Justia New York Court of Appeals Opinion Summaries

Articles Posted in Health Law
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In this insurance dispute involving an insurer withholding payments to a medical service corporation improperly controlled by nonphysicans the Court of Appeals ruled that the trial court did not err in declining to give a charge requiring the jury to find fraudulent intent or conduct "tantamount to fraud" in order to reach a verdict in favor of the insurers. Plaintiff Andrew Carothers, M.D., P.C., a professional service corporation, filed multiple collection actions against insurance carriers seeking to recover unpaid claims of assigned first-party no-fault insurance benefits. The jury found that Defendants had proved that Plaintiff was "fraudulently incorporated" and that Carothers did not engage in the practice of medicine. Plaintiff appealed, arguing that the court erred in failing to give a jury instruction on "the traditional elements of common-law fraud and fraudulent intent. The Appellate Division affirmed. The Court of Appeals affirmed, holding that the court's instructions to the jury were proper. View "Carothers v. Progressive Insurance Co." on Justia Law

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The Court of Appeals held that N.Y. Mental Hyg. Law 33.13, which protects the confidentiality of the clinical records of patients and clients as maintained by facilities licensed or operated by the Office of Mental Health or the Office for People with Developmental Disabilities, does not require automatic sealing of the entire court record of all proceedings involving insanity acquittees who have dangerous mental disorders within the meaning of N.Y. Crim. Proc. Law (CPL) 330.20. Defendant, an insanity acquittee, was found to have a dangerous mental disorder as defined by CPL 330.20(1)(c) and was committed to the custody of the Commissioner for the Office for People with Developmental Disabilities. Supreme Court denied Defendant’s motion to seal the entire court record in his case, finding that the documents related to the legal proceedings rather than Defendant’s treatment. The Appellate Division modified. The Court of Appeals affirmed, holding that the legislature provided no automatic sealing requirement of an entire court record in either CPL 330.20 or the Mental Hygiene Law for an insanity acquittee, and Defendant cited no authority for such an obligation. View "In re James Q." on Justia Law

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The Court of Appeals reversed the order of the Appellate Division and dismissed this petition and proceeding, holding that Mental Hygiene Legal Service (MHLS) did not have standing to bring this proceeding in its own name to vindicate its clients’ rights under N.Y. Mental Hyg. Law 9.31(b). MHLS, a government entity charged with providing legal services to patients of mental health facilities and hospitals, brought this proceeding in its own name seeking a writ of mandamus to compel a hospital to comply with section 9.31(b), which sets forth the procedure to be followed after a patient requests an admission or retention hearing. The hospital moved to dismiss the petition on the ground the MHLS lacked standing to bring the claim in its own name. Supreme Court denied the hospital’s motion to dismiss and granted the petition, concluding that MHLS had demonstrated a right to mandamus relief. The Appellate Division affirmed. The Court of Appeals reversed and dismissing both the petition and the proceeding, holding that MHLS did not have standing to bring this petition. View "Mental Hygiene Legal Service v. Daniels" on Justia Law

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The Court of Appeals held that assigned Mental Hygiene Legal Services (MHLS) counsel is not entitled to be given an interview and an opportunity to participate in treatment planning meetings for article 10 respondents placed in a sex offender treatment program at a secure treatment facility simply by virtue of an attorney-client relationship with the article 10 respondent. Petitioners - an article 10 respondent called D.J. and his assigned MHLS counsel - requested that counsel be permitted to attend D.J.’s treatment planning meetings either as an “authorized representative” or a “significant individual” under N.Y. Mental Hyg. Law 29.13(b). The requests were denied, after which Petitioners commenced this N.Y. C.P.L.R. 78 proceeding. Supreme Court dismissed the petition, and the Appellate Division affirmed. The Court of Appeals affirmed, holding that MHLS counsel was not intended to be included, as a matter of law, within the terms “authorized representative” or “significant individual.” View "Mental Hygiene Legal Service v. Sullivan" on Justia Law

Posted in: Health Law
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The New York City Board of Health’s promulgation of the flu vaccine falls within the powers specifically delegated to the New York City Department of Health and Mental Hygiene in New York City Administrative Code 17-109. At issue was the Board’s amendments to the New York City Health Code mandating that children between the ages of six months and fifty-nine months who attend city-regulated child care or school-based programs receive annual influenza vaccinations. Petitioners - parents of children enrolled in child care programs subject to the flu vaccine rules who objected to their children receiving the vaccination - commenced this hybrid N.Y. C.P.L.R. 78 proceeding and declaratory judgment action to enjoin Respondents from enforcing the flu vaccine rules. Supreme Court granted Petitioners’ motion and permanently enjoined Respondents from enforcing the flu vaccine rules. The Appellate Division affirmed. The Court of Appeals reversed, holding (1) the Board permissibly adopted the flu vaccine rules pursuant to its authority to regulate vaccinations; (2) the Board’s actions did not violate the separation of powers doctrine; and (3) the flu vaccine rules are not preempted by state law. View "Garcia v. New York City Department of Health & Mental Hygiene" on Justia Law

