Justia U.S. 7th Circuit Court of Appeals Opinion Summaries

In 2012, Illinois enacted legislation requiring prior approval for reimbursement for more than four prescriptions for one Medicaid patient within a 30‐day period. 305 ILCS 5/5‐5.12(j). Ciarpaglini is an Illinois Medicaid recipient and suffers from chronic conditions, including bipolar disorder, attention deficit hyperactivity disorder, panic disorder, and generalized anxiety disorder. Doctors have prescribed at least seven medications to manage these conditions. Ciarpaglini alleges that after the prior‐approval requirement took effect, he could not, at least at times, obtain medications he needed and that he has contemplated committing suicide, committing petty crimes so that he would be jailed, or checking himself into hospitals just to get medications. He challenged the requirement under federal Medicaid law, the Americans with Disabilities Act, the Rehabilitation Act, and the Constitution. Illinois subsequently moved Ciarpaglini from the general fee‐for‐service Medicaid program to a new managed care program, under which the requirement does not apply. The district court dismissed the matter as moot. The Seventh Circuit remanded, finding insufficient evidence to determine whether the claims were moot, given Ciarpaglini’s stated desire to move to another county and the lack of information about whether the change in his program was individual or part of a change in policy. View "Ciarpaglini v. Norwood" on Justia Law

Dr. Liu, an Asian woman, began working at Stroger Hospital in 1984. Liu says that, beginning in 2003, her supervisors sent a disproportionate number of her cases to review committees as compared to white male colleagues. In 2004, Liu treated a 19-year-old with appendicitis non-operatively and the patient suffered a heart attack, resulting in a clash between Liu and administration regarding her preference for non-operative treatment. After several incidents involving her refusal to conform to policy and to treat appendicitis surgically, her supervisor suspended Liu’s surgical privileges and limited her to “low complexity” cases. The Peer Review Committee investigated several cases and recommended that the suspension continue until Liu completed counseling, “with the goals of gaining insight into her problems, accepting responsibility.” The Executive Medical Staff concurred. in 2010, Liu was terminated because, during the proceedings, she accessed patient records to try to support her position, violating HIPAA and the Hospital System Privacy Policy. The Seventh Circuit affirmed summary judgment, rejecting Liu’s claims under Title VII, 42 U.S.C. 2000e-2(a) & 2000e-3(a), and 42 U.S.C. 1981. Liu presented only sparse evidence of animus based on her race, sex, and national origin, none of it linked to the challenged decisions, and did not create a genuine dispute of fact as to whether the stated reasons for discipline were honest. View "Liu v. Cook County, Ill." on Justia Law

Stark worked at GM for over 10 years as a yard driver. Her back pain started in 2000, when she underwent her first of three surgeries. She has been diagnosed with degenerative disc disease, nerve root irritation, moderate-to-severe spinal stenosis, and possible radiculopathy. Stark underwent numerous nonsurgical treatments for pain, including epidural spinal injections and a nerve root block, with a regimen of Neurontin, Darvocet, Celebrex, Oxycocone, Avinza, physical exercises, and physical therapy. Stark’s pain control was “fair-to-poor.” She stopped working in 2009. A doctor assessed that Stark could do light physical demand activities based on her full range of motion and ability to squat, kneel, and walk. A medical consultant estimated that Stark occasionally could lift or carry 20 pounds and sit for about 6 hours in an 8-hour day. At a 2012 hearing, Stark testified to a “tremendous amount of pain every day.” She could no longer take narcotic pain relievers because of a hepatitis C diagnosis. An ALJ denied benefits, finding that “the objective evidence does not substantiate the extreme symptoms and limitations to which she testified” and that her testimony regarding daily activities “demonstrates a level of daily function not inconsistent with light work activity.” The Seventh Circuit reversed, finding the credibility analysis flawed. View "Stark v. Colvin" on Justia Law

In 2003 Tipton Hospital awarded Babchuk medical staff privileges and gave his professional corporation an exclusive contract to provide radiology services. In 2012 Tipton cancelled both his medical privileges and his corporation’s contract. In Babchuk’s suit under 42 U.S.C. 1983, the district judge granted summary judgment in favor of all defendants, reasoning that the plaintiffs had failed to prove they had a federally protected property interest in Dr. Babchuk’s hospital privileges or in the contract between his professional corporation and the hospital. The Seventh Circuit affirmed, finding that the conduct of which Babchuk complained was not state action and, therefore, not actionable under 42 U.S.C. 1983. The fact that some of Tipton’s revenues are siphoned off to the state university that owns it does not make the hospital a state actor. The university may well exert pressure direct and indirect on Tipton, just as federal and state governments in manifold ways exert pressure on private institutions. “Government is omnipresent; that doesn’t make all employees of private entities state actors.“ View "Babchuk v. IN Univ. Health, Inc" on Justia Law

On July 5, 2013, the Governor of Wisconsin signed into a law a statute that the Wisconsin legislature had passed one month earlier prohibiting a doctor from performing an abortion unless he or she has admitting privileges at a hospital no more than thirty miles from the clinic in which the abortion is performed. Planned Parenthood of Wisconsin and Milwaukee Women’s Medical Services (which operate the only four abortion clinics in Wisconsin) joined by two doctors employed by Planned Parenthood, challenged the statute’s constitutionality under 42 U.S.C. 1983, first seeking and obtaining a preliminary injunction and ultimately seeking a permanent injunction against enforcement of the statute. After a trial, the trial judge granted a permanent injunction against enforcement of the statute. The Seventh Circuit affirmed, holding (1) Plaintiffs had standing to sue; and (2) the statute is unconstitutional because it imposes a burden excessive in relation to the aims of the statute and the benefits likely to be conferred by it. View "Planned Parenthood of Wisconsin, Inc. v. Schimel" on Justia Law

