Justia New York Court of Appeals Opinion Summaries

Petitioners were two medical providers whose patients included individuals insured by the State’s primary health benefit plan. The State Comptroller reviewed Petitioners’ billing records as part of an audit of billing practices in the health care industry for claims paid by the State. While Petitioners conceded that the State paid eighty percent of the costs of their services, Petitioners challenged the Comptroller’s authority to audit their books. Supreme Court concluded that the Comptroller lacked constitutional authority to audit Petitioners because Petitioners were “not a political subdivision of the State.” The Appellate Division modified Supreme Court’s orders to reinstate the audits. The Court of Appeals affirmed, holding that the State Constitution does not limit the Comptroller’s authority to audit, as part of its audit of State expenditures, the billing records of private companies that provide health care to beneficiaries of a State insurance program. View "Martin H. Handler, M.D., P.C. v. DiNapoli" on Justia Law

This case arose out of dispute over the administration of a workers’ compensation self-insurance plan (“Plan”) administered by Herkimer County. Dozens of municipalities participated in the Plan, including the Village of Herkimer. In 2005, the County passed a resolution to terminate the plan. To ensure funding for outstanding workers’ compensation claims, the County created an Abandonment Plan that allowed municipalities to withdraw from the plan and pay a lump sum withdrawal fee. Several of the participating municipalities, including the Village, filed an action challenging the Plan and Abandonment Plan based on alleged mismanagement by the County. The County counterclaimed for breach of contract, seeking to recover the withdrawal liability. The County prevailed on summary judgment as to the liability on its counterclaim for breach of contract against the Village. After a trial on damages, the jury awarded the full amount of damages sought by the County against the Village. The Appellate Division affirmed the damages award. The Court of Appeals affirmed as modified, holding that the fee for the Village’s withdrawal from the Plan reflected benefits to be paid in the future and therefore should have been discounted to its current value as of the date it was due. View "Village of Ilion v. County of Herkimer" on Justia Law

The Board of Managers of the French Oaks Condominium, a residential complex located in the Town of Amherst, commenced a Real Property Tax Law article 7 proceeding against the Town challenging the Town’s tax assessment of the development as excessive. A referee concluded that the Board established that its property was overassessed and directed the Town to amend its tax roll and remit any tax overpayments to the Board. The Appellate Division affirmed. The Court of Appeals reversed, holding that the Board did not rebut the presumption that the initial tax assessment was valid. View "Bd. of Managers of French Oaks Condo. v. Town of Amherst" on Justia Law

Plaintiff was injured during the course of his employment when he was struck by a sheet of plywood that fell from a building under construction. Plaintiff received workers' compensation benefits for his injuries and then filed this personal injury action. Thereafter, the insurance carrier for Plaintiff's employer filed a motion to discontinue Plaintiff's workers' compensation benefits. An administrative law judge found Plaintiff had no further causally-related disability and that he had no further need for treatment. The Workers' Compensation Board Panel (Board) affirmed. Subsequently, in this negligence action, Defendants moved for an order estopping Plaintiff from relitigating the issue of causally-related disability. Supreme Court granted the motion. The Appellate Division reversed, concluding that the determination of the Board was one of ultimate fact and thus did not preclude Plaintiff from litigating the issue of his ongoing disability. The Court of Appeals affirmed, holding that Defendants failed to establish that the issue decided in the workers' compensation proceeding was identical to that presented in this negligence action. View "Auqui v. Seven Thirty One Ltd. P'ship" on Justia Law

The New York City Department of Homeless Services (DHS) is the entity charged with providing temporary housing assistance to homeless men and women in the City. In 2011, DHS announced the adoption of a new eligibility procedure that required applicants to meet a need standard and to cooperate with investigations of need. The New York City Council brought a declaratory judgment action asserting that the new procedure could not be implemented because DHS failed to comply with the notice and hearing provisions in the City Administrative Procedure Act (CAPA). Supreme Court and the Appellate Court concluded that DHS violated CAPA. The Court of Appeals affirmed, holding that because DHS did not follow the notice and hearing steps necessary to formally promulgate the eligibility procedure, the provision was unenforceable until compliance was achieved. View "Council of the City of N.Y. v. Dep't of Homeless Servs. of the City of N.Y." on Justia Law

