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Access over workers' compensation decisions, including En Banc, Significant Panel Decisions, and writ-denied cases.

Case No. 03-12-00293-CV
Regular Panel Decision
Jul 12, 2013

Southwest Pharmacy Solutions, Inc. D/B/A American Pharmacies v. Texas Health and Human Services Commission and Thomas Suehs, Solely in His Official Capacity as Executive Commissioner of the Texas Health and Human Services Commission

Southwest Pharmacy Solutions, Inc. d/b/a American Pharmacies appealed a trial court's judgment granting a plea to the jurisdiction filed by the Texas Health and Human Services Commission (HHSC) and its Executive Commissioner. American Pharmacies challenged HHSC's rulemaking obligations and specific rules related to pharmacy benefits under the Texas Medicaid managed care (MMC) program. They argued that HHSC failed to regulate reimbursement rates for pharmacies and did not comply with statutory requirements for analyzing the economic impact on small businesses. The appellate court affirmed the trial court's judgment, concluding that HHSC was not obligated to set reimbursement rates under the MMC model and had substantially complied with the relevant government code regarding small business impact. The court also determined that American Pharmacies lacked a justiciable interest as their economic losses stemmed from legislative changes rather than the challenged rules.

Medicaid Managed CarePharmacy BenefitsReimbursement RatesAdministrative Procedure ActDeclaratory JudgmentPlea to the JurisdictionUltra ViresStatutory ConstructionSmall Business ImpactTexas Court of Appeals
References
37
Case No. 03-15-00348-CV
Regular Panel Decision

Todd Enright v. Asclepius Panacea, LLC Asclepius Panacea GP, LLC Daily Pharmacy, LLC Daily Pharmacy GP, LLC And Toth Enterprises II, P .A. D/B/A Victory Medical Center

Todd Enright appealed a district court's denial of his special appearance in a case brought by Asclepius Panacea, LLC et al. (VMC). The dispute originated from VMC's equity purchase of Texas pharmacies from QVL. Enright, acting for QVL, allegedly made fraudulent misrepresentations during negotiations concerning drug inventory and handling of insurance receipts. Post-acquisition, Enright reportedly controlled QVL's finances, directing payments and wrongfully withholding VMC's funds. VMC's claims against Enright include common law fraud, Texas Securities Act violations, tortious interference, conversion, money had and received, and a request for an accounting, asserting his actions establish sufficient minimum contacts with Texas for personal jurisdiction.

Personal JurisdictionFraudTexas Securities ActTortious InterferenceConversionEquitable AccountingSpecial AppearanceMinimum ContactsFiduciary Shield DoctrineAppellate Procedure
References
34
Case No. MISSING
Regular Panel Decision

Innoviant Pharmacy, Inc. v. Morganstern

Innoviant Pharmacy, Inc. sued its former sales executive, Max Morganstern, for unfair competition and breach of a non-compete agreement after he joined a competitor, Summit Pharmacy, Inc., and solicited Innoviant's customer referral sources. Innoviant sought a preliminary injunction to prevent Morganstern from contacting 114 key New York referral sources. The court found Innoviant unlikely to succeed on its breach of contract claim because the employment agreement was deemed unenforceable due to a later signed document. However, the court found Innoviant likely to succeed on its unfair competition claim, as Morganstern misappropriated a list of potential referral sources and business cards. Consequently, the court granted the preliminary injunction, restraining Morganstern from contacting the specified referral sources until February 24, 2006, conditioned on Innoviant posting a $100,000 security bond.

