemic. The federal program has served as a lifeline to frontline healthcare workers who’ve experienced revenue losses and increased demand for their services during the pandemic.

To date, it has allocated more than $178 billion in payments to over 410,000 providers across the United States. Click here to learn more.

COVID-19 Uninsured Relief Fund.

Let’s start with some good news: Under the COVID-19 relief funding, HHS created the “uninsured relief fund.” This program provides claims reimbursement to health care providers for testing, treating, diagnosis, and administering vaccines to uninsured individuals for COVID-19. It has paid out more than $17 billion throughout the pandemic. It has paid out more than $17 billion throughout the pandemic.

Of the $17 billion, HHS has distributed nearly $10 billion for testing, more than $6 billion reimbursed for treatment, and the remainder covered vaccinations. Read more on the statistics here.

Running Out of Money.

Now for the bad news: According to an HHS spokesperson, there’s only $7.6 billion left, and the money will run out in the coming months. Congress isn’t currently considering making more funding available, meaning providers and patients are likely to have soon to bear the costs themselves.

Therefore, many hospitals and healthcare organizations urge Congress to replenish the PRF. “One of the most helpful and patient-oriented uses of the PRF was to help those people who for whatever reasons are uninsured and suffer from COVID-19,” said Federation of American Hospitals CEO Chip Kahn. “It meant that no one should have any reluctance to go to the hospital if they have COVID but no insurance.”

Additionally, on February 9, 2022, the American Hospital Association released a statement urging readers to contact lawmakers to get Congress to provide another $25 billion for the PRF in the government funding package. Read the AHA’s action alert here.

As we approach nearly two years since HHS declared COVID-19 a national public health emergency, PRF has been a lifeline to hospitals, health systems, and medical professionals. It has been helping to keep doors open during the pandemic to continue providing essential care to patients and communities. However, if the program runs out of money and Congress doesn’t appropriate more, hospitals could be left footing the bill, which will hurt both providers and patients in the end.

Read one of my previous blogs on a similar case regarding a Florida Dentist’s COVID-19 Business Interruption Insurance Claim to learn even more.

Contact Health Law Attorneys Experienced in Representing Health Care Professionals and Providers.

At the Health Law Firm, we provide legal services for all health care providers and professionals. This includes physicians, nurses, dentists, psychologists, psychiatrists, mental health counselors, home health agencies, hospitals, ambulatory surgical centers, pain management clinics, nursing homes, and any other healthcare provider. It also includes medical students, resident physicians, and fellows, as well as medical school professors and clinical staff. We represent health facilities, individuals, groups, and institutions in contracts, sales, mergers, and acquisitions. The lawyers of The Health Law Firm are experienced in complex litigation and both formal and informal administrative hearings. We also represent physicians accused of wrongdoing, patient complaints, and in Department of Health investigations.

To contact The Health Law Firm, please call our office at (407) 331-6620 or toll-free at (888) 331-6620 and visit our website at www.ThehealthLawFirm.com.

Sources:

Hellmann, Jessie. “HHS running out of money to pay providers for treating uninsured COVID-19 patients.” Modern Healthcare. (February 8, 2022). Web.

HRSA. “Covid Uninsured Claim.” Health Resources & Services Administration. (February 2022). Web.

About the Author: George F. Indest III, J.D., M.P.A., LL.M., is Board Certified by The Florida Bar in Health Law; he is the President and Managing Partner of The Health Law Firm, which has a national practice. Its main office is in Orlando, Florida, area. www.TheHealthLawFirm.com The Health Law Firm, 1101 Douglas Ave. Suite 1000, Altamonte Springs, FL 32714, Phone: (407) 331-6620 or Toll-Free: (888) 331-6620.

“The Health Law Firm” is a registered fictitious business name of and a registered service mark of The Health Law Firm, P.A., a Florida professional service corporation, since 1999.
Copyright © 2022 The Health Law Firm. All rights reserved.

Florida Gov Signs Sweeping COVID-19 Liability Protections Into Law

George Indest HeadshotBy George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law

On March 29, 2021, Florida Gov. Ron DeSantis signed a bill that protects businesses, governments, and healthcare providers in Florida from COVID-19 lawsuits if they make a reasonable effort to follow guidelines to prevent the spread of coronavirus (whatever that means). Specifically, the measure gives civil immunity to corporations, hospitals, nursing homes, government entities, schools, and churches as long as the alleged negligence doesn’t involve gross negligence or intentional misconduct. The House Passed S.B. 72 on March 26, in an 83-31 vote, and DeSantis signed it the same day he received it from the Legislature.

