Latest 3 Cases This Week: Bloom v. Azar (2d Cir.), Sahara Health Care, Inc. v. Azar (5th Cir.), In re Guardianship of D.E. (N.H.)

In Ruth We Trust: How the Pregnant Workers Fairness Act Can Promote Women’s Equal Citizenship and Justice Ginsburg’s Legacy

JOANNA L. GROSSMAN

In honor of the late Justice Ruth Bader Ginsburg, SMU Dedman School of Law professor Joanna L. Grossman explains how the Pregnant Workers Fairness Act (PWFA) can promote women’s equal citizenship and protect Justice Ginsburg’s legacy of shaping gender equality. Grossman argues that the PWFA could help break down entrenched occupational segregation in the American economy, and, in so doing, honor Justice Ginsburg’s lifelong commitment to ensuring that women can be full members of society.

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A Half Century After Its Publication, What Can “The Greening of America” Tell Us About the United States Today?

RODGER CITRON

In recognition of the 50-year anniversary of the publication of Charles Reich’s “The Greening of America,” Touro law professor Rodger D. Citron explains what Reich actually said in “The Greening,” explains why it generated such a strong response, and reflects on what the piece has to say about the fractures of our current moment. Citron cautions that the promise of a new consciousness is as alluring—and may be as illusory—as it was when Reich wrote the article and book, 50 years ago.

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Bloom v. Azar

Court: US Court of Appeals for the Second Circuit

Docket: 18-2390

Opinion Date: September 23, 2020

Judge: Raymond Joseph Lohier, Jr.

Areas of Law: Health Law

Plaintiff, a Medicare beneficiary who uses a Continuous Glucose Monitoring device (CGM) to manage his Type I diabetes, sought Medicare coverage to offset the costs associated with his CGM. After the Medicare Appeals Council rejected plaintiff's requests for coverage, he challenged the adverse decisions in federal court. The district court concluded that two of the three challenged decisions failed to meet the $1,500 amount-in-controversy threshold for federal court jurisdiction and that the Medicare Act did not permit plaintiff to cure the jurisdictional deficiency by aggregating the three separate amounts. The Second Circuit held, based on the text of the statute and reinforced by its regulatory and legislative history, that the Medicare Act does not prohibit plaintiff from aggregating his claims for the first time in district court. Therefore, the district court erred in refusing to let plaintiff aggregate his claims to satisfy the Act's amount-in-controversy requirement. The court vacated the district court's judgment and remanded for further proceedings.

Sahara Health Care, Inc. v. Azar

Court: US Court of Appeals for the Fifth Circuit

Docket: 18-41120

Opinion Date: September 18, 2020

Judge: Jennifer Walker Elrod

Areas of Law: Constitutional Law, Government & Administrative Law, Health Law

The Fifth Circuit affirmed the district court's grant of the government's motion to dismiss Sahara's suit for injunctive relief in a Medicare recoupment case, holding that the government provided Sahara adequate process. Applying the Mathews factors, the court held that the sufficiency of the current procedures and the minimal benefit of the live hearing weighs so strongly against Sahara that its due process claim fails. In this case, Sahara received some procedure, chose to forego additional protections, and cannot demonstrate the additional value of the hearing it requests. The court also held that Sahara failed to state a claim for ultra vires actions under 42 U.S.C. 1395ff.

In re Guardianship of D.E.

Court: New Hampshire Supreme Court

Docket: 2020-0368

Opinion Date: September 18, 2020

Judge: Gary E. Hicks

Areas of Law: Health Law, Trusts & Estates

In February 2020, the 79-year-old ward was a patient at a hospital in Lebanon, New Hampshire. At that time, the hospital filed a petition to appoint a guardian over the ward’s person and estate. The hospital alleged a guardianship was necessary because the ward “has persistent cognitive impairment due to an anoxic brain injury and a major [neurocognitive] disorder,” which “renders him unable to provide for his personal needs for health care, food, clothing, shelter and safety” or to “manage his finances or estate.” The court held a hearing in March at which only the ward’s adult children were present. The ward’s children testified that, in October 2019, when their father was in the intensive care unit, they executed a “Do Not Resuscitate” (DNR) order for him. The ward had no DNR order previously. When the ward’s condition improved and he was transferred to a medical ward, he specifically told his children that he wanted the DNR order removed. Based upon the evidence at the March hearing, the court found that the ward was incapacitated and that a guardianship was necessary as a means of providing for his “continuing care ... and for the prudent management of [his] property and financial affairs.” The court limited the guardian’s authority to execute either a DNR order or an order limiting life-sustaining treatment. In August 2020, the guardian moved for a hearing to ask the court to remove the limitations on her authority regarding the ward’s medical care. The guardian averred that the ward, who now resided in a nursing home, was in need of dialysis but had refused dialysis on three occasions, and refused future treatment. The guardian asserted that, by declining to resume dialysis, “the ward himself has decided to stop his own life sustaining treatment,” and that “without having a DNR order in place and without anyone else having the ability to sign [one],” it will be “quite problematic and painful for the ward.” The ward’s attorney informed the court that the ward was “very clear that he did not want a DNR Order.” Upon interlocuroty transfer without a ruling from the circuit court, the New Hampshire Supreme Court accepted review of issues arising from the ward's guardianship. The Court determined that although the ward had a guardian to make health care decisions on his behalf, the trial court had limited the guardian’s authority to withhold life-sustaining treatment, including whether to execute a DNR order on his behalf. "Under these circumstances, given the ward’s lack of capacity to make health care decisions generally, and assuming that he does not have a valid and unrevoked living will or an authorized agent under a durable power of attorney for health care, the process for appointing a surrogate, as described in RSA 137-J:34-:37, applies. ... Accordingly, it does not appear that at this time, a DNR order may be executed on his behalf by his health care providers."