Justia U.S. 5th Circuit Court of Appeals Opinion Summaries

Articles Posted in Health Law
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In section 901 of the Family Smoking Prevention and Tobacco Control Act (TCA), Congress authorized the Secretary of Health and Human Services to determine which other products should be governed by the TCA's regulatory scheme. Plaintiffs filed suit against the FDA, its Commissioner, and the Secretary, asserting that Congress's delegation to the Secretary was unconstitutional.The Fifth Circuit affirmed the district court's dismissal of the complaint, holding that section 901's delegation to the Secretary does not violate the nondelegation doctrine. The court held that Congress undeniably delineated its general policy in the TCA; Congress plainly limited the authority that it delegated; and the relevant caselaw supports these conclusions. View "Big Time Vapes, Inc. v. FDA" on Justia Law

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Plaintiffs, a Louisiana church and its pastor, filed suit seeking to enjoin stay-at-home orders restricting in-person church services to ten congregants.The Fifth Circuit held that the appeal of the denial of injunctive relief and related request for an injunction under Federal Rule of Appellate Procedure 8(a)(1) are moot because the challenged orders expired more than a month ago. In this case, plaintiffs failed to cite any authority applying the "capable of repetition" exception to support an injunction against an order that is no longer in effect. View "Spell v. Edwards" on Justia Law

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Plaintiffs filed suit alleging that TDCJ's adoption and implementation of measures guided by changing CDC recommendations in regards to the COVID-19 pandemic do not go far enough. Plaintiffs filed a class action alleging violations of the Eighth Amendment's prohibition against cruel and unusual punishment, and the Americans with Disabilities Act, seeking a preliminary injunction.The Fifth Circuit granted TDCJ's motion to stay the district court's preliminary injunction, which regulates the cleaning intervals for common areas, the types of bleach-based disinfectants the prison must use, the alcohol content of hand sanitizer that inmates must receive, mask requirements for inmates, and inmates' access to tissues (amongst many other things). The court held that TDCJ is likely to prevail on the merits of its appeal because: (1) after accounting for the protective measures TDCJ has taken, plaintiffs have not shown a "substantial risk of serious harm" that amounts to "cruel and unusual punishment"; and (2) the district court committed legal error in its application of Farmer v. Brennan, by treating inadequate measures as dispositive of defendants' mental state. In this case, even assuming that there is a substantial risk of serious harm, plaintiffs lack evidence of defendants' subjective deliberate indifference to that harm. The court also held that TDCJ has shown that it will be irreparably injured absent a stay, and that the balance of the harms and the public interest favor a stay. Finally, the court held that plaintiffs have not exhausted their administrative remedies as required in the Prison Litigation Reform Act (PLRA), and the district court's injunction goes well beyond the limits of what the PLRA would allow even if plaintiffs had properly exhausted their claims. View "Valentine v. Collier" on Justia Law

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On April 7, 2020, the Fifth Circuit issued a writ of mandamus vacating the district court's temporary restraining order (TRO) that exempted abortions from GA-09, an emergency measure temporarily postponing non-essential medical procedures during the COVID-19 pandemic. On April 9, 2020, the district court entered a second TRO exempting various categories of abortion from GA-09. At issue in this mandamus petition is the April 9 TRO.The court held that the district court disregarded the court's mandate in Abbott II and failed to apply the framework governing emergency exercises of state authority during a public health crisis, established over 100 years ago in Jacobson v. Commonwealth of Massachusetts, 197 U.S. 11 (1905). Furthermore, the district court second-guessed the basic mitigation strategy underlying GA-09 (the concept of "flattening the curve"), and also acted without knowing critical facts such as whether, during this pandemic, abortion providers do (or should) wear masks or other protective equipment when meeting with patients. The court concluded that these errors resulted in an overbroad TRO that exceeds the district court's jurisdiction, reaches patently erroneous results, and usurps the state's authority to craft emergency public health measures "during the escalating COVID-19 pandemic." Therefore, the court granted the writ in part and directed the district court to vacate parts of the April 9 TRO. View "In re: Greg Abbott" on Justia Law

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In this case, the parties dispute the proper method for calculating the hospital specific limit for annual DSH payments. The Hospitals filed suit challenging the 2017 final rule clarifying that hospitals' "costs incurred" are net of payments from third parties, liked Medicare and private insurers. The Hospitals contend that the Secretary's definition of "costs incurred" conflicted with the Medicaid Act, 5 U.S.C. 706(2)(C).The Fifth Circuit reversed the district court's grant of summary judgment for the Hospitals, and joined three other circuits in holding that the 2017 rule was consistent with the Medicare Act. The court could not agree with the Hospitals that the ordinary meaning and dictionary definitions of "costs" and "payments" rendered the disputed language unambiguous; the court was unpersuaded by the Hospitals' argument that the statute draws a "clear line" between costs and payments; the court rejected the Hospitals' contention that Congress, by expressly excluding payments from Medicaid and the uninsured, meant to exclude only those payments and no others; the court rejected the Hospitals' argument that the express exclusion of third-party payments in a related Medicaid provision indicates that Congress chose not to deduct third-party payments in 42 U.S.C. 1396r-4(g)(1)(A); and the court saw no basis for the Hospitals' argument that the 2017 Rule conflicts with the statutory purpose of the hospital-specific limit. Accordingly, the court remanded for further proceedings. View "Baptist Memorial Hospital - Golden Triangle, Inc. v. Azar" on Justia Law

