An Update from the NC Supreme Court: Two Cases to Watch

This week the Supreme Court of North Carolina heard arguments in two cases of significance to physicians that the NCMS has been closely watching.

The first case, Abrons Family Practice v. NC DHHS, arose out of the troubled launch of Medicaid’s NCTracks claims system in 2013. The physician-plaintiffs originally brought their suit against the NC Department of Health and Human Services (DHHS) and CSC, the contractor responsible for implementing and managing NCTracks, in Superior Court, and requested relief on a variety of grounds. The primary question for the Supreme Court is whether the physicians should have first sought relief from DHHS or the Office of Administrative Hearings, or whether the extraordinary circumstances involved in this case justified proceeding straight into court. The case has significant implications not only for the parties involved, but also for Medicaid providers who may want to appeal the program’s adjudication of claims in the future. The NCMS joined with the American Medical Association, NC Academy of Family Physicians, NC Hospital Association, and the NC Healthcare Facilities Association in filing a friend-of-the-court brief in support of the physician-plaintiffs.

Another case before the Court is a medical malpractice action, Vaughan v. Mashburn. In this case involving gynecological care, the plaintiff-patient and her attorney failed to properly certify in the Complaint that the medical records and the medical care were reviewed prior to initiating the lawsuit and in accordance with Rule 9(j). Because of the plaintiff’s defective certification, the trial court dismissed the case against Dr. Mashburn. The plaintiff has appealed, arguing that the 9(j) records review still occurred as required, and that she should be allowed to amend her Complaint even though the statute of limitations has since expired. On appeal, the N.C. Court of Appeals agreed with the trial court that dismissal was appropriate based on the defective certification. The plaintiff appealed again, and earlier this year, the Supreme Court agreed to hear the case.

Decisions in both cases are expected in 2018.

 
 

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