Why doesn’t this conflict with the Florida Governor’s ban on any mandatory masking, vaccination, or vaccination “passport” requirements? This is very unclear. Perhaps the courts will need to straighten it out.


Details of Senate Bill 72.

The new law establishes significant legal hurdles for individuals who want to sue businesses and health care professionals over coronavirus-related injuries. Plaintiffs who file suit will need to show that the defendant deliberately ignored public health safety guidelines. They will also need a signed affidavit from a doctor stating with reasonable certainty that injury or death caused by COVID-19 was a direct result of the defendant’s actions. Does this sound arbitrary and capricious to anyone other than me?

Now how can a doctor or anyone else make a statement like the one required by the law? How does a doctor know where the patient has been or with whom the patient has been in contact the last fifteen days? How is a physician going to conduct contact tracing and figure out where the patient’s COVID-19 came from? This is very unclear. Perhaps the courts will need to straighten it out.

The law states that it will apply retroactively to the beginning of the pandemic. One must ask if this is an ex post facto law prohibited by the U.S. Constitution (Art. I, § 10, cl. 1.) and the Florida Constitution (Art. 1, § 10)? Additionally, the new law establishes a one-year limitation period to sue from the date of death, hospitalization, or COVID-19 diagnosis that forms the basis of the claim. Boy, this should really throw a big stumbling block in front of any potential plaintiff trying to get into court. (Note: Yes, I know that the federal prohibition on ex post facto laws was held to apply to criminal laws.)

“Over the course of the past year, our state’s businesses, health care providers, and other organizations have been forced to operate in fear of frivolous lawsuits with no merit threatening their livelihoods. As we move forward in our state’s economic recovery, this piece of legislation will provide Floridians with greater peace of mind as they go to work, go to school, and go about their daily lives,” DeSantis said applauding the quick passage of the legislation.

View S.B. 72 here.

To read about a recent case in Florida involving a COVID-19 death lawsuit, click here to read my blog.

Contact Health Law Attorneys Experienced in Representing Health Care Professionals and Providers.

At the Health Law Firm, we provide legal services for all health care providers and professionals. This includes physicians, nurses, dentists, psychologists, psychiatrists, mental health counselors, home health agencies, hospitals, ambulatory surgical centers, pain management clinics, nursing homes, and any other healthcare provider. It also includes medical students, resident physicians, and fellows, as well as medical school professors and clinical staff. We represent health facilities, individuals, groups, and institutions in contracts, sales, mergers, and acquisitions. The lawyers of The Health Law Firm are experienced in complex litigation and both formal and informal administrative hearings. We also represent physicians accused of wrongdoing, patient complaints, and in Department of Health investigations. We do NOT represent plaintiffs in COVID-19 injury suits, however.

To contact The Health Law Firm, please call our office at (407) 331-6620 or toll-free at (888) 331-6620 and visit our website at www.TheHealthLawFirm.com.

Sources:

Hale, Nathan. “Fla. Gov. Signs Sweeping COVID-19 Liability Protection Law.” Law360. (March 29, 2021). Web.

Kang, Y. Peter. “Fla. COVID-19 Biz Liability Shield Bill Sent To Gov.’s Desk.” Law360. (March 26, 2021). Web.

NBC 6 Miami. “Florida Governor Signs COVID-19 Liability Protection Bill.” AP News. (March 29, 2021). Web.

About the Author: George F. Indest III, J.D., M.P.A., LL.M., is Board Certified by The Florida Bar in Health Law; he is the President and Managing Partner of The Health Law Firm, which has a national practice. Its main office is in Orlando, Florida, area. www.TheHealthLawFirm.com The Health Law Firm, 1101 Douglas Avenue, Suite 1000, Altamonte Springs, Florida 32714, Phone: (407) 331-6620 Toll-Free: (888) 331-6620.

“The Health Law Firm” is a registered fictitious business name of and a registered service mark of The Health Law Firm, P.A., a Florida professional service corporation, since 1999. Copyright © 2021 The Health Law Firm. All rights reserved.

