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Administrative Law, Civil Procedure, Employment Law, Human Rights Law, Municipal Law, Religion

THE PETITIONER, A NEW YORK CITY FIREFIGHTER, DID NOT DEMONSTRATE THE FIRE DEPARTMENT IMPROPERLY DENIED PETITIONER’S REQUEST FOR A RELIGIOUS EXEMPTION FROM THE COVID VACCINE MANDATE; SUPREME COURT REVERSED (SECOND DEPT). ​

The Second Department, reversing Supreme Court, determined petitioner-firefighter did not demonstrate the NYC Fire Department (FDNY) improperly denied petitioner’s request for a religious exemption from the COVID vaccine mandate:

Pursuant to the NYCHRL [New York City Human Rights Law], it is “an unlawful discriminatory practice” for an employer “to refuse or otherwise fail to engage in a cooperative dialogue within a reasonable time with a person who has requested an accommodation” for, among other possibilities, “religious needs” (Administrative Code § 8-107[28][a][1]). Here, the petitioner failed to demonstrate that the appellants’ process for resolving requests for a reasonable accommodation from the vaccine mandate did not meet the requirements of the NYCHRL regarding cooperative dialogue … . The appellants provided information on the process for reviewing accommodation requests related to the vaccine mandate and informed employees on how to appeal request denials. The record demonstrates that the petitioner availed himself of this process. The record also shows that there were multiple communications between the petitioner, the FDNY, and the [City of New York Reasonable Accommodation Appeals Panel] regarding the petitioner’s accommodation request. The petitioner failed to establish that, under the unique circumstances present at the time of the vaccine mandate, the NYCHRL required a more robust or individualized dialogue.

The petitioner also failed to demonstrate that the determination to deny him a religious exemption from the vaccine mandate was arbitrary and capricious … . Matter of Smith v New York City Fire Dept., 2025 NY Slip Op 03728, Second Dept 6-18-25

Practice Point: Here the petitioner-firefighter had won in Supreme Court and was reinstated with back pay. But the Second Department reversed finding petitioner was not entitled to a religious exemption from the COVID vaccine mandate.

 

June 18, 2025
https://www.newyorkappellatedigest.com/wp-content/uploads/2018/03/NYAppelateLogo-White-1.png 0 0 Bruce Freeman https://www.newyorkappellatedigest.com/wp-content/uploads/2018/03/NYAppelateLogo-White-1.png Bruce Freeman2025-06-18 10:24:542025-06-21 11:10:13THE PETITIONER, A NEW YORK CITY FIREFIGHTER, DID NOT DEMONSTRATE THE FIRE DEPARTMENT IMPROPERLY DENIED PETITIONER’S REQUEST FOR A RELIGIOUS EXEMPTION FROM THE COVID VACCINE MANDATE; SUPREME COURT REVERSED (SECOND DEPT). ​
Administrative Law, Judges, Municipal Law, Town Law, Zoning

HERE PLAINTIFF’S PROPOSED CONSTRUCTION OF APARTMENTS WAS PROHIBITED BY A LOCAL LAW; PLAINTIFF ALLEGED THE BIAS OF THE CHAIRPERSON OF THE PLANNING BOARD INFECTED THE PLANNING BOARD’S RECOMMENDATION TO THE TOWN BOARD (WHICH ENACTED THE LAW); THOSE ALLEGATIONS RAISED A QUESTION OF FACT PRECLUDING SUMMARY JUDGMENT FINDING THE LOCAL LAW VALID (THIRD DEPT).

The Third Department, reversing Supreme Court, in a full-fledged opinion by Judge Garry, determined questions of fact precluded summary judgment in favor of the town in this dispute over the approval of the construction of apartments. Plaintiffs alleged that the chairperson of the planning board, who owned adjacent property, was biased against the proposed construction and his bias infected the planning board’s recommendation:

As Supreme Court correctly noted, the enactment that plaintiffs seek to invalidate in this action was a product of the Town Board, not the Planning Board … . We further note that it is expressly within the power of the Planning Board to submit advisory opinions to the Town Board for proposed amendment to the zoning law … . For these reasons, it is possible that the connection of the alleged bias to the action of the Town Board may ultimately be insufficiently direct. Supreme Court’s decision apparently rejected plaintiffs’ allegations on this ground. Nonetheless, accepting plaintiffs’ allegations as true, the extent to which the long-term Chairperson’s alleged bias infected the Planning Board’s recommendation to the Town Board that multifamily dwelling development be reconsidered, the Town’s subsequent investigation thereof, and the Town Board’s ultimate adoption of the challenged local law limiting same is not amenable to resolution as a matter of law at this procedural stage … . Thus, any declaration regarding the validity of Local Law No. 2022-08 was premature, and Supreme Court’s order must be reversed in full so that the action may proceed through the ordinary course. PF Dev. Group, LLC v Town of Brunswick, 2025 NY Slip Op 03671, Third Dept 6-18-25

Practice Point: Here allegations that the passage of a local law was influenced by bias on the part of the chairperson of the planning board raised a question of fact precluding summary judgment finding the local law valid.​

 

