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

The case involves the National Infusion Center Association (NICA) and other plaintiffs challenging the constitutionality of the Drug Price Negotiation Program established by the Inflation Reduction Act. This program requires the Department of Health and Human Services (HHS) to negotiate drug prices with manufacturers, setting a "maximum fair price" between 40% and 75% of the market price. Manufacturers who do not comply face significant fines or must withdraw from Medicare coverage entirely.The United States District Court for the Western District of Texas dismissed NICA's lawsuit for lack of subject-matter jurisdiction. The district court reasoned that NICA's claims had to be "channeled" through HHS as required by 42 U.S.C. § 405, which mandates that claims arising under the Medicare Act be decided by the relevant agency before being brought to federal court. The district court also dismissed the remaining plaintiffs due to improper venue without NICA.The United States Court of Appeals for the Fifth Circuit reviewed the case and found that NICA had standing based on both economic and procedural injuries. The court determined that NICA's claims did not arise under the Medicare Act but rather under the Inflation Reduction Act, and thus did not require channeling through HHS. The court held that the district court had subject-matter jurisdiction over NICA's claims and reversed the lower court's dismissal, remanding the case for further proceedings. View "Natl Infusion Center v. Becerra" on Justia Law

In March 2013, Woodsboro Farmers Cooperative contracted with E.F. Erwin, Inc. to construct two grain silos. Erwin subcontracted AJ Constructors, Inc. (AJC) for the assembly. AJC completed its work by July 2013, and Erwin finished the project in November 2013. However, Woodsboro noticed defects causing leaks and signed an addendum with Erwin for repairs. Erwin's attempts to fix the silos failed, leading Woodsboro to hire Pitcock Supply, Inc. for repairs. Pitcock found numerous faults attributed to AJC's poor workmanship, necessitating complete deconstruction and reconstruction of the silos, costing Woodsboro $805,642.74.Woodsboro sued Erwin in Texas state court for breach of contract, and the case went to arbitration in 2017. The arbitration panel found AJC's construction was negligent, resulting in defective silos, and awarded Woodsboro $988,073.25 in damages. The Texas state court confirmed the award in September 2022. In December 2018, TIG Insurance Company, Erwin's insurer, sought declaratory relief in the United States District Court for the Southern District of Texas, questioning its duty to defend and indemnify Erwin. The district court granted TIG's motion for summary judgment on the duty to defend, finding no "property damage" under the policy, and later ruled there was no duty to indemnify, as the damage was due to defective construction.The United States Court of Appeals for the Fifth Circuit reviewed the case. The court found that there were factual questions regarding whether the damage constituted "property damage" under the insurance policy, as the silos' metal parts were damaged by wind and weather due to AJC's poor workmanship. The court determined that the district court erred in granting summary judgment for TIG and concluded that additional factual development was needed. The Fifth Circuit reversed the district court's decision and remanded the case for further proceedings. View "TIG Insurance Company v. Woodsboro Farmers Coop" on Justia Law

Kelly Dwyer sought to recover mental health benefits for his minor daughter, E.D., under his employee group benefit health plan issued by United Healthcare Insurance Company. E.D. suffered from severe anorexia nervosa, leading her parents to admit her to a residential treatment facility, Avalon Hills. Initially, United approved full hospitalization benefits, but later reduced the coverage to partial hospitalization and eventually denied further hospitalization benefits, suggesting outpatient treatment instead. Despite E.D.'s doctors' objections and evidence of her ongoing severe symptoms, United maintained its decision.The United States District Court for the Western District of Texas conducted a bench trial and ruled in favor of United, finding that the insurer had not improperly withheld benefits. The court's decision was based on the administrative record and the arguments presented during the trial.The United States Court of Appeals for the Fifth Circuit reviewed the case and reversed the district court's judgment. The appellate court found that United's denial of benefits was both substantively and procedurally deficient. Substantively, the court held that United's decision was not supported by concrete evidence and contradicted the medical records. Procedurally, United failed to provide a meaningful dialogue or adequate explanation for its denial, violating ERISA requirements. Additionally, the court found that United improperly failed to process claims at the MultiPlan rate, as it did not respond to Mr. Dwyer's administrative appeal regarding this issue.The Fifth Circuit reversed the district court's judgment and remanded the case for the calculation of damages, statutory penalties, attorneys' fees, and other relief for Mr. Dwyer. View "Dwyer v. United Healthcare" on Justia Law

