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

Nelson D. was a convicted sex offender who suffered from mental retardation. The State filed a N.Y. Mental Hyg. Law 10 petition seeking to subject Nelson to civil management. After a dispositional hearing, Supreme Court found the State failed to establish that Nelson was a dangerous sex offender requiring confinement but concluded that Nelson required strict and intensive supervision and treatment (SIST). Supreme Court ordered Nelson's placement at Valley Ridge Center for Intensive Treatment was an appropriate SIST regimen as authorized under article 10. The Appellate Division affirmed. The Court of Appeals reversed, holding (1) absent a finding of the type of condition that statutorily subjected Appellant to confinement, his placement at Valley Ridge constituted involuntary confinement in violation of article 10; and (2) involuntary commitment, as part of a SIST plan, deprived Nelson of the statutorily proscribed procedures mandated for confinement under article 10. View "State v. Nelson D." 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

Plaintiffs challenged the facial constitutionality of N.Y. Pub. Health Law 2808(5)(c), which prohibits the withdrawal or transfer of residential health care facility equity or assets in amount exceeding three percent of the facility's most recently reported annual revenue from patient care services without the prior approval of the State Commissioner of Health. Plaintiffs in this case were concerned that the challenged provision would negatively impact nursing homes. Supreme Court granted summary judgment to Plaintiffs, concluding that the statute impermissibly ceded legislative policymaking power to a regulatory agency situated in the executive branch and infringed on the substantive due process property interests of facility owners. The Appellate Division affirmed. The Court of Appeals reversed, holding (1) the lower courts erred in concluding that the statute was offensive to substantive due process; and (2) the statute does not improperly delegate legislative policy-making power. View "Brightonian Nursing Home v. Daines" on Justia Law

Respondent was an inmate in the custody of the State Department of Corrections and Correctional Services (DOCCS). In 2010, Respondent undertook a month-long hunger strike, contending that he had ceased eating in order to secure transfer to another DOCCS facility and to bring attention to certain claims of mistreatment. After Respondent had lost 11.6 percent of his body weight, DOCCS commenced this proceeding requesting a court order permitting medical personnel to insert a nasogastric tube and take other reasonable steps necessary to provide hydration and nutrition to Respondent. Supreme Court granted DOCCS' motion. Respondent subsequently resumed eating solid food but nevertheless appealed. The Appellate Division concluded the case was moot except for the issue of whether the State violated Respondent's rights by securing the force-feeding order. On that issue, the Appellate Division ruled in favor of DOCCS, concluding that the force-feeding order did not violate Respondent's right to refuse medical treatment. The Court of Appeals affirmed, holding that Respondent's rights were not violated by the judicial order permitting the State to feed him by nasogastric tube after his health devolved to the point that his condition became life-threatening. View "Bezio v. Dorsey" on Justia Law

In 2007, Plaintiff's father (Decedent) collapsed and at a health club owned and operated by Bally Total Fitness of Greater New York, Inc. (Bally). Ambulance personnel administered shocks to Decedent with an automatic external defibrillator (AED), but he never revived. Plaintiff, as executor of Decedent's estate, brought a wrongful death suit against Bally, alleging that Bally employees negligently failed to use an available AED, or failed to use it within sufficient time, to save Decedent's life. Bally primarily argued that it was immune from liability under the State's Good Samaritan Law. Supreme Court denied Bally's motion to dismiss. The Appellate Division affirmed, concluding (1) N.Y. Gen. Bus. Law 627-a imposes an affirmative duty of care upon health clubs so as to give rise to a cognizable cause of action in negligence for failure to operate an available AED; and (2) the complaint stated a cause of action based upon common law negligence. The Court of Appeals affirmed, holding (1) section 627-a does not create an affirmative duty for health clubs to use the AEDs they are required to have available; but (2) Plaintiff pleaded a viable cause of action at common law. View "Miglino v. Bally Total Fitness of Greater N.Y., Inc." on Justia Law

The Commission is constitutionally charged with the oversight of all correctional facilities in the state. At issue was the enforceability of a subpoena deuces tecum issued by the Commission commanding Elmhurst, a health care facility operated by HHC, to produce its records respecting its care and treatment of a specified individual, who, at the time of his pre-mortem hospitalization at the Elmhurst facility, was a correctional inmate in the custody of the city. In the proceedings resulting in this appeal, the Commission's subpoena was quashed upon the ground that it sought material shielded from disclosure by the physician-patient privilege. The court held that this was error that the records sought were not properly withheld from the Commission by reason of the asserted privilege and that the subpoena should be enforced. View "Matter of New York City Health & Hosps. Corp. v New York State Commn. of Correction" on Justia Law

Petitioners provide protection and advocacy services to individuals with developmental disabilities. After receiving a complaint regarding the discharge practices of respondent, petitioners requested access to the clinical records of all individuals residing at two respondent facilities to investigate whether they were being denied the opportunity to live in less restrictive settings. Relying on Mental Hygiene Law 45.09(b) and 33.13(c)(4), petitioners asserted that they were entitled to unrestricted access to the clinical records. Answering a certified question, the court concluded that section 45.09(b) and section 33.13(c)(4) must be read in accord with federal law and that actively-involved family members could possess sufficient decision-making authority to qualify as legal representatives under the pertinent regime. Accordingly, the order of the Appellate Division should be modified, without costs, and the case remitted to Supreme Court for further proceedings in accordance with the opinion and, as so modified, affirmed. View "Matter of Albany Law School v New York State Off. of Mental Retardation & Dev. Disabilities" on Justia Law

Plaintiff represented psychiatrists who treated patients eligible for both Medicare and Medicaid and defendants were responsible for administering Medicaid in New York and for implementing and enforcing medicaid reimbursement rates. At issue was whether the 2006 amendment to the Social Services law found in a budget bill implementing a coinsurance enhancement for the benefit of psychiatrists who treat patients eligible for both Medicare and Medicaid was intended to be permanent or whether the amendment was intended only to provide a limited one-year enhancement. The court concluded that the Legislature only intended to provide for a one-time coinsurance enhancement, limited to the 2006-2007 fiscal year. View "New York State Psychiatric Assn., Inc. v New York State Dept. of Health" on Justia Law

Five days after Charmaine D. was admitted to the hospital, petitioner, the director of the psychiatry department at that hospital, applied to Supreme Court for an order that she be retained for 30 days. Charmaine moved to dismiss the retention proceeding, arguing, among other things, that her original commitment was defective because the emergency room psychiatrist at issue was not a proper applicant under Mental Hygiene Law 9.27. The court held that an emergency room psychiatrist was "supervising the treatment of or treating" a patient within the meaning of Mental Hygiene Law 9.27(b)(11), and so had standing to seek an involuntary commitment of the patient pursuant to section 9.27. The psychiatrist was not required to resort to the emergency procedure contained in Mental Hygiene Law 9.39. View "Matter of Rueda v Charmaine D." on Justia Law