5 big medical court cases that made a difference this year
The AMA and the Litigation Center of the American Medical Association and State Medical Societies covered a lot of legal ground in 2019, from the U.S. Supreme Court and state courts, where the nation's oldest and largest physician organization served as a powerful, unified voice for the nation's doctors and their patients.
1. Judge says AMA is right: Title X gag rule violates medical ethics
"This is madness," wrote U.S. District Judge Michael McShane in Portland, Oregon, in a scathing rebuke of the Trump administration's new Title X regulations that includes a gag rule dictating what physicians must and must not say to their patients in the Title X program about family planning.
"The gag rule prevents doctors from behaving like informed professionals," McShane wrote. "At the heart of this rule is the arrogant assumption that government is better suited to direct the health care of women than their medical providers." The Title X program ensures that every person has access to basic, preventive reproductive health care, such as birth control, cancer screenings, sexually transmitted infection testing and treatment regardless of where they live or whether they have health insurance. About 4,000 clinics received Title X funds in 2017. Judge McShane issued a temporary injunction against the gag rule and a new requirement for clinics to create financial and physical separation between Title X and non-Title X abortion-related activities. A three-judge panel of the 9th U.S. Circuit Court of Appeals, however, stayed that district court ruling in June, allowing the new rule to take effect. Attorneys for the AMA and the other co-plaintiffs argued before an 11-judge panel of the appeals court on Sept. 23 to reverse course. The 9th U.S. Circuit Court en banc panel is considering whether to reverse the stay order. In the meantime, many of the former Title X recipients are continuing to provide family planning services, but without federal funding so they can operate without being subject to the gag rule.
2. Court blocks law that would force physicians to mislead patients
A federal district court in North Dakota sided with the AMA and others and issued a preliminary injunction to block enforcement of a state law that would force physicians to violate the AMA Code of Medical Ethics and act as mouthpieces for a politically motivated message that is misleading and could harm patients. Earlier this year, the AMA filed an amicus brief in the case arguing that the law runs contrary to the AMA Code of Medical Ethics and they should issue an injunction, and AMA President Patrice A. Harris, MD, MA, also published an op-ed in The Advocate urging the Supreme Court justices to "do the right thing" in the case.
3. New Jersey court weighs whether non-patient can sue physician
The family of a New Jersey woman who died after a car-bicycle crash involving a psychiatrist's patient wanted the right to sue the doctor who prescribed medication to the car's driver. If the courts had allowed the lawsuit to go forward, it would have opened up New Jersey physicians to an endless number of lawsuits from members of the public who would sue doctors whenever they believe harm from a patient can be tied to the care that patient received. The Superior Court of New Jersey Appellate Division in June upheld a trial court decision to dismiss the psychiatrist from the lawsuit.
4. Physicians increasingly face "hybrid" medical liability claims
California physicians are increasingly facing "hybrid" lawsuits alleging professional negligence as well as medical battery from plaintiffs who want to avoid the state's long-standing $250,000 limit on what juries can award for noneconomic damages in medical liability cases. A jury recently awarded $22,246 in economic damages and $9.25 million in past and future noneconomic damages to a plaintiff who tried this approach, with the court refusing to apply limits set in California's Medical Injury Tort Compensation Reform Act. The physician defendant is appealing the ruling and the Litigation Center of the American Medical Association and State Medical Societies joined with the California Medical Association and two other groups to file an amicus brief urging the appellate court to apply the law's $250,000 cap.
5. High court should hear case on site skirting gun background checks
The daughter of a woman who was killed by a man barred from gun possession has sued the website that facilitated the killer's purchase of the weapon used in the crime. The AMA and the Wisconsin Medical Society (WMS) are supporting the daughter, Yasmeen Daniel, and requesting that her case be heard by the U.S. Supreme Court.
Medicaid fraud: Case would wrongly expand physician liability
A health professional doesn't know that a patient she is seeing is a Medicaid recipient. She types up notes about her patient interactions, but a physician in the clinic writes the prescriptions, codes the interaction and bills the government. Can she be convicted of Medicaid fraud?
A Michigan trial court did just that. An appeals court upheld the decision and now the Michigan Supreme Court will have the final say on whether the conviction will stand. The AMA litigation center and State Medical Societies joined the Michigan State Medical Society (MSMS) in filing an amicus brief that urges the state's highest court to overturn her convictions on two counts of Medicaid fraud.
"The breadth of this finding is of great concern to MSMS, AMA and their members," the brief tells the court. "Under the lower courts' conviction rationale, other clinic employees whose tasks are completely unrelated to billing—and those who are involved with billing but who do not set billing policies or assign diagnostic codes and who must rely upon others in the performance of their duties—are likewise at risk for criminal liability."
AMA policy supports efforts to clearly define health care fraud and calls for laws that ensure the equal application of due-process rights to physicians in health care fraud prosecution. The AMA Litigation Center brief filed in the case, Michigan v. Wang, notes that the Medicaid False Claim Act says that a person will not file a claim "knowing the claim to be false." The act defines "knowing" or "knowingly" to mean a "person is in possession of facts under which he or she is aware or should be aware of the nature of his or her conduct and that his or her conduct is substantially certain to cause the payment of a Medicaid benefit" and includes "acting in deliberate ignorance of the truth or falsity of facts or acting in reckless disregard of the truth or falsity of facts."
"Respectfully, the evidence presented at trial did not satisfy the statutory requirements for a knowing violation," the brief tells the court.
Read more about this case here.
