Justia Texas Supreme Court Opinion Summaries

After experiencing ongoing struggles with gender identity, a young adult sought a double mastectomy and was informed by the surgical clinic that a letter from a mental health practitioner was required to proceed. The petitioner requested this letter from her therapist, who had previously counseled her on unrelated matters. The therapist provided a letter recommending the surgery on February 22, 2021. Their therapeutic relationship ended on May 14, 2021. The petitioner underwent surgery on June 11, 2021, subsequently suffered medical complications, and later regretted the procedure. In 2023, she filed suit against the therapist and the therapist’s employer, alleging negligence and fraud in the issuance of the recommendation letter, and sought to hold the employer vicariously and directly liable.The case was first adjudicated in a Texas district court, where the respondents sought summary judgment, arguing that the petitioner’s claims were time-barred by the two-year statute of limitations for health care liability claims under Section 74.251(a) of the Texas Civil Practice and Remedies Code. The district court granted summary judgment and severed the claims, making the decision final as to the therapist and her employer. On appeal, the Court of Appeals for the Second District of Texas affirmed, holding that the statute of limitations began to run on the date the recommendation letter was provided.The Supreme Court of Texas reviewed the case and concluded that the lower courts erred in their interpretation of the statute of limitations. The Court held that, under Section 74.251(a), a claim is timely if filed within two years of the completion of the relevant health care treatment or the occurrence of the tort. Here, treatment concluded on May 14, 2021, and the alleged injury occurred on June 11, 2021, when the surgery was performed. Because the petitioner gave notice of her claims within two years of these events, her suit was not time-barred. The judgment of the court of appeals was reversed and remanded for further proceedings. View "ALDACO v. WOOD" on Justia Law

A laboratory testing services company, which participates in the Texas Medicaid program, was accused by the State and a private qui tam relator of violating Texas administrative regulations. The State alleged that the company failed to offer Medicaid the same pricing and discounts it provided to other payors, and that it made false statements, misrepresentations, and omissions about its compliance with those regulations. The State sought civil penalties under Texas’s Health Care Program Fraud Prevention Act for conduct going back more than twenty years.After a private party initiated a qui tam action in 2013, the Office of the Attorney General conducted a lengthy investigation, during which the company provided detailed disclosures about its billing practices and its interpretation of the relevant regulations. Despite this, the State continued to pay the company’s Medicaid claims without objection for seven years. In 2021, the State intervened, alleging that the company’s conduct resulted in overpayments by Medicaid.The trial court granted summary judgment for the company, holding that the State failed to prove that the alleged false statements, misrepresentations, or omissions were material to its payment decisions. The Court of Appeals for the First District of Texas reversed, holding that materiality was not required for omissions under the Act, and that fact issues remained regarding materiality.The Supreme Court of Texas reviewed the case. It held that the Act requires a showing of materiality for omissions as well as for false statements or misrepresentations. The court found no materiality in this record, given the State’s knowledge of and acquiescence to the company’s practices for years. The Supreme Court of Texas reversed the judgment of the court of appeals and reinstated the trial court’s judgment in favor of the company. View "LABORATORY CORPORATION OF AMERICA HOLDINGS v. THE STATE OF TEXAS" on Justia Law

A dentist who worked for a group of dental practices in Texas discovered what he alleged to be a scheme of fraudulent dental procedures billed to the Texas Medicaid program. After being promoted to a leadership role in 2019, he claimed to have uncovered practices where dentists were pressured to perform unnecessary fillings and bill them under specific ADA codes. The dentist filed a qui tam action under the Texas Health Care Program Fraud Prevention Act in 2021, naming the dental group, its management company, and related entities as defendants. The alleged scheme involved hiring dentists burdened by student debt and compensating them in ways that encouraged compliance with these practices.Previously, another employee had filed a similar qui tam action in Travis County in 2012, alleging a broader fraudulent scheme by the same dental group, including unnecessary procedures and improper billing. That action also involved a third-party payment processor and resulted in a large settlement with the State in 2019. The earlier action was still pending on appeal. After the dentist who filed the 2021 action died, the defendants moved to dismiss, arguing that the claim was extinguished by his death and barred by the earlier pending action, the public disclosure of fraud allegations, and the doctrine of dominant jurisdiction. The trial court denied all these motions, including substituting the deceased relator’s widow as representative, and the defendants sought mandamus relief in the Court of Appeals for the Fifteenth District of Texas, which denied their petition.The Supreme Court of Texas reviewed the petition for writ of mandamus. It held that qui tam claims under the Act survive the relator’s death because they belong to the State, not the individual relator. The Court also found that the defendants had not conclusively shown the later suit was based on the same facts as the earlier action, nor that public disclosure barred the claims. Finally, dominant jurisdiction did not require abatement. The Court denied the petition. View "IN RE TAFEL" on Justia Law