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The Fifth Circuit granted a writ of mandamus directing vacatur of the district court's issuance of a temporary restraining order (TRO) against executive order GA-09 as applied to abortion procedures. In order to preserve critical medical resources during the escalating COVID-19 pandemic, the Governor of Texas issued GA-09, which postpones non-essential surgeries and procedures until 11:59 p.m. on April 21, 2020.The court held that the drastic and extraordinary remedy of mandamus was warranted in this case because the district court ignored the framework governing emergency public health measures, like GA-09, in Jacobson v. Commonwealth of Massachusetts, 197 U.S. 11 (1905); the district court wrongly declared GA-09 an "outright ban" on previability abortions and exempted all abortion procedures from its scope, rather than apply the Jacobson framework to decide whether GA-09 lacks a "real or substantial relation" to the public health crisis or whether it is "beyond all question, a plain, palpable invasion" of the right to abortion; the district court failed to apply the undue-burden analysis in Planned Parenthood v. Casey, 505 U.S. 833, 857 (1992), and thus failed to balance GA-09's temporary burdens on abortion against its benefits in thwarting a public health crisis; and the district court usurped the state's authority to craft emergency health measures, substituting instead its own view of the efficacy of applying GA-09 to abortion. Therefore, the court found that the requirements for a writ of mandamus are satisfied in light of the extraordinary nature of these errors, the escalating spread of COVID-19, and the state's critical interest in protecting the public health. View "In re: Gregg Abbott" on Justia Law

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The Fifth Circuit affirmed the district court's grant of summary judgment to the Secretary in an action brought by Hendrick challenging Medicare payments it received for the 2015 federal fiscal year. The court held that the district court did not err by dismissing Hendrick's appeal, because the Board's determination that it did not have jurisdiction over Hendrick's appeal for failure to exhaust administrative remedies was correct. In this case, Hendrick received notice via the Federal Register but failed to request correction of its wage data by the published deadline in accordance with the established process under the statute. View "Hendrick Medical Center v. Azar" on Justia Law

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The Fifth Circuit affirmed the district court's preliminary injunction enjoining Senate Bill 2116, which makes it a crime to perform an abortion, with exceptions only to prevent the death of, or serious risk of "substantial and irreversible" bodily injury to, the patient, after a "fetal heartbeat has been detected." The court previously upheld an injunction enjoining a law prohibiting abortions, with limited exceptions, after 15 weeks' gestational age.The court held that S.B. 2116 bans abortions at a previability stage of pregnancy regardless of the reason the abortion is sought. In this case, the parties agree that cardiac activity can be detected well before the fetus is viable. Therefore, the court held that if a ban on abortion after 15 weeks is unconstitutional, then it follows that a ban on abortion at an earlier stage of pregnancy is also unconstitutional. View "Jackson Women's Health Organization v. Dobbs" on Justia Law

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The Fifth Circuit affirmed HHS's decision that extrapolating the Medicare underpayment rate to all claims paid over the relevant time period resulted in a repayment demand of more than $12 million. The court held that the district court correctly rejected Palm Valley's due process claim; Palm Valley failed to exhaust its challenge to the "homebound" standard and thus the court could not consider the issue; substantial evidence supported HHS's determination that many beneficiaries were not homebound; and there was no error in the extrapolation methodology. View "Palm Valley Health Care, Inc. v. Azar" on Justia Law

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Plaintiffs, two private citizens and eighteen states, filed suit challenging the individual mandate requirement of the Patient Protection and Affordable Care Act (ACA). The individual mandate required individuals to maintain health insurance coverage and, if individuals did not maintain this coverage, they must make a payment to the IRS called a shared responsibility payment.Plaintiffs argued that the individual mandate was no longer constitutional because: (1) Nat'l Fed'n of Indep. Bus. v. Sebelius, 567 U.S. 519, 538 (2012), rested the individual mandate's constitutionality exclusively on reading the provision as a tax; and (2) a 2017 amendment, which changed the amount of the shared responsibility payment to zero dollars, undermined any ability to characterize the individual mandate as a tax because the provision no longer generates revenue, a requirement for a tax. Plaintiffs further argued that the individual mandate was essential to, and inseverable from, the rest of the ACA and thus the entire ACA must be enjoined.The Fifth Circuit affirmed in part and vacated in part the district court's judgment, holding that there is a live case or controversy because the intervenor-defendant states have standing to appeal and, even if they did not, there remains a live case or controversy between plaintiffs and the federal defendants; plaintiffs have Article III standing to bring this challenge to the ACA because the individual mandate injures both the individual plaintiffs, by requiring them to buy insurance that they do not want, and the state plaintiffs, by increasing their costs of complying with the reporting requirements that accompany the individual mandate; the individual mandate is unconstitutional because it can no longer be read as a tax, and there is no other constitutional provision that justifies this exercise of congressional power; and, on the severability question, the court remanded to the district court to provide additional analysis of the provisions of the ACA as they currently exist. View "Texas v. United States" on Justia Law