University of Colorado Sued For Denying COVID-19 Vaccine Religious Exemptions

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law

On September 29, 2021, a pediatrician and medical student sued the University of Colorado Anschutz Medical Campus (CU) for denying COVID vaccine religious exemptions. The U.S. District Court lawsuit argued that school administrators judge the validity of personal religious beliefs in violation of the First Amendment.

Religious Exception For COVID Vaccine.

Both plaintiffs are challenging the denial of their requests for religious exemptions from the school’s COVID vaccination mandate. The lawsuit alleges that the university arbitrarily grants religious exemptions to its vaccine requirement for all staff and students. It also claims that CU is approving requests that are based on organized religious beliefs that oppose vaccinations while subjecting requests based on personal religious beliefs to “intrusive religious inquisition to test the veracity of students’ and employees’ asserted religious beliefs.”

Details of the Denials.

Neither plaintiff is named in the lawsuit ostensibly to protect them from retaliation. Instead, the pediatrician is referred to as “Dr. Jane Doe,” and the first-year medical student as “John Doe.”

According to the complaint, Dr. Jane Doe requested a religious exemption based on her Catholic beliefs and opposition to “abortion-derived cell lines” used in the three available U.S. vaccines. However, she did not oppose other vaccines, such as the flu shot.

Because of this, CU denied her request, stating that campus policy “only recognizes religious exemptions based on a religious belief whose teachings are opposed to all immunizations,” according to the complaint. Jane Doe argues that her pending termination will harm her reputation and stain her record as a licensed medical professional.

According to the complaint, the second plaintiff, John Doe, a first-year medical student, requested a religious exemption citing his Buddhist beliefs and avoidance of “products developed through the killing or harming of animals (including human beings).”

CU officials also denied the exception request, stating that John Doe’s objections to the vaccine “are all of a personal nature and not part of a comprehensive system of religious beliefs.”

The lawsuit says John Doe’s pending termination from CU would bar him from transferring to a different medical school under guidelines issued by the Association of American Medical Colleges and that he would have to reapply to attend a different U.S. medical program.

In response to the lawsuit, a spokesperson for the university said their mandatory vaccine policy “offers the best way to protect” the more than two million patients that the university faculty serve annually.

Both plaintiffs seek approval of their requests for religious exemptions and money for court costs and personal damages. This lawsuit is just one example of the fight over a growing number of COVID vaccine mandates nationwide. As a result, businesses need to be mindful and provide reasonable accommodations to employees with disabilities or religious beliefs that prevent them from receiving the COVID vaccine.

To read about another recent case regarding a hospital’s COVID vaccine mandate, click here to read my prior blog.

Contact Health Law Attorneys Experienced in Representing Health Care Professionals and Providers.

At the Health Law Firm, we provide legal services for all health care providers and professionals. This includes physicians, nurses, dentists, psychologists, psychiatrists, mental health counselors, home health agencies, hospitals, ambulatory surgical centers, pain management clinics, nursing homes, and any other healthcare provider. It also includes medical students, resident physicians, and fellows, as well as medical school professors and clinical staff. We represent health facilities, medical groups, institutions, and individual health professionals in contracts, sales, mergers, and acquisitions. The lawyers of The Health Law Firm are experienced in complex litigation and both formal and informal administrative hearings. We also represent physicians accused of wrongdoing, patient complaints, and in Department of Health and DORA investigations. We represent medical students and resident physicians in disputes with their medical education programs. We do NOT represent plaintiffs seeking to avoid vaccinations or in COVID-19 injury suits, however.

To contact The Health Law Firm, please call our office at (407) 331-6620 or toll-free at (888) 331-6620 and visit our website at www.TheHealthLawFirm.com.

Sources:

Nieberg, Patty. “University of Colorado faces COVID religious exemption suit.” AP News. (September 29, 2021). Web.

“Pediatrician, medical student sue University of Colorado over denial of COVID vaccine religious exemption.” The Colorado Sun. (September 30, 2021). Web.

About the Author: George F. Indest III, J.D., M.P.A., LL.M., is Board Certified by The Florida Bar in Health Law; he is the President and Managing Partner of The Health Law Firm, which has a national practice. Its main office is in Orlando, Florida, area. www.TheHealthLawFirm.com The Health Law Firm, 1101 Douglas Avenue, Suite 1000, Altamonte Springs, Florida 32714, Phone: (407) 331-6620 Toll-Free: (888) 331-6620.