Preliminary InjunctionUnfair CompetitionBreach of ContractNon-compete ClauseTrade SecretsCustomer ListsConfidential InformationEmployment AgreementSales ExecutiveReferral Sources
References
50
Case No. 2021 NY Slip Op 03820 [195 AD3d 776]
Regular Panel Decision
Jun 16, 2021

21st Century Pharmacy v. American Intl. Group

21st Century Pharmacy appealed a Supreme Court order that dismissed its declaratory judgment action against American International Group (AIG) and the New York Workers' Compensation Board (WCB). The pharmacy sought a declaration that it could pursue payment for prescription bills in a plenary court proceeding, rather than solely through the WCB, and also sought a monetary judgment. The Supreme Court dismissed the complaint, asserting the WCB had exclusive subject matter jurisdiction. The Appellate Division, Second Department, reversed this decision, clarifying that while the WCB holds primary jurisdiction over Workers' Compensation Law applicability, it does not possess exclusive jurisdiction in a declaratory judgment action. The case was remitted to the Supreme Court for a determination on the merits of AIG's motion to dismiss.

Declaratory JudgmentSubject Matter JurisdictionWorkers' Compensation LawPrimary JurisdictionExclusive JurisdictionPrescription BillsAppellate ProcedureRemittalPharmacy RightsCourt Jurisdiction
References
8
Case No. MISSING
Regular Panel Decision

Rivera v. Ndola Pharmacy Corp.

Plaintiff Siew Lian Rivera brought an action alleging violations of the Fair Labor Standards Act (FLSA), New York Labor Law, Human Rights Law, Administrative Code, and common law claims against Ndola Pharmacy Corp. and several individuals. Defendants moved for partial summary judgment on the FLSA and Labor Law claims and to dismiss state law claims for lack of subject matter jurisdiction. The court denied partial summary judgment, finding Rivera's testimony sufficient for overtime claims despite credibility questions. Supplemental jurisdiction was retained for the sexual harassment claim against N. Patel due to its connection to wage allegations, but other state law claims were dismissed without prejudice for lacking a common nucleus of operative fact with the federal claim. Additionally, certain motions related to amending the answer regarding the plaintiff's standing due to bankruptcy were granted in part and denied in part.

FLSAOvertime CompensationWage ClaimsSexual HarassmentHostile Work EnvironmentSummary JudgmentSupplemental JurisdictionBankruptcy EstateCredibility of WitnessEmployment Law
References
46
Case No. MISSING
Regular Panel Decision

Lamarr-Arruz v. CVS Pharmacy, Inc.

This case involves claims of a hostile work environment and retaliation brought by Zaire Lamarr-Arruz and Mominna Ansoralli against CVS Pharmacy, Inc. Plaintiffs allege racial profiling of customers and a barrage of racial slurs by supervisors and managers, violating 42 U.S.C. §1981, NYSHRL, and NYCHRL. Lamarr-Arruz also filed a retaliation claim, alleging delayed return from medical leave and termination due to his complaints. CVS sought summary judgment, denying the allegations and arguing the lack of supervisory responsibility for some alleged harassers and the availability of their anti-harassment policy. The court denied CVS's motions for summary judgment, finding genuine disputes of material fact regarding the existence of a hostile work environment for Ansoralli, the imputation of hostile conduct to CVS, and Lamarr-Arruz's retaliation claim, including the pretextual nature of his termination reasons.

Hostile Work EnvironmentRacial DiscriminationRetaliationSummary JudgmentEmployment LawCivil Rights Act of 1991New York Human Rights LawNew York City Human Rights LawEmployer LiabilitySupervisory Liability
References
60
Case No. MISSING
Regular Panel Decision

Southwest Pharmacy Solutions, Inc. v. Texas Health & Human Services Commission

American Pharmacies appealed a trial court's judgment that granted a plea to the jurisdiction to the Texas Health and Human Services Commission (HHSC) and Thomas Suehs, Executive Commissioner of HHSC, and denied American Pharmacies' requests for declaratory and injunctive relief. American Pharmacies challenged HHSC's rulemaking obligations and certain rules related to pharmacy benefits under Texas’s Medicaid managed care (MMC) program. Specifically, they argued that HHSC failed to regulate reimbursement rates and comply with small business impact analysis requirements. The appellate court affirmed the trial court's judgment, concluding that HHSC was not obligated to regulate pharmacy reimbursement rates under MMC and had substantially complied with the government code regarding economic impact analysis. The court also found that American Pharmacies failed to assert a justiciable interest.