Plaintiff has a neurological disorder, tardive dyskinesia. Plaintiff’s involuntary movements include tongue thrusting, pursing of the lips, choking, and side-to-side chewing of the jaw. She becomes mute, screams or makes non-verbal sounds, particularly under stress. She also suffers post-traumatic stress disorder and bipolar disorder, with severe anxiety. Shortly after plaintiff was diagnosed with TD, a personal injury suit that she had filed went to trial. She had no lawyer. Before trial, she sought accommodations of her medical problems, and was permitted to have a friend and a family member take notes, was given a podium, and was allowed to take occasional recesses. She was denied other requested help—a microphone, an interpreter, and a jury instruction explaining her disorder, lest the jurors think she was just acting up. She was hectored by the judge, who told the jury that the plaintiff has a “speech impediment.” She suffered other embarrassments in front of the jury, which returned a verdict for the defendant. Plaintiff unsuccessfully moved for a new trial on the ground that she was disabled within the meaning of the Americans with Disabilities Act yet had been denied reasonable accommodations. The Seventh Circuit reversed and remanded, finding that plaintiff was denied a full and fair opportunity to vindicate her claims. View "Reed v. State of Illinois" on Justia Law

Religious, not-for-profit organizations challenged the “contraceptive mandate” of the Patient Protection and Affordable Care Act of 2010 (ACA), 42 U.S.C. 300gg-13(a)(4), arguing that the ACA’s accommodations for religious organizations impose a substantial burden on their free exercise of religion, and that the ACA and accompanying regulations are not the least restrictive means of furthering a compelling government interest, in violation of the plaintiffs’ rights under the Religious Freedom Restoration Act of 1993 (RFRA), 42 U.S.C. 2000bb. The district court entered a preliminary injunction. The Seventh Circuit reversed, stating: It is the operation of federal law, not any actions that the plaintiffs must take, that causes the provisions of services that the plaintiffs find morally objectionable. The accommodation has the legal effect of removing from objectors any connection to the provision of contraceptive services. View "Grace Schools v. Burwell" on Justia Law

Textron began operations at its fastener manufacturing plant in Rochester, Indiana, in 1954; it remained in operation through 2006. The plant released vinyl chloride, a toxic gas, which eventually seeped into the groundwater, contaminating nearby residential wells. One of those wells belonged to the Woods. Both Textron and the Indiana Department of Environmental Management performed testing on the Woods’ well. The family left immediately. While living at the Rochester house, their adopted children, C.W. and E.W., experienced gastrointestinal issues (vomiting, bloody stools), immunological issues, and neurological issues. Both children were younger than two years old when the family left the house; their health improved after leaving. The parents sued on behalf of their children, alleging negligence, negligence per se, negligent infliction of emotional distress, and willful and wanton misconduct. The court excluded their three expert witnesses, finding they did not use reliable bases to support their opinions, and granted Textron summary judgment. The Seventh Circuit affirmed, finding that the district court properly applied the Daubert framework to the experts and, without the experts, the plaintiffs could not prove causation. View "C.W. & E.W. v. Textron, Inc." on Justia Law

Defendant-appellant Dr. Kamal Patel was a physician who commonly prescribed home health care services for his patients. Federal investigators learned that defendant had been receiving undisclosed payments from Grand Home Health Care. Patel was charged with six counts of violating (and one count of conspiring to violate) the Anti-Kickback Statute. During his bench trial, at the close of the government’s evidence, defendant moved to acquit, arguing that he had not “referred” any patients to Grand because there was no evidence that he steered or directed his patients to Grand; rather, the patients independently chose Grand as their provider after defendant prescribed home health care. The district court rejected that argument, holding that, even if a patient had initially chosen Grand, defendant “referred” the patient to Grand when he certified or recertified that the patient needed care, that the care would be provided by Grand, and that Grand could be reimbursed by Medicare for services provided. On appeal, defendant argued that the district court erred by holding that the certification and recertification, via a standardized Medicare form (Form 485), of patients for treatment constituted a “referral” under the Anti-Kickback Statute. He also argued that even if those certifications were referrals, there was insufficient evidence to conclude that Patel was paid “in return for” certifications, as required by the statute. Finding no reversible error, the Seventh Circuit affirmed the district court's judgment. View "United States v. Patel" on Justia Law

Scrogham, then age 53, applied for disability benefits under the Social Security Act, submitting medical conditions including degenerative discs, spinal stenosis, sleep apnea, hypertension, arthritis, atrial fibrillation and restless leg syndrome. An ALJ denied the application and the Appeals Council denied his request for review. The district court affirmed, holding that the ALJ did not err in giving less weight to the opinion of a treating physician than to the opinions of nontreating physicians, that the ALJ permissibly found Scrogham not to be credible and that the ALJ’s decision otherwise was supported by substantial evidence. The Seventh Circuit reversed and remanded. The ALJ impermissibly ignored a line of evidence demonstrating the progressive nature of Scrogham’s degenerative disc disease and arthritis and inappropriately undervalued the opinions of Scrogham’s treating physicians, whose longitudinal view of Scrogham’s ailments should have factored prominently into the ALJ’s assessment of his disability status. Even considering only “the snapshots of evidence that the ALJ considered,” that limited evidence does not build the required logical bridge to her conclusions. The ALJ apparently misunderstood or at least considered only partially some of the evidence about Scrogham’s daily activities, rehabilitation efforts and physicians’ evaluations.View "Scrogham v. Colvin" on Justia Law