Articles Posted in Public Benefits

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Here the Supreme Court answered a question of Utah law certified to it by the U.S. district court. The question was, "Is a signed agreement to donate preserved sperm to the donor's wife in the event of his death sufficient to constitute 'consent in a record' to being the 'parent' of a child conceived by artificial means after the donor's death under Utah intestacy law?" In this case, after she gave birth, the wife of the donor applied for social security benefits based on the donor's earnings. The Social Security Administration denied the benefits, finding that the wife had not shown the child was the donor's "child" as defined by the Social Security Act. The wife subsequently filed a petition for adjudication of paternity, and the district court adjudicated the donor to be the father of the child. On appeal, the U.S. district court certified the state law question to the Supreme Court. The Court held that an agreement leaving preserved frozen semen to the deceased donor's wife does not, without more, confer on the donor the status of a parent for purposes of social security benefits. View "Burns v. Astrue" on Justia Law

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The State appealed the dismissal of its complaint against seventeen pharmaceutical companies, which the State alleged defrauded Utah's Medicaid program by reporting inflated drug prices. In its complaint, the State pursued two causes of action, violation of the Utah False Claims Act (UFCA) and fraudulent misrepresentation. The district court dismissed the claims based on three alternative grounds. The Supreme Court reversed in part and affirmed in part, holding (1) although the State's complaint was insufficiently particular under the appropriate Utah R. Civ. P. 9(b) standard for claims alleging a widespread scheme to commit fraud and submit false claims, it was in the interest of justice to grant the State leave to amend its complaint under the new standard; (2) the district court erred in dismissing the State's claims under Utah R. Civ. P. 12(b)(6) because the State alleged all the elements of its causes of action; and (3) the district court properly applied the one-year statute of limitations to the State's UFCA cause of action and its dismissal of those claims alleged to have arises before April 30, 2006. Remanded. View "State v. Apotex Corp." on Justia Law

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Plaintiff's son, Hayden, was involved in a near-drowning accident in which he suffered severe permanent injuries. Plaintiff subsequently sought coverage for the cost of his treatment from Wasatch Crest Mutual Insurance, under which Hayden was insured. Wasatch Crest was later declared insolvent, and Plaintiff filed a claim against the Wasatch Crest estate. The liquidator of the estate denied Plaintiff's claim, concluding that Wasatch Crest had properly terminated coverage under the language of the plan. The Supreme Court reversed, interpreting the plan in favor of coverage. Plaintiff resubmitted her claim for medical expenses to the liquidator for payment under the Utah Insurers Rehabilitation and Liquidation Act. One year later, Plaintiff filed a motion for summary judgment with the district court. The liquidator subsequently issued a second amended notice of determination denying Plaintiff's claim on the merits. The district court then denied Plaintiff's motion for summary judgment, as Plaintiff had not yet challenged the second amended notice of determination and could do so under the Liquidation Act. Plaintiff appealed the district court's order. The Supreme Court dismissed the appeal because Plaintiff did not appeal from a final judgment and had not satisfied any of the exceptions to the final judgment rule. View "Mellor v. Wasatch Crest Mut. Ins." on Justia Law