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Administrative

Administrative – Medicare – Denial of Coverage – Arthritis Treatment (access required)

Almy v. Sebelius The 4th Circuit upholds the Secretary of Health and Human Services’ denial of Medicare Part B coverage for the BIO-1000, a device to treat osteoarthritis of the knee, rejecting the claims of the manufacturer’s bankruptcy trustee that the Secretary improperly used the adjudicative process to develop a policy denying coverage and her decisions were arbitrary and capricious.

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Administrative – Licenses & Permits – ABC Permit – Sale to Underage Customer – Counterfeit CDs & DVDs – Convicted Felon – Firearm (access required)

NC Alcoholic Beverage Control Commission v. CK2, LLC While executing a search warrant for illegal gambling devices at respondent’s convenience store, police found a firearm – which the store owner had a permit to buy – in a cigar box in front of a store employee who was a convicted felon. In addition, the store owner admitted that CDs and DVDs were sold in the store, and counterfeit CDs and DVDs were found among those for sale.

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Administrative – Immigration – Removal Order – Vacated – Adjusted Status – Waiver of Inadmissibility (access required)

Bracamontes v. Holder Section 212(h) of the Immigration and Nationality Act does not bar an alien who adjusts his status post-entry to lawful permanent resident from seeking a waiver of inadmissibility, and the 4th Circuit grants a petition filed by this married father of three, who obtained lawful resident status prior to his felony conviction and marriage to a U.S. citizen, vacates the order of removal, and remands the case to the Board of Immigration Appeals.

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Administrative – Stark Law Violations – False Claims Act – Constitutional – Jury Trial – Hospital (access required)

U.S. ex rel. Michael K. Drakeford MD v. Tuomey Healthcare System Inc. A federal appeals court vacates a $45 million judgment against a Sumter, S.C., health care system for Stark Law violations and sends the case back, saying the district court’s handling of the case violated the defendant’s Seventh Amendment right to a jury.

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Administrative – Commission of Indian Affairs – Jurisdiction – Intra-Tribal Dispute – Unfilled Seat (access required)

Meherrin Tribe of North Carolina v. North Carolina State Commission of Indian Affairs A review of G.S. §§143B-405 through -407 reveals that the General Assembly intended for the Commission of Indian Affairs to serve an advocacy and resource provision function and not to resolve intra-tribal disputes, such as the issue of who is to fill the Meherrin seat on the Commission.

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Administrative – Medicaid Lien – Medical Malpractice Settlement – Past Medical Expenses Limit (access required)

E.M.A., a minor v. Cansler, Sec’y DHHS North Carolina’s third-party liability statutes, under which it asserts a lien for one-third of an infant Medicaid recipient’s $2.9 million med-mal settlement, do not comply with federal Medicaid law, which limits a state’s recovery to past medical expenses, and the 4th Circuit vacates judgment for the state and remands for further proceedings consistent with the federal anti-lien provision.

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Administrative – Health Care Personnel Registry – Patient Abuse Allegation – Labor & Employment (access required)

Byrom v. Department of Health & Human Services, Division of Health Service Regulation At an assisted living facility, activities assistant Rodriquez allegedly stuck her head inside a resident’s room and saw petitioner sexually abusing the resident by standing behind her and rubbing her breasts. However, Rodriquez did not intervene and did not immediately tell her fellow activities assistant who was standing down the hall. Instead, Rodriquez went to her supervisor’s office to report what she had seen.

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Administrative – Driver’s License – Restoration – ‘Excessive User of Alcohol’ (access required)

Simpson v. Robertson Fifteen years after having his driver’s license permanently revoked because of multiple DWIs, petitioner presented evidence that he only occasionally drinks beer or wine. Respondent denied the petition based on its misconstruction of the term “excessive user of alcohol” to include “anyone [who] consumes an alcohol[ic] beverage and operates a motor vehicle to any degree” and anyone who does not totally abstain from drinking rather than exceeding what is usual, proper, necessary, or normal. Respondent incorrectly imposed a higher standard on petitioner than required by N.C. law; thus, its decision was arbitrary and capricious.

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