Josephine Perez-Gorda was convicted of fraud after she and her husband, Justin, misrepresented his medical condition to the U.S. Department of Veterans Affairs. Justin, who suffered a brain injury while on duty, and Perez-Gorda claimed he was unable to walk or care for himself, leading to the receipt of various government benefits, including a new home, car, and caregiver stipend. However, evidence showed Justin was more mobile and self-sufficient than they had represented. After Justin's death in 2022, Perez-Gorda was indicted on multiple counts of wire fraud, mail fraud, health care fraud, conspiracy to commit health care fraud, and aiding and abetting offenses.The United States District Court for the Western District of Texas convicted Perez-Gorda on all counts, and she was sentenced to forty-six months in prison. Perez-Gorda appealed, arguing that the jury instructions on wire and mail fraud were erroneous based on intervening circuit precedent. She did not object to these instructions at trial. The Fifth Circuit reviewed the instructions for plain error and found them erroneous but concluded that the error did not affect Perez-Gorda’s substantial rights, as there was no reasonable probability that the jury would have acquitted her under the correct instructions.Perez-Gorda also challenged statements made during the grand jury proceedings and the sufficiency of the evidence supporting the jury verdicts. The Fifth Circuit found that the statements did not influence the grand jury’s decision and that a rational jury could have found her guilty beyond a reasonable doubt. Additionally, Perez-Gorda contested her sentence, specifically the two-level upward adjustment for her role as an organizer or leader. The Fifth Circuit reviewed this factual finding for clear error and upheld it, noting evidence that Perez-Gorda supervised Justin in the fraudulent activities. The Fifth Circuit affirmed the district court’s judgment. View "USA v. Perez-Gorda" on Justia Law

In 2001, RSM Production Corporation (RSM) and the Republic of Cameroon signed a concession contract granting RSM the right to explore and develop hydrocarbons in the Logbaba Block. In 2005, RSM and Gaz du Cameroun (GdC) entered into a Farmin Agreement and a Joint Operating Agreement (JOA), with GdC becoming the project operator. The Farmin Agreement allowed GdC to recover its drilling costs from production revenues before sharing profits with RSM. A dispute arose over the Payout date, with RSM claiming it was February 1, 2016, and GdC asserting it was June 1, 2016.The dispute was submitted to arbitration under the International Chamber of Commerce (ICC) Rules. The arbitral tribunal ruled in favor of RSM, awarding $10,578,123.28 based on a February 1, 2016, Payout date. GdC requested corrections, arguing the tribunal included damages for claims not substantively addressed. The tribunal issued an Addendum Award, reducing RSM's award by $4,011,625.90, citing computational errors.RSM sought to vacate the Addendum Award in the United States District Court for the Southern District of Texas. The district court vacated the part of the Addendum Award that reduced RSM's recovery, concluding the tribunal exceeded its powers by reconsidering the merits of RSM's claims under the guise of correcting computational errors.The United States Court of Appeals for the Fifth Circuit reviewed the case. The court held that the tribunal had the authority to correct computational errors and to determine what constituted such errors under ICC Rule 36. The tribunal's interpretation of the rule and the parties' agreements was entitled to deference. The Fifth Circuit reversed the district court's judgment and remanded with instructions to confirm the Addendum Award. View "RSM Prod v. Gaz du Cameroun" on Justia Law

Three black officers, Cedric Green, Darrell Clark, and Reginald Cooper, alleged a history of racial discrimination within the Alexandria Police Department (APD). They claimed that over their decades-long careers, they faced systemic racism, including derogatory comments and unfair treatment. Clark and Cooper were eventually terminated, and Green was demoted. They argued that these actions were retaliatory, following their complaints to HR and the FBI about racial harassment and misconduct within the department.The United States District Court for the Western District of Louisiana granted summary judgment in favor of the City of Alexandria and other defendants. The court found that the plaintiffs failed to present competent evidence to support their claims. Specifically, the court noted that the plaintiffs' reliance on their complaint and unsubstantiated assertions did not meet the evidentiary standards required to survive summary judgment. The court also found that the city provided legitimate, non-retaliatory reasons for the adverse employment actions taken against the plaintiffs.The United States Court of Appeals for the Fifth Circuit reviewed the case de novo and affirmed the district court's decision. The appellate court agreed that the plaintiffs did not provide sufficient evidence to establish a hostile work environment, as the incidents cited were either not racially motivated or not severe and pervasive enough. The court also found no causal connection between the plaintiffs' protected activities (complaints to HR and the FBI) and the adverse employment actions. Additionally, the court held that the city had legitimate reasons for the terminations and demotion, which the plaintiffs failed to show were pretextual. The court also dismissed the plaintiffs' claims under Louisiana's whistleblower statute and their Monell claims against the city, citing a lack of evidence of a discriminatory policy or custom. View "Clark v. City of Alexandria" on Justia Law

On November 4, 2020, San Antonio police officers stopped a car driven by Ronnie Diaz, Jr. They detected a strong odor of marijuana and found empty baggies commonly used for narcotics. Diaz admitted to having ammunition in his pocket and being a convicted felon. A search of the vehicle revealed a .45 caliber pistol, methamphetamine, counterfeit Xanax, and heroin. Diaz had prior convictions, including theft of a vehicle and evading arrest in 2014, and possession of a firearm as a felon in 2018.Diaz was charged in the Western District of Texas with possession with intent to distribute methamphetamine, possessing firearms during a drug trafficking crime, and being a felon in possession of a firearm. He moved to dismiss the felon-in-possession charge, arguing it violated the Second Amendment. The district court denied the motion, and Diaz was convicted on all counts and sentenced to 120 months for counts one and three, to run concurrently, and 60 months for count two, to run consecutively.The United States Court of Appeals for the Fifth Circuit reviewed the case. Diaz raised two claims: that his conviction under 18 U.S.C. § 922(g)(1) was unconstitutional under the Second Amendment, both facially and as applied, and that the statute exceeded Congress’s power under the Commerce Clause. The court dismissed the Commerce Clause argument as foreclosed by precedent. Applying the historical analysis required by New York Rifle and Pistol Association, Inc. v. Bruen, the court found that the regulation of firearm possession by felons is consistent with the Nation’s historical tradition of firearm regulation. The court held that 18 U.S.C. § 922(g)(1) is constitutional as applied to Diaz and facially. Consequently, the Fifth Circuit affirmed Diaz’s conviction. View "United States v. Diaz" on Justia Law