“The Health Law Firm” is a registered fictitious business name of and a registered service mark of The Health Law Firm, P.A., a Florida professional service corporation, since 1999. Copyright © 2021 The Health Law Firm. All rights reserved.

 

Texas Hospital’s COVID-19 Vaccine Mandate Upheld by Federal Court

George Indest HeadshotBy George F. Indest III, J.D., M.P.A., LL.M., is Board Certified by The Florida Bar in Health Law

As some states lift COVID-19 restrictions, the business community is still grappling with the dynamic between the COVID-19 vaccine and workplace operations. To address this, some U.S. employers have elected to adopt mandatory vaccination policies. These policies, in essence, require that, subject to a few exceptions, all employees must receive the COVID-19 vaccine as a condition of continued employment.

Not surprisingly, we see various legal challenges to mandatory COVID-19 vaccination policies across the country. On June 12, 2021, a federal court in Texas became the first to rule on the permissibility of such policies enforced by private employers. In a landmark ruling, the court stated that mandatory workplace vaccination policies are lawful under Texas and federal law and may be enforced as a condition of continued employment.


The Court’s Ruling on Mandatory Vaccination Policies.

The lawsuit, Bridges v. Houston Methodist Hospital, was initially filed on behalf of 117 employees after their employer, Houston Methodist Hospital, instituted a policy requiring employees to receive a COVID-19 vaccine as a condition of continued employment. Employees who were not vaccinated by the deadline were to be placed on a two-week unpaid suspension to allow them to comply with the policy. Under the policy, those who ultimately did not comply would be terminated.

In the law suit challenging the employer’s policy, the Plaintiffs asserted: (1) the employees whose employment was terminated as a result of this policy were wrongfully terminated in violation of Texas law, and (2) the vaccine mandate violated public policy of the state of Texas.

Texas Wrongful Termination Claim.

Under Texas law, the court found that firing an employee who is unwilling to comply with an employer’s mandatory COVID-19 vaccine policy does not constitute wrongful termination. Texas law only protects employees who are fired for refusing to commit an illegal act at the request of their employer. The court reasoned that receiving the vaccine is not an illegal act given the U.S. Supreme Court’s rulings upholding involuntary quarantines and mandatory vaccines.

Violation of Public Policy.

The court dismissed the plaintiffs’ public policy arguments because, according to the court, Texas law does not recognize a public policy exception to the at-will employment doctrine. Additionally, the court noted that a mandatory vaccine requirement is consistent with public policy. The Supreme Court has previously held that state-imposed quarantine and vaccination requirements do not violate due process of law.

The court held that the plaintiffs were not being coerced to get the vaccine but were being given a basic choice by its employer: get the vaccine so the hospital could safely continue its business of saving lives or seek employment elsewhere.

Lastly, the court also cited recent Equal Employment Opportunity Commission (EEOC) guidance in its decision. The guidance states that employers can require employees to be vaccinated, subject to the obligation to provide reasonable accommodations to employees with legitimate medical or religious reasons for not being vaccinated. Click here to view.

To view the court’s order in full, click here.

Important Takeaway From This Court Decision.

While there are sure to be future legal challenges to mandatory workplace vaccination policies, this decision provides strong support for their use and permissibility. However, even with this ruling, employers with policies need to be mindful of their obligations and potentially provide reasonable accommodations to employees with disabilities or sincerely held religious beliefs that prevent them from receiving the COVID-19 vaccine. Of course, we will see numerous legal challenges of all kinds to these decisions.

Contact Health Law Attorneys Experienced in Representing Health Care Professionals and Providers.

At the Health Law Firm, we provide legal services for all health care providers and professionals. This includes physicians, nurses, dentists, psychologists, psychiatrists, mental health counselors, home health agencies, hospitals, ambulatory surgical centers, pain management clinics, nursing homes, and any other healthcare provider. It also includes medical students, resident physicians, and fellows, as well as medical school professors and clinical staff. We represent health facilities, individuals, groups, and institutions in contracts, sales, mergers, and acquisitions. The lawyers of The Health Law Firm are experienced in complex litigation and both formal and informal administrative hearings. We also represent physicians accused of wrongdoing, patient complaints, and in Department of Health investigations. We do NOT represent plaintiffs in COVID-19 injury suits, however.

To contact The Health Law Firm, please call our office at (407) 331-6620 or toll-free at (888) 331-6620 and visit our website at www.TheHealthLawFirm.com.

