Justia U.S. 1st Circuit Court of Appeals Opinion Summaries
Articles Posted in Public Benefits
Hawkins v. Dep’t of Health & Human Servs. for the State of NH
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.
United States v. Parisi
The former governor and former financial director of the Tribe were convicted for conspiracy to defraud the United States (18 U.S.C. 371), and of violations of 18 U.S.C. 287, 666 and 669, involving misuse of federal grant and tribal monies at the Passamaquoddy Tribe Indian Township Reservation in Maine. The First Circuit vacated the conviction of the financial director for making material misstatements about how grant money intended for HIV and substance abuse prevention was spent, but otherwise affirmed. The evidence that the director knew that his statements were false was insufficient. The district court had jurisdiction; several counts involved mismanagement of federal grants and contracts, which are subject to regulations that the Tribe is not free to ignore, and do not constitute internal tribal matters.
Brown v. Blackstone Medical, Inc
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.
Elgin v. U.S. Dept of Treasury
The district court rejected a challenge to 5 U.S.C. 3328, which bars males who have knowingly and willfully failed to register for the draft by age 26 from employment by the executive branch. The First Circuit vacated and remanded for entry of a judgment denying relief for lack of subject matter jurisdiction. The exclusive remedy for the plaintiffs, who were dismissed or resigned from federal employment after discovery of their failure to register, is under the Civil Service Reform Act. Although the claims implicate constitutional violations, Congress intended to consolidate employee removal actions in a single forum. The Merit System Protection Board cannot grant relief by invalidating the statute, but a court could do so on review of board action. The court characterized the constitutional challenges as "unpromising."