In 2020, Mix Creative Learning Center, an art studio offering children's art lessons, began selling online art kits during the pandemic. These kits included reproductions of artworks from Michel Keck's Dog Art series. Keck sued Mix Creative and its proprietor for copyright and trademark infringement, seeking enhanced statutory damages for willful infringement.The United States District Court for the Southern District of Texas found that the fair use defense applied to the copyright claim and granted summary judgment to Mix Creative. The court also granted summary judgment on the trademark claim, even though Mix Creative had not sought it. Following this, the district court awarded fees and costs to Mix Creative under 17 U.S.C. § 505 but declined to hold Keck’s trial counsel jointly and severally liable for the fee award under 28 U.S.C. § 1927.The United States Court of Appeals for the Fifth Circuit reviewed the case and affirmed the district court's judgment. The appellate court held that the fair use defense applied because Mix Creative’s use was transformative and unlikely to harm the market for Keck’s works. The court also found that any error in the district court’s sua sponte grant of summary judgment on the trademark claim was harmless, given the parties' concession that the arguments for the copyright claim applied to the trademark claim. Lastly, the appellate court ruled that the district court did not abuse its discretion in awarding fees to Mix Creative or in refusing to hold Keck’s attorneys jointly and severally liable for the fee award. View "Keck v. Mix Creative Learning Center" on Justia Law

Astrid Dariana Lopez Orellana, a noncitizen, entered the U.S. without inspection in 2019, fleeing gang threats in Honduras. In 2022, she was convicted of accessory after the fact to armed robbery under Louisiana law. Subsequently, she was taken into ICE custody and designated as an aggravated felon, leading to expedited removal proceedings.The Department of Homeland Security (DHS) issued a Final Administrative Removal Order (FARO) and a Notice of Intent (NOI) to remove her, alleging her conviction was an aggravated felony. Lopez requested withholding of removal, and an asylum officer found she had a reasonable fear of persecution if returned to Honduras. Her case was referred to an Immigration Judge (IJ). DHS later issued a new NOI and FARO on the same day, claiming her conviction was an aggravated felony related to obstruction of justice. Lopez challenged this, arguing the Louisiana statute did not match the federal definition of obstruction of justice, and that DHS violated procedural regulations.The United States Court of Appeals for the Fifth Circuit reviewed the case. The court found that the Louisiana accessory-after-the-fact statute requires only general intent, whereas the federal obstruction of justice offense requires specific intent. Therefore, the state statute is not a categorical match for the federal offense. The court also determined that DHS violated Lopez’s due process rights by not following proper procedures, such as issuing the FARO and NOI on the same day and failing to serve the FARO in a timely manner.The Fifth Circuit granted Lopez’s petition for review, vacated the order of removal, and remanded the case to DHS for further proceedings consistent with its opinion. The court directed the government to facilitate Lopez’s participation in these proceedings. View "Orellana v. Garland" on Justia Law

In July 1, 2021, the United Electrical, Radio, and Machine Workers of America sought to represent employees of Hudson Institute of Process Research Incorporated, a legal outsourcing and staffing company. The National Labor Relations Board (NLRB) was tasked with determining the appropriate bargaining unit, excluding supervisors. Hudson and the union disagreed on whether certain personnel, including team leads and revision specialists, were supervisors. Hudson also objected to an employer-wide bargaining unit. The NLRB held a hearing in September 2021, where Hudson argued that these personnel had supervisory authority.The NLRB regional director found that Hudson failed to prove that the disputed personnel were supervisors and approved an employer-wide bargaining unit. Hudson appealed to the NLRB, which denied the request for review. An election was conducted, and the union was certified. Hudson refused to bargain, leading the NLRB to find it had committed an unfair labor practice. Hudson then petitioned for review.The United States Court of Appeals for the Fifth Circuit reviewed the case. The court found that the NLRB lacked substantial evidence to support its findings that certain personnel were not supervisors. Specifically, the court determined that I-140 team leads, team lead assistants, floating team lead assistants, RFE team leads, and I-485 team leads possessed supervisory authority, including assigning work and recommending rewards, using independent judgment. The court also upheld the NLRB’s certification of an employer-wide bargaining unit but found that the unit improperly included supervisors.The Fifth Circuit granted Hudson’s petition for review, reversed the NLRB’s bargaining order, and denied enforcement, concluding that Hudson did not violate the National Labor Relations Act by refusing to bargain with the union. View "Hudson Institute of Process Research Incorporated v. NLRB" on Justia Law