Sources:

Downie, Alex. “Federal Court Upholds Employer’s COVID-19 Vaccine Mandate.” The National Law Review. (June 15, 2021). Web.

Brown, Amanda, Goldstein, Mark. “In first-of-its-kind decision, federal court rules that mandatory workplace COVID-19 vaccine policies are lawful.” Employment Law Watch. (June 16, 2021). Web.

About the Author: George F. Indest III, J.D., M.P.A., LL.M., is Board Certified by The Florida Bar in Health Law; he is the President and Managing Partner of The Health Law Firm, which has a national practice. Its main office is in Orlando, Florida, area. www.TheHealthLawFirm.com The Health Law Firm, 1101 Douglas Avenue, Suite 1000, Altamonte Springs, Florida 32714, Phone: (407) 331-6620 Toll-Free: (888) 331-6620.

“The Health Law Firm” is a registered fictitious business name of and a registered service mark of The Health Law Firm, P.A., a Florida professional service corporation, since 1999. Copyright © 2021 The Health Law Firm. All rights reserved.

 

Florida Judge Sides With Family of Florida Publix Employee Who Died of COVID-19

Attorney George F. Indest IIIBy George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law

On February 5, 2021, a judge in Florida refused to dismiss a lawsuit filed by the family of a Publix Super Markets deli worker who died after allegedly catching COVID-19 from a coworker. Judge Carlos Lopez announced that he would not dismiss the lawsuit filed by Gerardo Gutierrez’s family, who died on April 28, 2020, from complications caused by coronavirus. The suit was filed in the Florida Circuit Court for the Eleventh Judicial Circuit of Miami-Dade County, Florida, in November 2020.

Publix Accused of Failing Its Workers & the Miami Beach Community.

The suit alleged that on March 27 and 28, 2020, 70-year-old deli worker Gerardo “Gerry” Gutierrez worked at a Publix supermarket alongside a coworker who showed signs of COVID-19. Unfortunately, at that time, according to the complaint, Publix had made a decision to prohibit its employees from wearing masks and other personal protective equipment (PPE).

On April 2, Gutierrez was told by his supervisors to isolate at home; but by April 7, he tested positive for Covid-19, the complaint says. He died on April 28, 2020.

The family says in its complaint that Publix, a Florida-based grocery store chain, breached its duty to keep its employees safe. It knowingly failed to take proper precautions and prohibited its workers from wearing masks for fear it would “incite panic” among customers, claims the suit. The lawsuit echoes findings from an earlier Tampa Bay Times report that took the position that Publix lagged behind competitors in adopting employee and customer safety protections (such as employee PPE) during the early days of the pandemic.
Click here to learn more.

Additionally, the suit also references several Occupational Safety and Health Administration (OSHA) complaints, where employees repeatedly reported the grocer prohibited mask and glove use.

To view the family’s complaint, click here.

Publix Defends Itself.

In response to the lawsuit, Publix filed a motion to dismiss, calling the suit an attempt to circumvent the worker’s compensation process. Publix also argued that the claims in the case needed to be filed in the Florida Division of Administrative Hearings. The worker’s compensation system in Florida requires that employees of a corporation must file workers compensation claims for injuries sustained on the job. Civil litigation is prohibited against the employer, with a number of exceptions. The judge in the civil case disagreed with Publix, ruling in favor of the estate of the worker.

According to the complaint, it wasn’t until March 2020, after the realization set in that the spread of COVID-19 presented a major national crisis for Publix to post a statement on its website. In the statement, Publix CEO Todd Jones said the company had remained in close contact with the Centers for Disease Control and Prevention (CDC) and would “continue to focus on keeping [its] associates [employees] healthy—and [its] stores open and stocked—to serve and support all our communities.”

Click here to read the statement in full.

Despite the arguments, the family’s attorney Michael Levine said, “Publix has never taken any responsibility for its unthinkable decision to prohibit its employees from wearing masks as COVID-19 swept through Florida. Our case will make sure Publix is held accountable for its reckless decision. We look forward to uncovering the documents behind the mask prohibition and deposing its senior personnel.”

One problem that we see with this case is that many Publix employees work part-time. We had one working for our law firm, for example. By not allowing employees to wear proper PPE, and not requiring them to abide by other protective measures, the employer caused a far wider exposure of others, even many non-customers, and their families, to the COVID virus.

