Articles Posted in Health Law

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Petitioner Charlotte-Mecklenburg Hospital Authority, d/b/a Carolinas Medical Center-Fort Mill sought a writ of certiorari to review the court of appeals' decision in Amisub of South Carolina, Inc. v. South Carolina Department of Health & Environmental Control, Op. No. 2017-UP-013 (S.C. Ct. App. filed Jan. 11, 2017). In 2005, four hospitals, Petitioner, Respondent Amisub, Presbyterian Healthcare System, and Hospital Partners of America, applied for a certificate of need (CON) to construct and operate an acute-care hospital in Fort Mill. In May 2006, the Department of Health and Environmental Control (DHEC) determined the acute-care hospital was necessary, and granted a CON to Amisub, but denied a CON to Petitioner and the others. DHEC's decision to award the CON to Amisub was based in part on its interpretation of the language of the South Carolina Health Plan that only existing health care providers in York County were eligible for additional hospital beds. Petitioner filed a contested case at the ALC, contending DHEC had erroneously interpreted the language of the Health Plan. Alternatively, Petitioner argued that if DHEC's interpretation was correct, the Health Plan violated the dormant Commerce Clause because it improperly restricted interstate commerce. The ALC found DHEC's interpretation of the Health Plan was not correct, reversed, and remanded to DHEC. The ALC's determination made it unnecessary for the ALC to reach the alternative dormant Commerce Clause claim. On remand, DHEC granted a CON to Petitioner, but denied a CON to the others. Amisub filed a second contested case at the ALC, which again reversed, this time ordering a CON be granted to Amisub and denied to Petitioner. The court of appeals affirmed, finding "the record does not show [Petitioner] presented to the ALC any argument that [Amisub]'s positions on adverse impact and outmigration, if adopted by the ALC, would violate the Dormant Commerce Clause. [Petitioner] waited until filing its Rule 59(e) motion to present this argument, which is too late." If Petitioner had reason to believe this issue was actually being litigated before the ALC in the second contested case, and yet remained silent, the South Carolina Supreme Court would have agreed with the court of appeals. However, the dormant Commerce Clause issues arising out of the language of the Health Plan were resolved in Petitioner's favor in the first contested case. Thus, Petitioner could not reasonably have foreseen the ALC would craft its order in a fashion to revive those issues. Therefore, Petitioner had no reason to raise the dormant Commerce Clause challenge in the second contested case until the ALC issued its order. “No party should be penalized for not addressing an issue as to which it had previously prevailed, and which it did not reasonably contemplate would yet be the basis of the court's ruling.” Accordingly, the Supreme Court reversed the court of appeals' finding that the dormant Commerce Clause issue was not preserved for appellate review, and remanded the case to the court of appeals for a ruling on the merits of the issue. View "Amisub v. SCDHEC" on Justia Law

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In 2007, Linda Johnson enrolled her mother, Inez Roberts (Mrs. Roberts), in Heritage Healthcare of Estill (HHE) to receive nursing home care. Johnson held a general power of attorney for Mrs. Roberts, and as such, signed an arbitration agreement with HHE on her mother's behalf upon Mrs. Roberts's admission to HHE. Within six months of entering HHE, she developed severe pressure ulcers, resulting in the amputation of her leg and ultimately, her death in 2009. Prior to Mrs. Roberts's death, in August 2008, Johnson requested HHE allow her access to Mrs. Roberts's medical records, but HHE refused, citing privacy provisions in the Health Insurance Portability and Accountability Act (HIPAA). Johnson then filed an ex parte motion seeking to obtain a copy of Mrs. Roberts's medical records from HHE and to restrain HHE from changing, altering, or destroying the records. The circuit court granted a restraining order, and HHE filed a motion to dissolve the order, again citing HIPAA's privacy provisions. Subsequently, at Johnson's request, the circuit court appointed her Mrs. Roberts's guardian ad litem (GAL) in order to pacify HHE's HIPAA concerns. However, HHE still refused to produce the records. The court again ordered HHE to produce the records, and HHE appealed. During the pendency of the appeal, Mrs. Roberts died, and Johnson became her personal representative. HHE then produced the records, and the parties dismissed the appeal by consent. Several months after obtaining the records, in August 2010, Johnson filed a notice of intent (NOI) for a wrongful death and survival action against HHE. In October 2010, following an impasse at pre-suit mediation, Johnson filed her complaint. In November 2010, HHE filed its answer and asserted arbitration as one of several defenses, but did not move to compel arbitration at that time. Instead, HHE filed arbitration-related discovery requests on Johnson. Johnson asks this Court to review the court of appeals' decision to reverse the circuit court's finding that Heritage Healthcare of Estill (HHE) waived its right to arbitrate the claims between it and Johnson. Finding that HHE indeed waived its right to arbitrate the claims, the Supreme Court reversed the court of appeals. View "Johnson v. Heritage Healthcare" on Justia Law

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Believing the purchase of orthopaedic prosthetic devices and other implants were eligible for a sales tax exemption, CareAlliance Health Services (the Hospital) sought a refund from South Carolina Department of Revenue (DOR). Following an audit, DOR denied the request as to orthopaedic prosthetic devices on the grounds they did not require a prescription to be sold and a prescription was not used in the purchase of the devices. The DOR also held other bone, muscle, and tissue implants were not exempt because they did not replace a missing part of the body, as required for the exemption. The Hospital filed for a contested case hearing. After discovery, both parties filed motions for summary judgment. Following a hearing on the motions, the ALC granted summary judgment in favor of the Hospital, finding orthopaedic prosthetic devices qualified for the exemption and other bone, muscle, and tissue implants replaced a missing part of the body. The DOR appealed, arguing the ALC erred in finding a prescription was required for the sale of an orthopaedic device between the Hospital and vendor because of federal regulations. The Supreme Court agreed and reversed: "The ALC's broad interpretation of the federal regulation is fundamentally at odds with the plain reading of the regulation and the strict construction afforded a tax exemption." Further, the Court reversed the ALC's finding that other bone, muscle and tissue implants replace a missing body part because it was not supported by substantial evidence in the record. The Court reversed the ALC and found the Hospital was not entitled to a tax exemption. View "CareAlliance Health Services v. SCDOR" on Justia Law

