Carl Bernard Rubin

The case involved the University of Cincinnati Hospital's challenge to the Provider Reimbursement Review Board's (PRRB) denial of jurisdiction over its appeal from a Medicare fiscal intermediary's refusal to reopen cost reports for fiscal years 1986 through 1988. The hospital sought adjustments to its indirect medical education (IME) payments following revisions to its graduate medical education (GME) reimbursements under the Medicare program. The court granted summary judgment to the Secretary of Health and Human Services, holding that the PRRB lacked authority to review the intermediary's denial of reopening. The core reasoning was that 42 C.F.R. § 405.1885(c) assigns exclusive jurisdiction over reopenings to the intermediary that made the last determination, and the hospital's appeal was untimely with respect to the initial notices of program reimbursement.

healthcareprocedurefederal power

In Evans v. Jay Instrument and Specialty Co., an African-American female employee sued her employer for race and gender discrimination under Title VII after receiving a poor performance review, a one-day suspension, and eventual termination, also alleging retaliation for filing an EEOC charge and contacting the NAACP. The defendant moved for summary judgment, asserting that the discharge stemmed from documented performance errors, data deletion incidents, and attitude issues rather than discrimination or retaliation. The court granted the motion and dismissed the case with prejudice, finding that the plaintiff established a prima facie case of discrimination and retaliation but failed to demonstrate that the employer's legitimate, non-discriminatory explanations were pretextual. The ruling relied on evidence of similar terminations of Caucasian employees for performance problems and the absence of proof linking the adverse actions to protected characteristics or activity.

civil rightslabor & employment

The case involved owners of a commercial lounge suing various police officers and county officials in their official capacities under 42 U.S.C. § 1983, alleging that execution of a court-issued temporary restraining order closing the business due to alleged drug activity constituted unreasonable search and seizure and due process violations, along with related state-law tort claims. The court granted the defendants' motions for summary judgment and denied the plaintiffs' partial motion, ruling that quasi-judicial immunity protected the defendants because they acted solely pursuant to the TRO without any additional conduct. The federal claims were dismissed on that basis, and the pendent state claims were dismissed without reaching the merits under established Sixth Circuit precedent. The decision turned on the plaintiffs having sued only in official capacities and the doctrine shielding those carrying out judicial orders.

civil rightscriminal lawprocedure

United Magazine Company sued Prudential entities alleging breach of contract on an Agreement in Principle and Stock Purchase Agreement, promissory estoppel regarding proposed debt and equity financing, and tortious interference after the defendants withdrew from financing for magazine distribution acquisitions. The district court granted the defendants' motion for summary judgment in part, dismissing the tortious interference claim and request for punitive damages for lack of sufficient evidence, but denied summary judgment on the breach of contract and promissory estoppel claims. The core reasoning was that the agreements contained express non-binding language, conditions precedent such as board approvals and due diligence, and open terms that raised factual questions about intent to be bound and reasonable reliance, precluding dismissal as a matter of law.

business & regulatorytorts & liability

The case involved a landlord suing a housing advocacy organization, related entities, and several individuals for allegedly conspiring to damage his reputation by making false accusations of sexual harassment against him in connection with his rental properties. The plaintiff asserted federal claims under RICO and 42 U.S.C. § 1983, as well as a state-law malicious prosecution claim. The district court granted summary judgment to one defendant and dismissed the § 1983 claim entirely, along with portions of the RICO and malicious prosecution claims, because the pleadings failed to adequately allege required elements such as a RICO enterprise or pattern of racketeering activity, state action under § 1983, or all necessary components of the state tort. The court denied dismissal as to the remaining portions of the RICO and malicious prosecution claims, applying the standard that a complaint should not be dismissed unless no set of facts could entitle the plaintiff to relief, and it denied the defendants' sanctions motion without prejudice.

criminal lawcivil rightsproceduretorts & liability

In this case, plaintiff Marlene Misch filed a class action under ERISA against Community Mutual Insurance Co., alleging that the insurer negotiated secret discounts with health care providers, causing policyholders to pay more than their required 20% share of charges, misrepresenting payments on explanation of benefits statements, and improperly calculating lifetime maximums based on undiscounted amounts. The defendant moved to dismiss the complaint for failure to state a claim, arguing that it had followed the policy terms, owed no fiduciary duty regarding plan design, and that the relief sought was unavailable. The court denied the motion, finding that the complaint sufficiently alleged violations of the plan terms and fiduciary duties, and that the plaintiff might be able to prove facts entitling her to recover benefits or obtain injunctive relief. The decision rested on the liberal pleading standards under Rule 12(b)(6), accepting the allegations as true and concluding it was not beyond doubt that the claims lacked merit.