The case is Gutierrez v. Publix Super Markets Inc., case number 2020-025168-CA-01, and you can read the judge’s order in full here.

Read one of my prior blogs about OSHA previously handing out citations for COVID-19 PPE violations.

Contact Health Law Attorneys Experienced in Representing Health Care Professionals and Providers.

At the Health Law Firm, we provide legal services for all health care providers and professionals. This includes physicians, nurses, dentists, psychologists, psychiatrists, mental health counselors, home health agencies, hospitals, ambulatory surgical centers, pain management clinics, nursing homes, and any other healthcare provider. It also includes medical students, resident physicians, and fellows, as well as medical school professors and clinical staff. We represent health facilities, individuals, groups, and institutions in contracts, sales, mergers, and acquisitions. The lawyers of The Health Law Firm are experienced in complex litigation and both formal and informal administrative hearings. We also represent physicians accused of wrongdoing, patient complaints, and in Department of Health investigations.

To contact The Health Law Firm, please call our office at (407) 331-6620 or toll-free at (888) 331-6620 and visit our website at www.ThehealthLawFirm.com.

Sources:

Bolado, Carolina. “Fla. Judge Won’t Ax Suit Over Publix Worker’s COVID-19 Death.” Law360. (February 5, 2021). Web.

Toropin, Konstantin. “Family files suit over Publix employee’s death. It says company failed to protect him from Covid-19.” CNN. (November 23, 2020). Web.

DiNatale, Sara. “A Publix employee died from COVID-19. Now his family is suing over his death.” Tampa Bay Times. (November 23, 2020). Web.

About the Author: George F. Indest III, J.D., M.P.A., LL.M., is Board Certified by The Florida Bar in Health Law; he is the President and Managing Partner of The Health Law Firm, which has a national practice. Its main office is in Orlando, Florida, area. www.TheHealthLawFirm.com The Health Law Firm, 1101 Douglas Ave. Suite 1000, Altamonte Springs, FL 32714, Phone: (407) 331-6620 Toll-Free: (888) 331-6620.

“The Health Law Firm” is a registered fictitious business name of and a registered service mark of The Health Law Firm, P.A., a Florida professional service corporation, since 1999.
Copyright © 2021 The Health Law Firm. All rights reserved.

Judge Won’t Toss Lawsuit Filed By Family of Florida Publix Employee Who Died of COVID-19

Attorney George F. Indest IIIBy George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law

On February 5, 2021, a judge in Florida refused to dismiss a lawsuit filed by the family of a Publix Super Markets deli worker who died after allegedly catching COVID-19 from a coworker. Judge Carlos Lopez announced that he would not dismiss the lawsuit filed by Gerardo Gutierrez’s family, who died on April 28, 2020, from complications caused by coronavirus. The suit was filed in the Florida Circuit Court for the Eleventh Judicial Circuit of Miami-Dade County, Florida, in November 2020.

Publix Accused of Failing Its Workers & the Miami Beach Community.

The suit alleged that on March 27 and 28, 2020, 70-year-old deli worker Gerardo “Gerry” Gutierrez worked at a Publix supermarket alongside a coworker who showed signs of COVID-19. Unfortunately, at that time, according to the complaint, Publix had made a decision to prohibit its employees from wearing masks and other personal protective equipment (PPE).

On April 2, Gutierrez was told by his supervisors to isolate at home; but by April 7, he tested positive for Covid-19, the complaint says. He died on April 28, 2020.

The family says in its complaint that Publix, a Florida-based grocery store chain, breached its duty to keep its employees safe. It knowingly failed to take proper precautions and prohibited its workers from wearing masks for fear it would “incite panic” among customers, claims the suit. The lawsuit echoes findings from an earlier Tampa Bay Times report that took the position that Publix lagged behind competitors in adopting employee and customer safety protections (such as employee PPE) during the early days of the pandemic.
Click here to learn more.

Additionally, the suit also references several Occupational Safety and Health Administration (OSHA) complaints, where employees repeatedly reported the grocer prohibited mask and glove use.

To view the family’s complaint, click here.

Publix Defends Itself.

In response to the lawsuit, Publix filed a motion to dismiss, calling the suit an attempt to circumvent the worker’s compensation process. Publix also argued that the claims in the case needed to be filed in the Florida Division of Administrative Hearings. The worker’s compensation system in Florida requires that employees of a corporation must file workers compensation claims for injuries sustained on the job. Civil litigation is prohibited against the employer, with a number of exceptions. The judge in the civil case disagreed with Publix, ruling in favor of the estate of the worker.