Petitioners were current and former elected officials and appointed officers of the Village of Freeport. In 2008, Water Works Realty Corp. commenced lawsuits against the Village and Petitioners alleging, inter alia, violations of the Racketeer Influenced and Corrupt Organization Act. The Freeport Board of Trustees authorized the Village to defend and indemnify Petitioners, but after Petitioners refused to settle with Water Works due to Water Works' requirement that Petitioners sign a stipulation of discontinuance containing a nondisparagement clause, the Village withdrew Petitioners' defense and indemnification. Petitioners subsequently filed an action seeking a judgment directing the Village to provide a defense. Supreme Court denied the request. The Court of Appeals affirmed, holding that the municipality could withdraw its defense and indemnification of Petitioners for their failure to accept a reasonable settlement offer, and Petitioners' First Amendment concerns with respect to the settlement's nondisclosure clause did not warrant a different conclusion. View "Lancaster v. Inc. Vill. of Freeport" on Justia Law

Claimant was employed at a secure juvenile detention facility operated by the State Office of Children & Family Services (OCFS) when she was assaulted, raped, and abducted by a resident. Claimant received workers' compensation benefits for her injuries. Claimant also filed a civil rights lawsuit in federal district court against OCFS and three supervisory OCFS employees seeking, inter alia, punitive damages. The federal lawsuit was settled. The New York State Insurance Fund (SIF), the workers' compensation carrier in this case, approved the settlement. In so doing, SIF reserved its right to take a credit against Claimant's payments of benefits until the credit was exhausted. The Workers' Compensation Law judge (WCLJ) decided that SIF was not entitled to offset the proceeds of a civil rights lawsuit that sought punitive damages. On appeal, the Workers' Compensation Board found in SIF's favor. The Appellate Division affirmed. The Court of Appeals affirmed, holding that, in light of the terms of the settlement in this case, SIF could take a credit against the settlement proceeds of Claimant's lawsuit against her employer and coemployees for injuries arising from the same incident for which Claimant received worker's compensation benefits. View "Beth V. v. State Office of Children & Family Servs." on Justia Law

The Office of the Medicaid Inspector General (OMIG) terminated a physician's participation in the Medicaid program on the basis of a Bureau of Professional Medical Conduct (BPMC) consent order, in which the physician pleaded no contest to charges of professional misconduct and agreed to probation. Supreme Court annulled the OMIG's determination. The Appellate Division affirmed, concluding (1) the agency acted arbitrarily and capriciously in barring the physician from treating Medicaid patients when the BPMC permitted him to continue to practice; and (2) the OMIG was required to conduct an independent investigation before excluding a physician from Medicaid on the basis of a BPMC consent order. The Court of Appeals affirmed but for another reason, holding (1) the OMIG is authorized to remove a physician from Medicaid in reliance solely on a consent order between the physician and the BMPC, regardless of whether BPMC chooses to suspend the physician's license or OMIG conducts an independent investigation; but (2) because OMIG did not explain why the BPMC consent order caused it to exclude the physician from the Medicaid program, the agency's determination was arbitrary and capricious. View "Koch v. Sheehan" on Justia Law

Petitioner was a lifelong resident of a housing complex operated under the Limited-Profit Housing Companies Act and the Private Housing Finance Law. After Petitioner's parents vacated the apartment, Petitioner filed a successive application to succeed to the tenancy. The housing complex rejected the application. The Division of Housing and Community Renewal (DHCR) denied Petitioner's appeal, basing its denial on the fact that Petitioner's mother had failed to file an annual income affidavit listing Petitioner as a co-occupant for one of the two years prior to her vacatur. Supreme Court annulled DHCR's denial of Petitioner's appeal and granted his succession petition. The Appellate Division affirmed. The Court of Appeals affirmed, holding that because the evidence of Petitioner's primary residency was overwhelming, and because the was no relationship between the mother's failure to file the income affidavit and Petitioner's income or occupancy, DHCR's determination was arbitrary and capricious. View "Murphy v. N.Y. State Div. of Hous. & Cmty. Renewal" on Justia Law

In 1993, Antonio Hroncich was diagnosed with asbestos-related diseases resulting from his employment at the Consolidated Edison Company of N.Y., Inc. (Con Ed). The Workers' Compensation Board granted Hroncich compensation benefits. Hroncich was later diagnosed with thyroid cancer, a condition that was unrelated to his work at Con Ed. Hroncich died in 2007. Hroncich's widow, Gaudenzia, later field a claim for death benefits from Con Ed. The Workers' Compensation Law Judge (WCLJ) found that Hroncich's death was causally related to his occupational disease and awarded death benefits. In so doing, the WCLJ concluded that the Workers' Compensation Law does not require apportionment of death benefits between work-related and non-work-related causes. The Workers' Compensation Board and Appellate Division affirmed. The Court of Appeals affirmed, holding that the statute does not mandate the Board to factor out non-work-related causes of death when making an award for death benefits. View "In re Hroncich" on Justia Law