Justia New York Court of Appeals Opinion SummariesArticles Posted in Health Law
State v. Dennis K.
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
Aetna Health Plans v. Hanover Ins. Co.
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
Chanko v. American Broadcasting Cos.
While the decedent in this case was being treated in the emergency room of The New York and Presbyterian Hospital (Hospital), employees of ABC News, a division of American Broadcasting Companies, Inc. (ABC), filmed the decedent’s medical treatment and death without consent. ABC later broadcast a portion of the footage as part of a documentary series about medical trauma. Plaintiffs, the decedent’s family, commenced this action against ABC, the Hospital, and the decedent’s treating physician, alleging breach of physician-patient confidentiality and intentional infliction of emotional distress. Defendants moved to dismiss the complaint. Supreme Court partially granted the motions. The Appellate Division modified Supreme Court’s order by reversing the portions of the order that were appealed, granted the motions in their entirety, and dismissed the entire complaint. The Court of Appeals modified the Appellate Division order to reinstate the cause of action against the Hospital and treating physician for breach of physician-patient confidentiality, holding (1) Plaintiffs stated a cause of action against these defendants for breach of physician-patient confidentiality; but (2) Defendants’ conduct was not so atrocious and intolerable as to support a cause of action for intentional infliction of emotional distress. View "Chanko v. American Broadcasting Cos." on Justia Law
People ex rel. DeLia v. Munsey
Stephen S. was a patient who was involuntarily committed under article 9 of the Mental Hygiene Law. Because Stephen had been unlawfully held by a hospital beyond the authorized retention period Mental Hygiene Legal Service commenced this habeas corpus proceeding on behalf of Stephen seeking his immediate release from the hospital. Stephen argued that he was entitled to immediate release upon a writ of habeas corpus under N.Y. C.P.L.R. 70. Supreme Court directed the writ. The Appellate Division concluded that, despite the hospital’s failure to comply with the Mental Hygiene Law, Stephen was not entitled to immediate release because the habeas corpus petition was governed by N.Y. Mental Hyg. Law 33.15, not N.Y. C.P.L.R. 70. The Court of Appeals reversed, holding that N.Y. Mental Hyg. Law 33.15 is not the exclusive habeas corpus provision available to article 9 patients and does not govern habeas corpus proceedings for those patients whose detention is challenged for reasons other than the patient’s recovery. View "People ex rel. DeLia v. Munsey" on Justia Law
Posted in: Health Law
Universal Am. Corp. v Nat’l Union Fire Ins. Co. of Pittsburgh, PA
Plaintiff is a health insurance company that offers a choice of federal government-regulated alternatives to Medicare known as Medicare Advantage plans. These plans allow Medicare-eligible individuals to purchase health insurance from private insurance companies. Those companies are reimbursed by the government for health care services provided to the plans’ members. Before the Supreme Judicial Court was Plaintiff’s demand for indemnification to cover losses resulting from health care claims for unprovided services paid through Plaintiff’s computer system. At issue was the coverage available to Plaintiff pursuant to Rider #3 of a financial institution bond issued by Defendant. The bond insured Plaintiff against various losses, and the Rider amended the bond to provide indemnification specifically for computer systems fraud. When Plaintiff suffered more than $18 million in losses for payment for fraudulent claims for services never actually performed under its Medicare Advantage plans, Plaintiff sought payment from Defendant for its post-deductible losses. Defendant denied coverage, and Plaintiff sued. Supreme Court granted summary judgment for Defendant. The Court of Appeals affirmed, holding that the Rider applies to losses resulting directly from fraudulent access, not to losses from the content submitted by authorized users. View "Universal Am. Corp. v Nat’l Union Fire Ins. Co. of Pittsburgh, PA" on Justia Law
Shipley v. City of New York
Jesse Stipley (the decedent), a seventeen-year-old high school student, was killed in an automobile accident. During an authorized autopsy, the medical examiner removed, among other organs, the decedent’s brain, fixed it in formalin, and placed it in the autopsy room for further examination by a neuropathologist. The decedent’s body was subsequently retrieved from the mortuary, and a funeral was held. Approximately three months later, the decedent’s family discovered that the decedent’s brain had been retained by the medical examiner. Plaintiffs, the decedent’s family, commenced this action against the City of New York alleging negligent infliction of emotional distress resulting from the mishandling and withholding of their son’s brain. Supreme Court granted Plaintiffs’ motion for a directed verdict as to liability. After a trial, Plaintiffs were awarded $1 million in damages. That amount was subsequently reduced. The Court of Appeals reversed, holding that a medical examiner is not legally required to notify next of kin that organs, tissues or other specimens have been removed from the body during a lawful autopsy and retained by the medical examiner after such an autopsy. View "Shipley v. City of New York" on Justia Law