According to the complaint, it wasn’t until March 2020, after the realization set in that the spread of COVID-19 presented a major national crisis for Publix to post a statement on its website. In the statement, Publix CEO Todd Jones said the company had remained in close contact with the Centers for Disease Control and Prevention (CDC) and would “continue to focus on keeping [its] associates [employees] healthy—and [its] stores open and stocked—to serve and support all our communities.”

Click here to read the statement in full.

Despite the arguments, the family’s attorney Michael Levine said, “Publix has never taken any responsibility for its unthinkable decision to prohibit its employees from wearing masks as COVID-19 swept through Florida. Our case will make sure Publix is held accountable for its reckless decision. We look forward to uncovering the documents behind the mask prohibition and deposing its senior personnel.”

One problem that we see with this case is that many Publix employees work part-time. We had one working for our law firm, for example. By not allowing employees to wear proper PPE, and not requiring them to abide by other protective measures, the employer caused a far wider exposure of others, even many non-customers, and their families, to the COVID virus.

The case is Gutierrez v. Publix Super Markets Inc., case number 2020-025168-CA-01, and you can read the judge’s order in full here.

Read one of my prior blogs about OSHA previously handing out citations for COVID-19 PPE violations.

Contact Health Law Attorneys Experienced in Representing Health Care Professionals and Providers.

At the Health Law Firm, we provide legal services for all health care providers and professionals. This includes physicians, nurses, dentists, psychologists, psychiatrists, mental health counselors, home health agencies, hospitals, ambulatory surgical centers, pain management clinics, nursing homes, and any other healthcare provider. It also includes medical students, resident physicians, and fellows, as well as medical school professors and clinical staff. We represent health facilities, individuals, groups, and institutions in contracts, sales, mergers, and acquisitions. The lawyers of The Health Law Firm are experienced in complex litigation and both formal and informal administrative hearings. We also represent physicians accused of wrongdoing, patient complaints, and in Department of Health investigations.

To contact The Health Law Firm, please call our office at (407) 331-6620 or toll-free at (888) 331-6620 and visit our website at www.ThehealthLawFirm.com.

Sources:

Bolado, Carolina. “Fla. Judge Won’t Ax Suit Over Publix Worker’s COVID-19 Death.” Law360. (February 5, 2021). Web.

Toropin, Konstantin. “Family files suit over Publix employee’s death. It says company failed to protect him from Covid-19.” CNN. (November 23, 2020). Web.

DiNatale, Sara. “A Publix employee died from COVID-19. Now his family is suing over his death.” Tampa Bay Times. (November 23, 2020). Web.

About the Author: George F. Indest III, J.D., M.P.A., LL.M., is Board Certified by The Florida Bar in Health Law; he is the President and Managing Partner of The Health Law Firm, which has a national practice. Its main office is in Orlando, Florida, area. www.TheHealthLawFirm.com The Health Law Firm, 1101 Douglas Ave. Suite 1000, Altamonte Springs, FL 32714, Phone: (407) 331-6620 Toll-Free: (888) 331-6620.

“The Health Law Firm” is a registered fictitious business name of and a registered service mark of The Health Law Firm, P.A., a Florida professional service corporation, since 1999.
Copyright © 2021 The Health Law Firm. All rights reserved.

Judge Sides With AdventHealth, Allows Fraud Claims Over $57.5 Million PPE Deal to Move Forward

Headshot of attorney George IndestBy George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law

On February 23, 2021, a federal court in Orlando, Florida, ruled that Adventist Health System Sunbelt (now known as AdventHealth, and which owns Florida Hospital, among others) could pursue claims it has over a bad $57.5 million deal to buy personal protective equipment (PPE). The defendants whom the hospital system is suing include Tomax Capital Management, Inc. (“Tomax”), a California corporation; a California attorney and his law firm; and others.

U.S. District Judge Paul G. Byron said the hospital system provided sufficient evidence that Tomax failed to deliver the promised PPE and then conspired to keep the $2 million which was not returned.

The PPE Contract.

