Justia U.S. 9th Circuit Court of Appeals Opinion Summaries

Plaintiffs, on behalf of thousands of retired county employees participating in county-sponsored health care plans, filed suit against the county challenging changes it made to the structure of two health benefits. Plaintiffs appealed the district court's order granting a motion for judgment on the pleadings filed by the county. The court reversed and remanded for further proceedings and with the answer provided by the California Supreme Court to the certified question in the Retired Employees Association of Orange County, Inc.(REAOC) litigation. The court took judicial notice of the documents; reversed the district court's dismissal of plaintiffs' subsidy claims and remanded so that the district court could reassess those claims in light of the California Supreme Court's opinion, and coordinate those claims with the REAOC litigation; the court reversed the district court's dismissal of plaintiffs' grant claims because the court found that plaintiffs should be given an opportunity to amend their complaint to set out specifically the terms of those memoranda of understanding (MOUs) on which their claim predicated; and the court reversed the district court's dismissal of plaintiffs' Fair Employment and Housing Act (FEHA), California Government Code 12940 et seq., claim because the court found that Mr. McConnell's timely filed administrative complaint was sufficient to establish exhaustion of the administrative remedies for all class members.

Plaintiffs, severely disabled California residents, alleged that conventional medical services, drugs, and medications have not alleviated the pain caused by their impairments. Therefore, each plaintiff has obtained a recommendation from a medical doctor to use marijuana to treat her pain. Plaintiffs obtained medical marijuana through collectives located in Costa Mesa and Lake Forest, California. These cities, however, have taken steps to close marijuana dispensing facilities operating within their boundaries. Plaintiffs brought an action in federal district court, alleging that the cities' actions violated Title II of the Americans with Disabilities Act (ADA), 42 U.S.C. 12101 et seq. The court held that Congress has made clear that the ADA defined "illegal drug use" by reference to federal, rather than state law, and federal law did not authorize plaintiffs medical marijuana use. Therefore, the court concluded that plaintiffs' medical marijuana use was not protected by the ADA.

Defendant, a former research assistant at UHS, entered a conditional guilty plea for violating the Health Insurance Portability and Accountability Act of 1996 (HIPAA), 42 U.S.C. 1320d-6(a)(2), because he accessed patient records without authorization after his employment terminated. Defendant moved to dismiss the information because it did not allege that he knew that the statute prohibited him from obtaining the health information. The court affirmed the judgment of the district court because the plain text of Section 1320d-6(a)(2) was not limited to defendants who knew that their actions were illegal. Rather, the misdemeanor applied to defendants who knowingly obtained individual identifiable health information relating to an individual, and obtained that information in violation of HIPPAA.

Plaintiff appealed the district court's dismissal of claims he brought against Board Members, in their individual capacities, under 42 U.S.C. 1983. Plaintiff alleged that the Board Members deprived him of his constitutional rights when, in an ex parte emergency proceeding, they summarily suspended his authority to prescribe medication. The court held that the Board Members were absolutely immune from plaintiff's claims for money damages where they were functionally comparable to judges and their summary suspension authority was comparable to a judicial act. The court also held that Younger abstention barred plaintiff's claims for equitable relief. Accordingly, the court affirmed the judgment.

Plaintiffs brought several state causes of action in Arizona state court against Medtronic for injuries sustained by Richard Stengel from his use of a pain pump manufactured by Medtronic. Medtronic timely removed the case to the United States District Court for the District of Arizona and the district court dismissed plaintiffs' claims as preempted by federal law. The court held that even if some of plaintiffs' claims could be interpreted to escape express preemption, they could not be interpreted to escape implied preemption. Therefore, the district court correctly held that plaintiffs' proposed amendment was futile and thus did not abuse its discretion in denying leave to amend.

Appellant filed a declaratory judgment action seeking a declaration that AHCCCS had no right to recover from her father's annuity at all or, alternatively, had no right to recover for any costs incurred for the care of her mother received after her father's death. Appellant subsequently appealed the district court's judgment granting summary judgment to AHCCCS. The court held that the 2006 amendment to 42 U.S.C. 1396p(c)(1)(F)(i) created a right in the State to recover as a remainder beneficiary against a community spouses' annuity for an institutionalized spouse's medical costs. The court further held that the State's recovery was not limited to the amount it paid for the institutionalized spouse's medical costs as of the date of the community spouse's death. Accordingly, the court affirmed the judgment, concluding that AHCCCS could be reimbursed as the primary remainder beneficiary from the father's annuity for the cost of the medical assistance it paid on the mother's behalf after the father's death.

Plaintiffs, Washington Medicaid beneficiaries with severe mental and physical disabilities, appealed the district court's denial of their motion for a preliminary injunction. Plaintiffs sought to enjoin the operation of a regulation promulgated by Washington's DSHS that reduced the amount of in-home "personal care services" available under the state's Medicaid plan. The court concluded that plaintiffs have demonstrated a likelihood of irreparable injury because they have shown that reduced access to personal care services would place them at serious risk of institutionalization. The court further concluded that plaintiffs have raised serious questions going to the merits of their Americans with Disabilities Act, 42 U.S.C. 12132, and Rehabilitation Act, 29 U.S.C. 794(a), claims, that the balance of hardships tipped sharply in their favor, and that a preliminary injunction would serve the public interest. Accordingly, the court remanded for entry of a preliminary injunction.

Plaintiffs challenged the constitutionality of the ban on compensation for human organs in the National Organ Transplant Act, 42 U.S.C. 274e, as applied to bone marrow transplants. Plaintiffs sought declaratory and injunctive relief to allow harvesting of hematopoietic stem cells which would be extracted by peripheral blood stem cell apheresis (the same technique sometimes used to collect plasma or platelets). The court concluded that Congress made a distinction between body material that was compensable and body material that was not. The distinction had a rational basis, so the prohibition on compensation for bone marrow donations by the aspiration method did not violate the Equal Protection Clause. The court also concluded that when the peripheral blood stem cell apheresis method of bone marrow transplantation was used, it was not a transfer of a "human organ" or a "subpart thereof" as defined by the statue and regulation, so the statue did not criminalize compensating the donor. Therefore, the court need not decide whether prohibiting compensation for such donations would be unconstitutional.

Defendant appealed the district court's preliminary injunction precluding enforcement of California Welfare and Institutions Code 14105.191(f), which amended California's Medicaid Plan and set provider reimbursement rates for the 2009-2010 rate year, and for each year thereafter. Plaintiffs challenged the law under 42 U.S.C 1983 and the Supremacy Clause because the State did not obtain federal approval of its State Plan Amendment (SPA) prior to implementing the rate changes. The court vacated the preliminary injunction and held that plaintiffs have not shown that they have an unambiguously conferred right to bring a section 1983 claim.

Plaintiff, the personal representative of the Estate of Gaye S. Glaser, appealed the district court's affirmance of the Medicare Appeals Council's (MAC) ruling that Kaiser was not required to pay for Glaser's liver surgery. Plaintiff contended that by refusing to cover the procedure, Kaiser failed to comply with 42 C.F.R. 422.112(a)(3), which required Medicare Advantage plans to make their services available, accessible, and adequate, and 42 C.F.R. 422.112(a)(9) and 422.113(b)(iii), which required the plans to cover "urgently needed services." The court held that substantial evidence supported the MAC's decision and affirmed the judgment.