In re Shannon
Eastchester Rehabilitation & Health Care Center cared for Edna Shannon for four years. During the fourth year, Family Service Society of Yonkers (FSS Yonkers) was appointed as guardian of Shannon’s person and property. Eastchester later made a claim with FSS Yonkers seeking compensation for services it rendered to Shannon that were not covered by Medicaid. Thereafter, Westchester County Department of Social Services (DSS) advised FSS Yonkers that Shannon was indebted to DSS for medical assistance paid on her behalf. After Shannon died, FSS Yonkers commenced this proceeding to settle its final account and seeking a determination as to how it should disburse Shannon’s remaining property. Supreme Court held that the balance of Shannon’s remaining property should be paid to DSS. The Appellate Division reversed. The Supreme Court reversed, holding (1) N.Y. Ment. Hyg. Law 81.44 does not permit a guardian to retain property of an incapacitated person after the incapacitated person has died for the purpose of paying a claim against the incapacitated person that arose before that person’s death; and (2) inasmuch as Eastchester’s claim for medical services rendered to Shannon was unrelated to the administration of her guardianship, section 81.44 does not allow FSS Yonkers to withhold from Shannon’s estate funds to pay Shannon’s debt to Eastchester. View "In re Shannon" on Justia Law
State v. Robert F.
In 2004, Respondent pleaded guilty to sexual abuse in the first degree. Respondent was previously convicted in three separate cases to sexual abuse in the first degree, rape in the first degree, and sodomy in the second degree. As Respondent’s release date approached, the Attorney General commenced this N.Y. Mental Hyg. Law 10 proceeding seeking a determination that Respondent was a detained sex offender requiring civil management. After a dispositional hearing, Supreme Court issued an order finding that Respondent was a dangerous sex offender and ordering his confinement. Defendant appealed, arguing that Supreme Court improperly permitted an expert witness to testify via electronic video conferencing. The Appellate Division affirmed. The Court of Appeals affirmed, holding (1) Supreme Court erred by permitting the expert witness to testify via electronic appearance on rebuttal without a showing of exceptional circumstances; but (2) the error was harmless in light of the overwhelming evidence presented by the State. View "State v. Robert F." on Justia Law
Lopez v. Evans
Petitioner was convicted of murder and eventually released on lifetime parole supervision. Petitioner was subsequently charged with misdemeanor assault. Petitioner was found to be unfit to stand trial and was committed to the custody of the Office of Mental Health. While committed, Petitioner was charged with assault and harassment stemming from his attack on a fellow patient. The charges were eventually dismissed. Meanwhile, the New York State Department of Corrections and Community Supervision commenced parole revocation proceedings against Petitioner on the incident based on the patient attack. An administrative law judge (ALJ) recommended parole revocation. The Division of Parole adopted the ALJ’s recommendation, and Petitioner was incarcerated. While incarcerated, Petitioner commenced this N.Y. C.P.L.R. 78 contending that due process prohibits the Division from proceeding with a revocation hearing against a person who has been deemed mentally unfit to proceed to trial. Supreme Court denied the petition, determining that an assertion of incompetency does not bar parole revocation proceedings. The Appellate Division reversed. The Court of Appeals affirmed, holding that when a parolee lacks mental competency to stand trial, it is a violation of his or her due process rights to conduct a parole revocation hearing. View "Lopez v. Evans" on Justia Law
Tyrone D. v. State
Petitioner was adjudicated a dangerous sex offender in need of confinement to a secure treatment facility. Petitioner later exercised his annual right to petition for discharge under N.Y. Mental Hyg. Law 10 and commenced a proceeding in Oneida County seeking his discharge from confinement. Petitioner then moved to change venue for the annual review hearing to New York County, citing to N.Y. Ment. Hyg. Law 10.08(e). Supreme Court denied the motion, finding that, while N.Y. Mental Hyg. Law 10.08(e) does allow venue to be changed for annual review hearings, Petitioner failed to establish the requisite good cause in this case. Thereafter, Supreme Court found that Petitioner remained a dangerous sex offender in need of confinement to a secure treatment facility. The Appellate Division affirmed. The Court of Appeals affirmed, holding (1) N.Y. Ment. Hyg. Law 10 authorizes a change of venue in article 10 annual hearings upon an appropriate showing of good cause; but (2) Petitioner failed to establish good cause for the change of venue. View "Tyrone D. v. State" on Justia Law
Posted in: Health Law