A group of businesses and consumers involved in the sale and manufacture of consumable hemp products containing manufactured delta-8 THC challenged actions taken by the Texas Department of State Health Services and its commissioner. Following federal and state legislative changes in 2018 and 2019 that removed “hemp” and certain tetrahydrocannabinols (THC) in hemp from the definition of controlled substances, the Texas commissioner objected to a federal rule that would have further decontrolled hemp-derived extracts, including delta-8 THC. The commissioner then amended the state schedules to clarify that manufactured delta-8 THC remained a Schedule I controlled substance, leading to substantial business disruption for the vendors who had entered the delta-8 market.The vendors sued in district court, arguing that the commissioner exceeded her authority both procedurally and substantively under Texas law by modifying the schedules in a way that contradicted the Texas Farm Bill, and that the Department’s website statement about delta-8 THC was an invalid rule under the Texas Administrative Procedure Act (APA). The trial court denied the Department’s plea to the jurisdiction (challenging standing and sovereign immunity) and issued a temporary injunction against enforcement of the amended schedules and the website statement. The Court of Appeals for the Third District of Texas affirmed, concluding that the vendors had standing, the claims were justiciable, and a temporary injunction was appropriate.The Supreme Court of Texas held that the vendors had standing and their claims were ripe for review. However, it concluded that the commissioner acted within her broad statutory discretion and followed proper procedures under Health & Safety Code § 481.034(g) in objecting to the federal rule and amending the schedules. The court also held that the website statement was not an APA “rule.” Accordingly, it reversed the injunction and rendered judgment for the Department, with the only affirmed portion being the finding of standing. View "TEXAS DEPARTMENT OF STATE HEALTH SERVICES v. SKY MARKETING CORP." on Justia Law

The Supreme Court of Texas reviewed a case involving a new law that prohibits certain medical treatments for children if administered for the purpose of transitioning a child's biological sex or affirming the child's perception of their sex if it is inconsistent with their biological sex. Several parents of children with gender dysphoria, along with physicians and groups that would be affected by the law, sued to enjoin its enforcement, alleging that it is facially unconstitutional. The trial court concluded that the law likely violates the Texas Constitution and temporarily enjoined the law's enforcement.The Supreme Court of Texas disagreed with the trial court's decision. The court held that the plaintiffs failed to establish a probable right to relief on their claims that the prohibition of certain treatments for children suffering from gender dysphoria violates the Texas Constitution. The court emphasized that while parents have a fundamental interest in directing the care, custody, and control of their children, this interest is not absolute. The court concluded that the Legislature made a permissible, rational policy choice to limit the types of available medical procedures for children, particularly in light of the relative nascency of both gender dysphoria and its various modes of treatment. The court also concluded that the law does not unconstitutionally deprive parents of their rights or physicians or health care providers of an alleged property right in their medical licenses or claimed right to occupational freedom. The court further concluded that the law does not unconstitutionally deny or abridge equality under the law because of sex or any other characteristic asserted by plaintiffs. The court therefore reversed and vacated the trial court's order. View "STATE OF TEXAS v. LOE" on Justia Law

This case involves a dispute over the interpretation of a statute that regulates healthcare providers participating in the federal Medicaid program. The State of Texas, acting through the Attorney General, sought to enforce a statute that imposes penalties on a provider who submits a claim for payment and knowingly fails to indicate the type of professional license and the identification number of the person who actually provided the service. The defendant, a dentist, argued that the statute only applies if a claim fails to indicate both the license type and the identification number of the actual provider.Previously, the trial court granted the State's motion for partial summary judgment and denied the defendant's motion. The court rendered a final judgment awarding the State more than $16,500,000. The defendant appealed, and the court of appeals affirmed the trial court's judgment, except for the amount of attorney’s fees and expenses.The Supreme Court of Texas reversed the lower courts' decisions. The court agreed with the defendant's interpretation of the statute. The court held that the statute applies only if a claim fails to indicate both the license type and the identification number of the actual provider. The court found that the 1,842 claims at issue did indicate the actual providers’ license type, so they did not constitute an unlawful act under the statute. The court rendered judgment in the dentist’s favor. View "MALOUF v. THE STATE OF TEXAS EX RELS. ELLIS AND CASTILLO" on Justia Law

The case involves Image API, LLC, a company that provided services to the Texas Health and Human Services Commission (HHSC) from 2009 to 2015. Image's job was to manage a processing center for incoming mail related to Medicaid and other benefits programs. The agreement between the parties stated that HHSC would compensate Image using its “retrospective cost settlement model”. In 2016, HHSC notified Image that an independent external firm would conduct an audit of Image’s performance and billing for the years 2010 and 2011. The audit concluded that HHSC had overpaid Image approximately $440,000 in costs relating to bonuses, holiday pay, overtime, and other unauthorized labor expenses. HHSC then sought to recoup the overpayments by deducting from payments on Image’s invoices.The trial court granted HHSC’s motion for summary judgment and signed a final judgment for the commissioner. The court of appeals reversed the trial court’s judgment and dismissed Image’s entire suit for want of jurisdiction. Image sought review.The Supreme Court of Texas held that Image is a Medicaid contractor under Section 32.0705(a), and that the deadline in Section 32.0705(d) for auditing HHSC’s Medicaid contractors is mandatory. However, the court ruled that HHSC’s failure to meet the deadline does not preclude it from using the result of the audit or pursuing recoupment of overcharges found in the audit. The court affirmed the part of the court of appeals’ judgment dismissing Image’s claims arising from the 2016 audit for lack of jurisdiction, reversed the part of the judgment dismissing the remainder of Image’s suit, and remanded to the trial court for further proceedings. View "IMAGE API, LLC v. YOUNG" on Justia Law