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The Justice Center for the Protection of People with Special Needs acted within its authority under N.Y. Social Services Law 493 when it required Petitioner to undertake certain remedial measures to correct the systemic problems that led to three sexual assaults at Petitioner’s residential health care facility. The sexual assaults at Petitioner’s facility were committed by the same resident and occurred within a six-month period. After an investigation, the Justice Center substantiated allegations of neglect against Petitioner and required it to undertake certain remedial measures to correct its “systemic problems.” Petitioner brought this N.Y. C.P.L.R. 78 proceeding seeking to annul the Justice Center’s determination, contending that section 493 did not authorize the Justice Center to substantiate a finding of neglect against Petitioner and that the Justice Center’s determination was not supported by substantial evidence. The Appellate Division granted the petition and annulled the Justice Center’s determination. The Court of Appeals reversed, holding that section 493 enables the Justice Center to address systemic issues at a facility regardless of whether allegations against a particular employee are also substantiated. View "Anonymous v. Molik" on Justia Law

Posted in: Health Law
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The Court of Appeals held that whether an absolute privilege applies to a communication made in the course of a quasi-judicial proceeding depends on the status of the subject of the communication. New York Downtown Hospital terminated the employment of Plaintiff, a medical scientist, and removed her as chairperson of the hospital’s Institutional Review Board. Dr. Steven Friedman’s statements to the FDA during an investigation of Downtown Hospital’s IRBs about Plaintiff, which discussed the reasons for the removal of Plaintiff from her positions, were published in an Establishment Inspection Report (EIR) released by the FDA. Plaintiff commenced this defamation action against Downtown Hospital, Friedman, and others, asserting that her professional reputation was damaged by the publication of defamatory statements about her made by Friedman to the FDA inspectors. Defendants filed a motion to dismiss. Supreme Court allowed Plaintiff’s defamation claim against Downtown Hospital and Friedman to survive, concluding that the statements were not shielded by an absolute privilege because the FDA’s investigation had none of the indicia of a quasi-judicial proceeding. The Appellate Division reversed, concluding that the complained-of statements were made in a quasi-judicial context in which an absolute privilege protected them. The Court of Appeals reversed, holding that Friedman’s statements, as published in the EIR, were not protected by absolute privilege. View "Stega v. New York Downtown Hospital" on Justia Law

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The Court of Appeals rejected Plaintiffs’ argument that an individual has a fundamental constitutional right to aid-in-dying as defined by Plaintiffs and also rejected Plaintiffs’ assertion that the State’s prohibition on assisted suicide is not rationally related to legitimate state interests. Plaintiffs filed this action requesting declaratory and injunctive relief to permit “aid-in-dying,” which would allow a mentally competent, terminally ill patient to obtain a prescription from a physician to cause death. The Attorney General filed a motion to dismiss on the grounds that Plaintiffs failed to state a cause of action and did not present a justiciable controversy. Supreme Court granted the motion. The Appellate Division affirmed as modified, declaring that the assisted suicide statutes provide a valid statutory basis to prosecute physicians who provide aid-in-dying and that the statutes do not violate the New York Constitution. The Court of Appeals affirmed, holding (1) the State Constitution’s Due Process Clause does not encompass a fundamental right to physician-assisted suicide; and (2) the State’s prohibition is rationally related to a number of legitimate state interests, and heightened scrutiny is unwarranted. View "Myers v. Schneiderman" on Justia Law

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The three respondents in these cases had been diagnosed with antisocial personality disorder (ASPD) and other conditions, diseases, and/or disorders. The State brought Mental Hygiene Law article 10 proceedings against each respondent. Respondents argued that the Court of Appeals’ holding in State v. Donald DD warranted the dismissal of the petitions brought against them. In Donald DD, that Court held that, in a trial conducted pursuant to article 10, evidence that a respondent suffers from ASPD cannot be used to support a finding that he has a mental abnormality as defined by Mental Hygiene Law 10.03(i) “when it is not accompanied by any other diagnosis of mental abnormality.” The Court of Appeals rejected Respondents’ arguments, holding that in each of the article 10 proceedings, the evidence was sufficient to support the verdicts that Respondents suffered from a “mental abnormality” as defined in the Mental Hygiene Law. View "State v. Dennis K." on Justia Law

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Luz Herrera was injured in an accident while operating a vehicle insured by Hanover Insurance Company, a no-fault insurer. Herrera also had private health insurance through Aetna Health Plan. Herrera received medical treatment for her injuries, and the medical providers submitted some of their bills directly to Aetna, who paid the bills. Aetna subsequently sought reimbursement from Hanover, but Hanover did not respond. Meanwhile, Aetna filed a lien against Herrera for reimbursement. Herrera then resubmitted all of the medical bills to Hanover and assigned her rights against Hanover to Aetna. Aetna then commenced this action against Hanover seeking reimbursement for the medical bills it paid on Herrera’s behalf. Supreme Court dismissed the complaint, concluding (1) because Aetna was not a “health care provider” under the no-fault statute, it was not entitled to direct payment of no-fault benefits; (2) Aetna was neither in privity of contract with Hanover nor an intended third-party beneficiary of Hanover’s contract with Herrera; and (3) Aetna could not maintain a subrogation claim against Hanover. The Appellate Division affirmed. The Court of Appeals affirmed, holding that New York’s Comprehensive Motor Vehicle Reparations Act statutory law and regulatory scheme does not contemplate reimbursement to a health insurer, as opposed to a health care provider. View "Aetna Health Plans v. Hanover Ins. Co." on Justia Law