ILNews

Court doesn't order contempt sanctions on state

Back to TopCommentsE-mailPrintBookmark and Share

The 7th Circuit Court of Appeals was presented with the question in an Indiana case of how much non-compliance of a consent decree involving Medicaid applications is needed before a District Court can impose civil contempt sanctions. The issue is before the 7th Circuit because plaintiffs believed Indiana's Medicaid program administrators violated a portion of a consent decree in the handling of applications for the disability program.

The case, LaMont G. Bailey, et al. v. E. Mitchell Roob, Jr., et al., No. 08-3592, has been before the U.S. District Court, Southern District of Indiana, off and on since 1994 when the plaintiffs and the program administrators agreed to certain terms for the handling of disability applications. Part of the agreement stated the program would compile a complete 12-month medical history before reaching a decision on the application, but it didn't define "complete." The plaintiffs claimed the program violated the decree by relying on summary forms rather than compiling an applicant's complete medical history; they filed a petition to hold the administrators in contempt in 2006.

The District Court determined that only nine of the 26 sample files introduced by administrators were less than complete than others presented and that five contained only a summary form 251A that physicians complete but no medical records. The District Court didn't find administrators in contempt because the plaintiffs didn't meet the burden for a civil contempt petition and invited them to re-file their motion with more information, but the plaintiffs instead appealed to the 7th Circuit.

The 7th Circuit ruled the District Court didn't commit a clear legal error by requiring the plaintiffs to demonstrate Indiana Medicaid's lack of reasonable diligence because the Circuit's caselaw requires the party seeking sanctions to demonstrate that the opposing party is in violation of a court order by clear and convincing evidence. Also, there must be evidence a party willfully refused to comply with a court order or wasn't "reasonably diligent" in carrying out the terms of the order, wrote Judge Joel M. Flaum.

On the issue how much non-compliance is needed to impose civil contempt sanctions, the 7th Circuit concluded the District Court didn't abuse its discretion by ruling the plaintiffs hadn't produced clear and convincing evidence of the state's violation of the court order. Due to the inconclusive nature by the parties as to what makes a "complete" medical history, the District Court couldn't make any factual findings about whether or not they were incompliance with the consent decree. In addition, the plaintiffs cited caselaw outside the civil contempt context by using cases seeking injunctive or equitable relief. Based on the lack of evidence, sanctions aren't warranted, Judge Flaum wrote.

Finally, on the issue of whether the District Court erred by not interpreting "complete medical history" as always requiring copies of a treating physician's records, Judge Flaum wrote, "Based on this record we are not prepared to hold categorically that an agency can never use a summary form when developing that record or that the absence of any document from a physician within the last twelve months, whatever its relevance, is a violation of the regulations."

The 7th Circuit's ruling doesn't foreclose all future claims on this issue from the plaintiffs, and the District Court did indicate it would be willing to hear future claims with a greater fact-finding on the meaning of "complete medical history," he wrote.

ADVERTISEMENT

Post a comment to this story

COMMENTS POLICY
We reserve the right to remove any post that we feel is obscene, profane, vulgar, racist, sexually explicit, abusive, or hateful.
 
You are legally responsible for what you post and your anonymity is not guaranteed.
 
Posts that insult, defame, threaten, harass or abuse other readers or people mentioned in Indiana Lawyer editorial content are also subject to removal. Please respect the privacy of individuals and refrain from posting personal information.
 
No solicitations, spamming or advertisements are allowed. Readers may post links to other informational websites that are relevant to the topic at hand, but please do not link to objectionable material.
 
We may remove messages that are unrelated to the topic, encourage illegal activity, use all capital letters or are unreadable.
 

Messages that are flagged by readers as objectionable will be reviewed and may or may not be removed. Please do not flag a post simply because you disagree with it.

Sponsored by
ADVERTISEMENT
Subscribe to Indiana Lawyer
  1. File under the Sociology of Hoosier Discipline ... “We will be answering the complaint in due course and defending against the commission’s allegations,” said Indianapolis attorney Don Lundberg, who’s representing Hudson in her disciplinary case. FOR THOSE WHO DO NOT KNOW ... Lundberg ran the statist attorney disciplinary machinery in Indy for decades, and is now the "go to guy" for those who can afford him .... the ultimate insider for the well-to-do and/or connected who find themselves in the crosshairs. It would appear that this former prosecutor knows how the game is played in Circle City ... and is sacrificing accordingly. See more on that here ... http://www.theindianalawyer.com/supreme-court-reprimands-attorney-for-falsifying-hours-worked/PARAMS/article/43757 Legal sociologists could have a field day here ... I wonder why such things are never studied? Is a sacrifice to the well connected former regulators a de facto bribe? Such questions, if probed, could bring about a more just world, a more equal playing field, less Stalinist governance. All of the things that our preambles tell us to value could be advanced if only sunshine reached into such dark worlds. As a great jurist once wrote: "Publicity is justly commended as a remedy for social and industrial diseases. Sunlight is said to be the best of disinfectants; electric light the most efficient policeman." Other People's Money—and How Bankers Use It (1914). Ah, but I am certifiable, according to the Indiana authorities, according to the ISC it can be read, for believing such trite things and for advancing such unwanted thoughts. As a great albeit fictional and broken resistance leaders once wrote: "I am the dead." Winston Smith Let us all be dead to the idea of maintaining a patently unjust legal order.

  2. The Department of Education still has over $100 million of ITT Education Services money in the form of $100+ million Letters of Credit. That money was supposed to be used by The DOE to help students. The DOE did nothing to help students. The DOE essentially stole the money from ITT Tech and still has the money. The trustee should be going after the DOE to get the money back for people who are owed that money, including shareholders.

  3. Do you know who the sponsor of the last-minute amendment was?

  4. Law firms of over 50 don't deliver good value, thats what this survey really tells you. Anybody that has seen what they bill for compared to what they deliver knows that already, however.

  5. As one of the many consumers affected by this breach, I found my bank data had been lifted and used to buy over $200 of various merchandise in New York. I did a pretty good job of tracing the purchases to stores around a college campus just from the info on my bank statement. Hm. Mr. Hill, I would like my $200 back! It doesn't belong to the state, in my opinion. Give it back to the consumers affected. I had to freeze my credit and take out data protection, order a new debit card and wait until it arrived. I deserve something for my trouble!

ADVERTISEMENT