healthcarebusiness & regulatory

In Reich v. Sysco Corp., the Secretary of Labor alleged that Sysco unlawfully retaliated against employee Kevin Willis by terminating him for filing occupational safety complaints with the company and OSHA, in violation of the Occupational Safety and Health Act §11(c). Defendant moved for summary judgment on two grounds: that Willis's prior arbitration of his discharge (resulting in reinstatement without backpay) barred the federal statutory claim, and that no genuine issue of material fact existed regarding retaliation. The court denied the motion, ruling that arbitration of contractual claims under a collective bargaining agreement does not preclude subsequent litigation of independent statutory rights, consistent with precedents such as Alexander v. Gardner-Denver and Marshall v. N.L. Industries. The court further held that stipulated facts about Willis's complaints, OSHA inspections, citations, and termination created a genuine issue of material fact sufficient to defeat summary judgment.

labor & employment

The case involved the University of Cincinnati's challenge to the Health Care Financing Administration's partial denial of its request for an exception to the standard Medicare composite reimbursement rate for outpatient end-stage renal dialysis treatments at University Hospital, based on claims of atypical services and higher costs for nursing, supplies, fringe benefits, non-nursing salaries, and overhead. The plaintiff appealed after the Provider Reimbursement Review Board affirmed aspects of the agency's decision on the effective date, benefit rate calculations using a national average, and denials of certain cost exceptions. The district court reviewed the agency actions under the Administrative Procedure Act (5 U.S.C. § 706) to determine if they were arbitrary, capricious, an abuse of discretion, or unsupported by substantial evidence, focusing on whether the hospital sufficiently documented the attributability of excess costs to atypical patient needs.

healthcarebusiness & regulatoryfederal powerprocedure

This case concerns Bethesda Hospital's appeal of a bankruptcy court ruling discharging Ronald Kessnick's debt for his daughter's medical treatment. Kessnick had signed an assignment of benefits directing insurance payments to the hospital but instead received and spent a $5,725 insurance check on personal expenses like his mortgage. The bankruptcy court found the debt dischargeable under Chapter 7 after determining that the hospital failed to prove by a preponderance of the evidence that Kessnick's actions constituted willful and malicious injury under 11 U.S.C. § 523(a)(6). On appeal, the district court affirmed, holding that the bankruptcy court's findings were not clearly erroneous and that the statutory requirements for non-dischargeability were not met.

procedurehealthcare

This case involved former executives and retirees of Dayton-Walther Corporation who sued the company, its pension committee, plan administrators, and parent entities under ERISA, alleging breaches of fiduciary duties in the management of a pension plan and a salaried retirees' insurance plan; the pension plaintiffs challenged decisions such as trustee selection and plan mergers, while the insurance plaintiffs also sought class certification. The district court, after reviewing the magistrate judge's findings of fact and recommendations de novo, denied the motion for class certification on the insurance plan claims. It also granted the defendants' motions for summary judgment on both the insurance plan and pension plan claims, disposing of the case in favor of the defendants.

labor & employmentprocedure

The case concerned the Knights of the Ku Klux Klan's request for a permit to erect an unattended wooden cross inscribed with 'John 3:16' on Cincinnati's Fountain Square, a traditional public forum, after the city denied the application under Municipal Code Section 713 on grounds that the display constituted fighting words or would incite violence. The court held that the display was constitutionally protected speech under the First Amendment, that Section 713 was facially invalid as a content-based prior restraint, and that the city must issue the permit on the same terms as for other users. The reasoning emphasized that speech in a public forum receives the highest level of scrutiny, the cross did not meet the legal standards for fighting words or incitement under Chaplinsky and Brandenburg, the city had no compelling interest to prohibit it, and the ordinance improperly vested officials with unbridled discretion while lacking procedural safeguards.

free speechcivil rights

This case involved a qui tam action under the False Claims Act brought by a private plaintiff on behalf of the United States against medical imaging companies, their physician owners, and related parties in Ohio and Kentucky. The plaintiff alleged that the defendants violated the Medicare Fraud and Abuse Statute by making referral-based payments to physicians and that these violations rendered the companies' claims for Medicare and Medicaid reimbursement false or fraudulent. The defendants moved to dismiss under Federal Rule of Civil Procedure 12(b)(6), arguing that violations of the Fraud and Abuse Statute do not automatically constitute False Claims Act violations. The court denied the motion, reasoning that the complaint sufficiently alleged facts that, if proven, could show the claims were tainted or constructively false under the False Claims Act, meeting the liberal pleading standard where it is not beyond doubt that the plaintiff could prove a viable claim.

criminal lawhealthcareprocedure

The case concerned Hunter Savings Association's lawsuit against the United States seeking a tax refund after the IRS issued a deficiency notice and assessed penalties related to Hunter's acquisition of the insolvent Home State Savings & Loan and its subsequent sale of certain branches and assets to Star Bank and Ameritrust. Hunter had allocated part of the $20.4 million premium paid to the State of Ohio to adjust the basis in the sold assets, reporting no taxable gain on the transactions, while the IRS contended that the allocation was improper and resulted in underreported income. After a bench trial with findings on the negotiations, contract terms, asset valuations, and closing details, the court concluded that Hunter had relied on substantial authority in its reporting, rendering any substantial underpayment penalty inappropriate.