The Supreme Court of Texas reviewed a case involving the State of Texas, Ken Paxton in his official capacity as Attorney General of Texas, the Texas Medical Board, and Stephen Brint Carlton in his official capacity as Executive Director of the Texas Medical Board (collectively, the State) against a group of women and physicians. The plaintiffs challenged the constitutionality of Texas's abortion laws, specifically the Human Life Protection Act, which generally prohibits performing an abortion except when a pregnant woman has a life-threatening physical condition that poses a risk of death or serious physical impairment unless an abortion is performed.The case reached the Supreme Court of Texas as a direct appeal from a temporary injunction issued by the 353rd District Court, Travis County, Texas, which halted the enforcement of Texas's abortion laws in various circumstances. The State contested the injunction, arguing that the plaintiffs lacked standing, the State had sovereign immunity, and the current Texas law permitting life-saving abortion was not more limiting than the Texas Constitution permits.The Supreme Court of Texas held that one of the plaintiffs, Dr. Damla Karsan, had standing to challenge the Attorney General’s enforcement of the Human Life Protection Act against her. The court also concluded that the Declaratory Judgments Act waives the State’s immunity for a claim that a statute violates the state constitution. The court further clarified that under the Human Life Protection Act, a woman with a life-threatening physical condition and her physician have the legal authority to proceed with an abortion to save the woman’s life or major bodily function, in the exercise of reasonable medical judgment and with the woman’s informed consent. The court concluded that Dr. Karsan had not demonstrated that the part of the Human Life Protection Act that permits life-saving abortion is narrower than the Texas Constitution allows. As a result, the court vacated the lower court's injunction order. View "State v. Zurawski" on Justia Law

The case revolves around the interpretation of the term "home" in the context of Medicaid eligibility. The applicants, Clyde and Dorothy Burt, sold their house to their daughter and son-in-law, Linda and Robby Wallace, and moved into a rental property owned by the Wallaces. Later, they moved into a skilled-nursing facility. After moving into the facility, the Burts used their cash assets to buy an undivided one-half interest in the house they had previously sold to the Wallaces. They then executed a Lady Bird deed in favor of the Wallaces, granting their newly acquired one-half interest back to the Wallaces, reserving an enhanced life estate. The Burts then applied for Medicaid assistance, but the Texas Health and Human Services Commission denied their claim, arguing that the property interest was not excluded from the calculation of resources for Medicaid eligibility.The trial court reversed the agency’s determination, and the court of appeals affirmed the trial court's decision. The court of appeals held that a property interest created after admission to a skilled-nursing facility can be excluded from the resources used to determine Medicaid eligibility if the applicant states an intent to live at the property in the future.The Supreme Court of Texas disagreed with the lower courts' interpretation. The court held that a “home” is the applicant’s principal place of residence before the claim for Medicaid assistance arises, coupled with the intent to reside there in the future. A property interest purchased with qualifying resources after the applicant moves to a skilled-nursing facility is an available resource for determining Medicaid eligibility under federal eligibility rules, as the property was not the applicant’s principal place of residence at the time the claim for benefits arose. The court reversed the judgment of the court of appeals and rendered judgment in favor of the Commission. View "TEXAS HEALTH AND HUMAN SERVICES COMMISSION v. ESTATE OF CLYDE L. BURT" on Justia Law

The case in question was heard by the Supreme Court of Texas and revolved around the interpretation of the term "psychiatrist" as it applies to the involuntary civil commitment of individuals exhibiting signs of mental illness. The case involved a 34-year-old man, A.R.C., who had exhibited psychotic symptoms and delusional behavior. Two second-year psychiatry residents completed the required "certificates of medical examination for mental illness," as outlined in Tex. Health & Safety Code § 574.009(a). However, a question arose as to whether these residents could be considered psychiatrists under the statute.The Supreme Court of Texas ruled that these residents were indeed psychiatrists, reversing the lower court's judgment. The court determined that the residents, who were licensed under a physician-in-training program and were engaged in specialized psychiatric training, fell within the definition of a physician specializing in psychiatry. The court rejected the argument that only board-certified psychiatrists qualify under the statute, stating that physicians who specialize in psychiatry qualify as psychiatrists under § 574.009(a).The court emphasized that it is the judge, not the physician, who ultimately decides whether involuntary commitment is necessary or lawful. The court also noted that the legislature has the power to amend the qualifications for psychiatrists and other physicians as it sees fit, provided it adheres to the constitutional requirement of competent medical or psychiatric testimony.The Supreme Court of Texas remanded the case to the court of appeals for consideration of A.R.C.'s remaining challenges. View "IN RE A.R.C." on Justia Law