According to the complaint in the case, the contract was for AdventHealth to purchase 10 million 3M N95 ventilator masks, according to the May 2020 complaint. Under the terms of the contract, the hospital was to pay a total of $57.5 million for 10 million 3M N95 masks to protect its workers during the Coronavirus pandemic. AdventHealth paid the $57.5 million into a California lawyer’s trust account. The 10 million masks were to be delivered to AdventHealth’s hospital in Orlando, Florida, by April 18, 2020. However, the masks never arrived.

Now, I just have to jump in and point out something. I don’t claim to have ironclad proof of it, but I have seen and read enough about 3M N95 masks on television and in the press while trying to purchase my own. I may be totally off on this figure, but I seem to remember around the beginning of the Coronavirus pandemic that 3M was only manufacturing approximately 1 million masks a month. So where someone would be able to come up with 10 million of these specific masks is mind-boggling to me. Let’s just say that this is my own opinion.

When the hospital system requested a refund of the $57.5 million it had paid, it claims it was only refunded $55.5 million, with $2 million missing in action. According to the complaint, AdventHealth never saw the remaining $2 million despite assurance from the attorneys involved in the deal that AdventHealth would get it back. Hence, the present lawsuit.

I mean, if you can’t trust an attorney nowadays, who can ya’ trust?

A Civil Conspiracy?

In its suit, AdventHealth makes various claims of breach of contract, conversion, and civil conspiracy and requests actual damages, punitive damages, and prejudgment interest. The conspiracy would involve the allegation that the attorney and law firm conspired with Tomax and others to deprive AdventHealth of the $2 million. Because AdventHealth alleged that it suffered damages in Florida, it was able to bring its case to the federal court here in Orlando.

Read the complaint filed in the U.S. District Court for the Middle District of Florida for more details.

Granted, $2 million isn’t a lot of money to some people, but it was obviously enough money to get these Defendants sued in federal court.

Judge Sides With the Hospital System’s Position on Motion to Dismiss Complaint.

The federal court judge denied a motion to dismiss the complaint filed by Tomax. In his order, the judge stated: “Plaintiff sufficiently pleads facts supporting the existence of a civil conspiracy that caused injury in Florida.” In addition to allowing the claims of the hospital system to move forward, the judge also ruled that the court has the authority to exercise personal jurisdiction over the attorney and law firm that was involved, under the state’s long-arm statute. To obtain more details, read the judge’s order denying the motion to dismiss.  Click here to visit our Areas of Practice page and learn more on how The Health Law Firm can assist you in legal cases like this.

PPE a “Hot Issue.”

In another recent pandemic-related case, OSHA began issuing fines to health care systems over PPE violations such as lack of proper equipment for their employees. We have also read a number of reports about companies and individuals being fined and injunctions being obtained by the Federal Trade Commission and the Food and Drug Administration over phony PPE being sold to Americans over the Internet.

Contact Health Law Attorneys Experienced in Representing Health Care Professionals and Providers.

At the Health Law Firm, we provide legal services for all health care providers and professionals. This includes physicians, nurses, dentists, psychologists, psychiatrists, mental health counselors, home health agencies, hospitals, ambulatory surgical centers, pain management clinics, nursing homes, and any other healthcare provider. It also includes medical students, resident physicians, and fellows, as well as medical school professors and clinical staff. The lawyers of The Health Law Firm are experienced in complex litigation in state and federal courts.

To contact The Health Law Firm, please call our office at (407) 331-6620 or toll-free at (888) 331-6620 and visit our website at www.ThehealthLawFirm.com

Sources:

Hale, Nathan. “AdventHealth’s Fraud Claim Over $57M PPE Deal Advanced.” Law360. (February 23, 2021). Web.

Bolado, Carolina. “AdventHealth Sues Attorney Over Failed $57.5M Masks Deal.” Law360. (May 29, 2020). Web.

About the Author: George F. Indest III, J.D., M.P.A., LL.M., is Board Certified by The Florida Bar in Health Law; he is the President and Managing Partner of The Health Law Firm, which has a national practice. Its main office is in Orlando, Florida, area. www.TheHealthLawFirm.com The Health Law Firm, 1101 Douglas Ave. Suite 1000, Altamonte Springs, FL 32714, Phone: (407) 331-6620 Toll-Free: (888) 331-6620.

“The Health Law Firm” is a registered fictitious business name of and a registered service mark of The Health Law Firm, P.A., a Florida professional service corporation, since 1999.
Copyright © 2021 The Health Law Firm. All rights reserved.

Go to Top