taxesbusiness & regulatory

In this case, plaintiff Norman Brophy sued his former railroad employer under the Federal Employers' Liability Act (FELA) for hearing loss allegedly caused by prolonged workplace noise exposure. The defendant moved for summary judgment, arguing that a 1987 settlement agreement resolving a prior FELA claim for a locomotive fall barred the new suit due to its broad release language covering unknown or future injuries. The court denied the motion, holding that the release was invalid under 45 U.S.C. § 55 because it went beyond compromising the specific prior claim and instead sought to exempt the employer from all future FELA liability. The decision emphasized that such broad releases for unknown injuries are void even when the employee was represented by counsel, as the statute prohibits devices enabling carriers to evade FELA responsibilities.

labor & employmentproceduretorts & liability

This case involved former employees of Quantum Chemical Corporation's Emery Division who participated in the company's employer-sponsored stock ownership plans and sued individual plan fiduciaries after Quantum sold the division to Henkel Corporation. The plaintiffs claimed that the defendants breached their fiduciary duties under ERISA by failing to promptly transfer, liquidate, or diversify the ESOP assets away from Quantum stock during an 18-month period when the stock value significantly declined, and by not allowing annual diversification elections. The court entered judgment in favor of the remaining defendants, finding that the plan documents required investment in Quantum stock, leaving the fiduciaries without authority to act otherwise, that the decision to transfer assets was a corporate business matter rather than a fiduciary one, and that the plaintiffs failed to show any denial of diversification rights or imprudence by the defendants under the prudent fiduciary standard.

labor & employment

This case concerns appeals from a bankruptcy court's order disallowing claims by groups of potentially responsible parties against debtor Eagle-Picher Industries for contribution to past and future cleanup costs at two CERCLA hazardous waste sites. The district court affirmed the disallowance under Bankruptcy Code § 502(e)(1)(B), finding that the claims were for reimbursement or contribution asserted by entities co-liable with the debtor on the EPA's primary claims and remained contingent at the time of disallowance. The court determined that EPA special notice letters established the necessary co-liability and that the claims depended on uncertain future response costs not yet fixed or paid. The parties had agreed that the claims qualified as reimbursement claims arising under CERCLA contribution rights, leaving only the co-liability and contingency elements in dispute.

environmentbusiness & regulatory

This interpleader action involved an insurance company that deposited $300,000 in policy limits into the court registry after multiple defendants obtained judgments against its insureds for property damage from asbestos-containing materials. The defendants proposed different distribution methods, with some favoring priority based on the chronological order of judgments and others advocating pro rata shares. The court, sitting in equity, ordered the full amount paid to the Rock Hill Defendants based on their August 1989 consent judgment being the earliest. The reasoning centered on equitable principles allowing priority by time of judgment, reinforced by policy language limiting liability after exhaustion by payment of judgments, and rejected both pro rata allocation and special priority for a judgment against the insurer itself.

proceduretorts & liability

The case involved the Knight Riders of the Ku Klux Klan seeking a permit to erect a Christian cross bearing the words 'John 3:16' on Fountain Square in Cincinnati for ten days around Christmas 1993. The city denied the permit under Ordinance No. 354-1993, which prohibited communications on the square that constituted obscenity, defamation, or fighting words. The court granted a preliminary injunction requiring the city to issue the permit. It reasoned that the display did not qualify as fighting words under Supreme Court precedents such as Chaplinsky v. New Hampshire and Texas v. Johnson, and that the First Amendment protects expression of ideas even if they are offensive or disagreeable to others, at least pending a full hearing on the merits.

free speechreligious liberty

This case involves an appeal from a bankruptcy court order in a Chapter 13 proceeding filed by Gerald and Sylvia Johnson. The debtors sought to confirm a plan that would treat Champion Windows' mechanic's lien on their principal residence as an unsecured claim, to the extent the lien exceeded the property's value after accounting for a first mortgage and exemptions, relying on 11 U.S.C. § 506(a). Champion objected, arguing that 11 U.S.C. § 1322(b)(2) prohibits modifying the rights of a creditor whose claim is secured only by a security interest in the debtor's principal residence. The bankruptcy court denied confirmation, finding the lien not subject to modification, and the district court affirmed that ruling. The court held that the Supreme Court's decision in Nobelman v. American Savings Bank prevents bifurcation of such a claim under § 506(a) for purposes of plan confirmation.

business & regulatoryproperty

This case involves former employees of Quantum Chemical Corporation's Emery Division who participated in the company's ERISA-governed 401(k) and ESOP plans and sued after the value of their Quantum stock holdings dropped sharply during an 18-month freeze period following the division's sale to Henkel Corporation but before a trust-to-trust asset transfer. The plaintiffs alleged that various defendants breached fiduciary duties under ERISA by failing to permit distributions, prevent the transfer, monitor the company's finances, allow diversification, or otherwise protect plan assets. On the defendants' motion for summary judgment, the court granted judgment to Quantum and its Board of Directors on the grounds that they were not fiduciaries with respect to the relevant decisions or that their actions were non-fiduciary business decisions, while denying summary judgment to the Plan Committee members and trustees because genuine issues of material fact remained as to whether they had breached duties to prudently manage and protect the plan assets.

labor & employmentbusiness & regulatory