Medicaid Managed CarePharmacy BenefitsRulemaking AuthorityPlea to JurisdictionDeclaratory ReliefInjunctive ReliefEconomic Impact AnalysisSmall Business ImpactUltra ViresStatutory Interpretation
References
121
Case No. KP-0480
Regular Panel Decision
Feb 05, 2025

Untitled Texas Attorney General Opinion: KP-0480

Enacted by House Bill 1763 and House Bill 1919, subchapter M and subchapter L of chapter 1369 of the Texas Insurance Code regulate certain contracts with pharmacists and pharmacies and certain referral and solicitation practices concerning affiliated providers. Under United States Supreme Court precedent, neither subchapter has an impermissible connection with ERISA plans as they do not dictate plan choices or add requirements to beneficiary status. The two subchapters also do not refer to ERISA plans as they neither exclusively apply to those plans nor are ERISA plans essential to the laws’ operation. Therefore, a court would likely conclude that ERISA does not preempt either subchapter. In addition, nothing in the language of either subchapter limits their applicability to plans domiciled in Texas. Thus, a court would likely conclude that both subchapters are enforceable against an issuer or PBM that satisfy the statutory definitions and administer a plan covering Texas residents or contracting with Texas pharmacy providers regardless of where the plan is domiciled.

ERISA PreemptionTexas Insurance CodePharmacy Benefit Managers (PBMs)Health Benefit PlansState Law EnforceabilityHouse Bill 1763House Bill 1919Regulatory CompliancePharmacy Reimbursement RatesReferral Practices
References
20
Case No. 03-12-00560-CV
Regular Panel Decision
Oct 31, 2014

the Texas State Board of Pharmacy, and in Their Official Capacities Only, Gay Dodson, Executive Director And Jeanne D. Waggener, President of the Board v. Tiana Jean Witcher

The Texas State Board of Pharmacy indefinitely suspended Tiana Jean Witcher's pharmacist license, citing a reciprocal suspension in North Carolina due to non-compliance with a recovery program. Witcher challenged this, arguing the suspension was arbitrary and based on an invalid unwritten "reciprocal-sanctions policy." The trial court reversed the Board's decision, and the appellate court affirmed, ruling that the Board's policy was an improperly promulgated "rule" under the Administrative Procedure Act. The appellate court emphasized that such ad hoc rulemaking is a narrow exception not applicable here, thus rendering the Board's indefinite suspension invalid and remanding the case for reconsideration of an appropriate sanction.

Pharmacist License SuspensionAdministrative LawJudicial ReviewReciprocal Sanctions PolicyAd Hoc RulemakingTexas State Board of PharmacyAdministrative Procedure ActDue ProcessAbuse of DiscretionProfessional Regulation
References
34
Case No. 2017-06-0526
Regular Panel Decision
Nov 27, 2017

Edwards, Glenda v. Fred's Pharmacy

Glenda Edwards sought medical and temporary disability benefits for a psychological injury she alleged resulted from a work-related shoplifting incident at Fred's Pharmacy. Fred's Pharmacy initially denied benefits, arguing the psychological injury did not arise from the incident and that Ms. Edwards had pre-existing conditions. The Court found Ms. Edwards likely to prevail, concluding that the shoplifting incident, where she was assaulted, exacerbated her pre-existing mental health conditions and qualified as a compensable injury. Due to the employer's failure to provide a panel of physicians, the Court appointed Dr. Oleksandr Osipchuk as the authorized treating physician. Consequently, Fred's Pharmacy was ordered to provide continuing medical treatment and accrued temporary total disability benefits for a specific period.

Workers' CompensationPsychological InjuryPTSDShoplifting IncidentExacerbation of Pre-existing ConditionTemporary Disability BenefitsMedical BenefitsUnauthorized PhysicianPanel of PhysiciansTennessee
References
6
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