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PPACA creeps into state and local courts: 5 early cases

By Allison Bell

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The Patient Protection and Affordable Care Act (PPACA) is starting to play starring — and supporting — roles in a wide range of civil disputes filed in state and local courts.

Wolters Kluwer Financial Services has helped agents, brokers, employers, lawyers and anyone else with an interest in PPACA litigation track where PPACA is showing up by introducing an insurance case law model.

The federal court system’s PACER case filing litigation already gives members of the public a way to read PPACA case filings — but only if they know the names of parties or lawyers involved, or can make good enough guesses to pull up interesting search results.

The Wolters Kluwer database provides keyword search capabilities, and users can use keyword searches for terms such as “Patient Protection and Affordable Care Act” to get a bird’s-eye view of PPACA litigation. Litigation scans could help producers and others think more comprehensively about the PPACA-related obligations and litigation risks they and their clients face.

Many federal cases still focus on concluded and pending challenges to the constitutionality of PPACA, or of specific PPACA provisions. Most of the state and local PPACA cases hinge on interpretations of specific PPACA provisions. In other cases, with no obvious relationship with PPACA, judges mention PPACA in opinions in connection with matters such as describing the health insurance arrangements of parties involved in domestic disputes.

A recent search produced a list of about 50 state and local court opinions dealing with PPACA. The opinions come from all over the United States. Here’s a peek at the most recent five cases that dealt with something other than domestic disputes.

Oakland Bay Bridge

1. Corea vs. City and County of San Francisco

(California Courts of Appeal)

In this case, petitioners purporting to speak for the indigent argued that local officials weren’t meeting PPACA standards for participant cost-sharing fees at a program aimed at the indigent. An appeals court found that the petitioners lacked standing to file the suit. 

Beach

2. Frost Street Medical Association vs. San Diego Internal Medical Group

(California Courts of Appeal)

In this case, a medical group has used PPACA hospital patient readmission penalties as justification for a new approach to hospitalist contracting. A lower court ruled in favor of the medical group on other grounds.

Paths split.

3. Pinnacle Healthcare L.L.C. vs. Sheets

(Indiana Court of Appeals)

 In this case, involving a noncompete clause in a contract between an entity that bought a practice and the physician who sold the practice, a trial court analyzing noncompete clauses suggested that PPACA provider access standards might have some bearing on any noncompete clauses that affect health care providers in areas underserved by health care providers.

Statue of Liberty

4. Mintz & Gold L.L.P. vs. the New York City Tax & Limousine Commission

(New York Miscellaneous Reports)

Taxi car owners in New York are fighting with city officials over whether the owners should have to pay 6 cents per fare to help the drivers get the individual health benefits required by the PPACA individual coverage mandate. 

A street in Iowa

5. Palmer College of Chiropractic vs. Davenport Civil Rights Commission

(Iowa Reports)

In an opinion on a suit involving access for people with disabilities at a chiropractic school, a judge noted in passing that PPACA includes accessibility incentives.

Image: National Park Service photo 

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