Justia U.S. 1st Circuit Court of Appeals Opinion Summaries

Plaintiffs are a dissident group, within a larger class of medical patient consumers in a case alleging fraud in overcharging for the medication Lupron. The patients, along with insurers and private health care providers, obtained a $150 million settlement agreement that was approved by the district court, of which $40 million was allocated to consumers. That agreement provided that if there were unclaimed monies from the $40 million consumer settlement pool after full recovery to consumer plaintiffs, all unclaimed funds would go into a cy pres fund to be distributed at the discretion of the trial judge. Dissident plaintiffs appealed distribution of the $11.4 million cy pres fund to the Dana Farber/Harvard Cancer Center and the Prostate Cancer Foundation for work on the treatment of the diseases for which Lupron is prescribed. They have already recovered more than 100% of their actual damages. The First Circuit affirmed. After expressing concern about distribution of such funds by judges and adding an audit requirement, the court noted the importance of avoiding windfalls for plaintiffs who have already been fully compensated. View "Rohn v. Dana Farber/Harvard Cancer Ctr." on Justia Law

Named plaintiffs sought to represent potential classes of hospital employees, some covered by collective bargaining agreements and others not, claiming that they were deprived of compensation for work performed during meal breaks, before and after shifts, and during training sessions. One case asserted only state law tort and regulatory claims; the other raised claims under the Fair Labor Standards Act, 29 U.S.C. 206-207, and the Employee Retirement Income Security Act, 29 U.S.C.1059(a)(1), 1104(a)(1). The district court dismissed. The First Circuit affirmed in part. The state law claims were properly removed to federal court and were preempted because many were dependent on the terms of a collective bargaining agreement. The federal law claims, dismissed for failure to identify specific employers, were remanded to permit amendment. View "Cavallaro v. UMass Mem'l Health Care,Inc." on Justia Law

Plaintiffs, seeking to represent a class, alleged failure to compensate them for work performed during their meal break and before and after shifts, and for time spent attending training sessions, in violation of the Fair Labor Standards Act, 29 U.S.C. 206-207; the Employee Retirement Income Security Act, 29 U.S.C. 1059(a)(1), 1104(a)(1); and the Racketeer Influenced and Corrupt Organizations Act, 18 U.S.C. 1962, 1964(c). The district court held that the FLSA claim was deficiently pled, and that this was fatal to the complaint because the ERISA and RICO claims were derivative of the FLSA claim. The court found the allegation of under-compensation insufficient, given the lack of any information on plaintiffs' approximate weekly wages and hours worked, or even an allegation that they had worked in excess of 40 hours in any workweek. The First Circuit vacated. The allegations were insufficient under the FLSA, but plaintiffs should be permitted to amend. View "Pruell v. Caritas Christi" on Justia Law

In 2003, the New Hampshire Department of Health and Human Services and a certified class of Medicaid-eligible children reached a settlement agreement and proposed a consent decree that outlined the Department's obligations to provide dental services to Medicaid-enrolled children in accordance with federal law. The district court approved the Decree in 2004. Between 2007 and 2010, the district court denied four motions alleging that the Department was not in compliance. The First Circuit affirmed, upholding the district court's requirement that the Class to file a motion for contempt to enforce the Decree; denial of a 2010 motion for contempt; denial of a request for an evidentiary hearing in 2010; and holding the Class to a clear and convincing burden of proof on its 2010 motion to modify or extend the Decree.

Plaintiff, who suffers epilepsy, began working as a part-time kitchen assistant in 1999. His episodes would cause him to leave work three to six times each year, but generally he just stepped back and resumed work after the episode passed. He was denied a full-time position, filed a complaint with the EEOC, and obtained a right-to-sue letter. The court rejected his suit under the Americans With Disabilities Act, 42 U.S.C. 12101, Title VII, and 42 U.S.C. 1983. The First Circuit affirmed, concluding that plaintiff was not substantially limited in his ability to work or in other work activities, within the meaning of the ADA,.

The city and stopped paying full reimbursement of certain medical expenses for former firefighters and police officers who had retired on disability pensions. The retirees alleged that the decision violated state statutes, constituted an ultra vires act, contradicted principles of equity, and offended the Due Process Clause.The district court entered summary judgment against all but three of the plaintiffs and resolved the remaining claims after trial. The First Circuit affirmed the summary judgment rulings. The state injured-on-duty statute does not require the benefit and there was no evidence that the city ever authorized such a benefit on a global basis or made specific promises to retirees, other than the three that went to trial.

Plaintiff claimed that her employer since 1990, the Puerto Rico Ports Authority, violated the Americans with Disabilities Act, 42 U.S.C. 12101, when it failed to provide her with reasonable accommodations (flexible schedule) for her chronic fatigue syndrome disabilities and retaliated against her, including by terminating her employment, for engaging in protected activities. The district court granted the Ports Authority's motion for judgment as a matter of law at the close of plaintiff's case-in-chief. The First Circuit vacated and remanded, concluding that a reasonable jury could have found facts supporting plaintiff's claims. The district court erred finding that plaintiff was not "qualified" under the ADA without considering that the accommodation she requested was a flexible schedule.

An inmate of the Maine corrections system, sought a civil rights remedy (42 U.S.C. 1983) for alleged denial of adequate medical care for human immunodeficiency virus (HIV) by healthcare professionals at a jail and the state prison. The district court entered summary judgment for the defendants. The First Circuit affirmed with respect to the contractor that provides care, stating that the evidence could not establish Eighth Amendment violations, but reversed with respect to a physicians' assistant. Although the contractor acknowledged that its care "fell short of the mark," carelessness or inadvertence falls short of the Eighth Amendment standard of deliberate indifference. There was a material dispute about deliberate indifference by the physicians' assistant, who had a financial interest in limiting care and a disciplinary history.

Plaintiff brought action under the False Claims Act, 31 U.S.C. 3729, claiming that the company used a kickback scheme and knowingly caused submission of false Medicare, Medicaid, and TRICARE claims by hospitals and doctors. The district court held that hospital claims at issue were not false or fraudulent, and that doctor claims were false or fraudulent, but not materially so. The First Circuit reversed. If kickbacks affected the transactions underlying the claims, the claims failed to meet a condition of payment and were false, regardless of the hospital's participation in or knowledge of the kickbacks. It cannot be said, as a matter of law, that the alleged misrepresentations were not capable of influencing Medicare's decision to pay the claims.