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The South Carolina Supreme Court answered certified two questions from the U.S. District Court for the District of South Carolina. The case concerned supplemental health insurance policies, which differ from ordinary health insurance policies in both purpose and operation. The questions were: (1) whether the definition of "actual charges" contained within S.C. Code Ann. 38-71-242 be applied to insurance contracts executed prior to the statute's effective date; and (2) whether the South Carolina Department of Insurance could mandate the application of "actual charges" to policies already inexistence on the statute's effective dates by prohibiting an insurance company from paying claims absent the application of that definition. The South Carolina Supreme Court answered both questions "no." View "Kirven v. Central States" on Justia Law

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Appellants Heritage Healthcare of Ridgeway, LLC, Uni-Health Post-Acute Care - Tanglewood, LLC (Tanglewood), and UHS-Pruitt Corporation (collectively, Appellants) ask this Court to reverse the circuit court's denial of their motion to compel arbitration in this wrongful death and survival action involving Appellants' allegedly negligent nursing home care. Tanglewood is a skilled nursing facility located in Ridgeway, owned and controlled by Appellants. In January 2007, Tanglewood and Respondent Darlene Dean entered into a nursing home residency agreement in which Tanglewood assumed responsibility for the care of Respondent's mother, Louise Porter (the patient). The same day, Respondent signed a separate, voluntary arbitration agreement. The patient did not sign either the residency agreement or the Agreement on her own behalf, although she was competent at the time of her admission to Tanglewood. Moreover, Respondent did not have a health care power of attorney empowering her to sign on the patient's behalf. In 2009, the patient fell three separate times within a ten day period, fracturing her hip in the third fall. Over the next two months, the patient underwent two hip surgeries; however, due to complications following the surgeries, the patient died on September 30, 2009. In late 2011, Respondent (acting in her capacity as personal representative of her mother's estate) filed a Notice of Intent (NOI) to file a medical malpractice suit against Appellants, as well as an expert affidavit in support of her NOI. Respondent also alleged claims for survival and wrongful death. In lieu of filing an answer to the complaint, Appellants filed a motion to dismiss pursuant to Rules 12(b)(1) and (6), SCRCP, or, in the alternative, a motion to compel arbitration and stay the litigation. Relying on "Grant v. Magnolia Manor-Greenwood, Inc.," (678 S.E.2d 435 (2009)), the circuit court invalidated the Agreement in its entirety and refused to compel arbitration between the parties. Appellants filed a motion to reconsider, which the circuit court denied. Upon review, the Supreme Court found that Respondent's argument that Appellants' waived their right to enforce the Agreement was without merit. On remand, the Supreme Court mandated that the circuit court consider her remaining arguments (concerning Respondent's authority to sign the Agreement and whether there was a meeting of the minds between the parties) prior to deciding whether to compel arbitration between the parties. View "Dean v. Heritage Healthcare" on Justia Law

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"At its most basic level, this case presents a policy dispute: whose policy choice concerning health insurance premiums for State employees controls—the General Assembly's or the Budget and Control Board's?" The issue before the Supreme Court centered on "maintaining and enforcing the constitutional and statutory framework through which such issues must be resolved. " Upon review of the arguments of the parties and the applicable case law, the Supreme Court found that the General Assembly had and exercised the power to determine the contribution rates of enrollees for the State's health insurance plan in 2013. The Court held that the Budget and Control Board violated the separation of powers provision by substituting its own policy for that of the General Assembly, entered judgment for the petitioners, and directed the Board to use the appropriated funds for premium increases and return the premium increases previously collected from enrollees. View "Hampton v. Haley" on Justia Law

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Vernon Sulton was rendered paraplegic by gunshot wounds he received as a bystander at an armed robbery. After initial treatment at Richland Memorial Hospital, he was transferred to the HealthSouth Rehab Hospital in Columbia. He was admitted with a sacral stage two pressure ulcer. In the eleven days Sulton remained at HealthSouth, the pressure ulcer progressed from stage two to stage four. Sulton underwent a colostomy and surgery that included a skin graft, and the pressure ulcer eventually fully healed. Sulton and his wife, Willie Mae Scott (Scott), sued HealthSouth and several of its nurses, alleging that Sulton had been injured by the defendants’ negligent provision of nursing care. Scott alleged a cause of action for loss of consortium. Sulton died of unrelated causes prior to trial. In the survival action, a jury found against all defendants and awarded $306,693.25 in economic damages but no non-economic damages. In the loss of consortium action, the jury found HealthSouth alone liable to Scott for four million dollars in non-economic damages. The jury also found that HealthSouth had been willful, wanton, or reckless. In the punitive damages phase of the bifurcated proceedings, the jury awarded eight million dollars in punitive damages. HealthSouth moved for JNOV, new trial absolute, and new trial nisi remittitur. These motions were denied. HealthSouth and the individual named nurse defendants challenged the jury’s verdict in a negligence and loss of consortium action. Because the trial court improperly instructed the jury that Appellants owed Respondents a heightened duty of care, the Supreme Court reversed and remanded the case for a new trial on all issues as to all Appellants. View "Sulton v. HealthSouth" on Justia Law