June 18, 2025
https://www.newyorkappellatedigest.com/wp-content/uploads/2018/03/NYAppelateLogo-White-1.png 0 0 Bruce Freeman https://www.newyorkappellatedigest.com/wp-content/uploads/2018/03/NYAppelateLogo-White-1.png Bruce Freeman2025-06-18 10:13:082025-06-22 10:42:45HERE PLAINTIFF’S PROPOSED CONSTRUCTION OF APARTMENTS WAS PROHIBITED BY A LOCAL LAW; PLAINTIFF ALLEGED THE BIAS OF THE CHAIRPERSON OF THE PLANNING BOARD INFECTED THE PLANNING BOARD’S RECOMMENDATION TO THE TOWN BOARD (WHICH ENACTED THE LAW); THOSE ALLEGATIONS RAISED A QUESTION OF FACT PRECLUDING SUMMARY JUDGMENT FINDING THE LOCAL LAW VALID (THIRD DEPT).
Administrative Law, Employment Law, Human Rights Law, Municipal Law

HERE THE HOSPITAL DEFENDANTS WERE NOT ENTITLED TO SUMMARY JUDGMENT ON THE DISABILITY DISCRIMINATION CAUSE OF ACTION UNDER THE NEW YORK CITY HUMAN RIGHTS LAW (NYCHRL) BUT WERE ENTITLED TO SUMMARY JUDGMENT ON THE DISABILITY DISCRIMINATION CAUSE OF ACTION UNDER THE NEW YORK STATE HUMAN RIGHTS LAW (NYSHRL) (SECOND DEPT).

The Second Department, reversing (modifying) Supreme Court, determined the defendant hospital was not entitled to summary judgment in this disability discrimination case under the New York City Human Rights Law (NYCHRL) but was entitled to summary judgment under the New York State Human Rights Law (NYSHRL):

In order to prevail on a claim of disability discrimination under the NYCHRL, “an employer must demonstrate that it engage[d] in a good faith interactive process that assesse[d] the needs of the disabled individual and the reasonableness of the accommodation requested” … . Here, the hospital defendants failed to show that they engaged in an interactive process and reasonable accommodation analysis prior to terminating the plaintiff’s employment … .

However, the Supreme Court should have granted those branches of the hospital defendants’ motion which were for summary judgment dismissing the causes of action alleging disability discrimination under the NYSHRL insofar as asserted against them. “To establish a prima facie case of disability discrimination under the Executive Law, a plaintiff must establish, inter alia, that he or she was otherwise qualified to perform the essential functions of the position, with or without a reasonable accommodation” … . Here, the hospital defendants established, prima facie, that the plaintiff could not perform the essential functions of her job with or without a reasonable accommodation … . In opposition, the plaintiff failed to raise a triable issue of fact. Contrary to the plaintiff’s contention, under the NYSHRL, the hospital defendants cannot be held liable for failing to engage in an interactive process where the employee has failed to provide evidence to the employer that he or she could perform the essential functions of the job with or without a reasonable accommodation … . Makharadze v Ognibene, 2025 NY Slip Op 03713, Second Dept 6-18-25

Practice Point: Consult this decision for an example of a disability discrimination case where the defendants were entitled to summary judgment under the New York State Human Rights Law but not under the New York City Human Rights Law.

 

June 18, 2025
https://www.newyorkappellatedigest.com/wp-content/uploads/2018/03/NYAppelateLogo-White-1.png 0 0 Bruce Freeman https://www.newyorkappellatedigest.com/wp-content/uploads/2018/03/NYAppelateLogo-White-1.png Bruce Freeman2025-06-18 08:52:222025-06-22 09:18:26HERE THE HOSPITAL DEFENDANTS WERE NOT ENTITLED TO SUMMARY JUDGMENT ON THE DISABILITY DISCRIMINATION CAUSE OF ACTION UNDER THE NEW YORK CITY HUMAN RIGHTS LAW (NYCHRL) BUT WERE ENTITLED TO SUMMARY JUDGMENT ON THE DISABILITY DISCRIMINATION CAUSE OF ACTION UNDER THE NEW YORK STATE HUMAN RIGHTS LAW (NYSHRL) (SECOND DEPT).
Administrative Law, Tax Law

THE TAX APPEALS TRIBUNAL’S DETERMINATION THAT PETITIONERS CANNOT REDUCE THEIR NEW YORK ADJUSTED GROSS INCOME BY THE AMORTIZED PREMIUMS ON THEIR OUT-STATE-BONDS UPHELD (THIRD DEPT).

The Third Department, in a full-fledged opinion by Justice Fisher, upheld the Tax Appeals Tribunal’s determination that petitioners can not reduce their New York adjusted gross income by amortized premiums on their out-of-state bonds:

Petitioners are married and residents of New York. During the years 2012 through 2016 (hereinafter the years at issue), they engaged in an investment strategy that included purchasing out-of-state bonds on the secondary market. Due to the initial interest rate of the bonds being higher than the prevailing market rate at the time of purchase, petitioners also paid an additional premium to acquire the bonds. Where the duration of a bond exceeded one year, petitioners further made an upfront premium payment for each remaining year until the bond’s maturity. As relevant here, the amount of the premium paid for each year of the bond is called the amortized premium.

On their respective tax returns for the years at issue, petitioners sought to reduce their New York adjusted gross income by the amortized premiums on their out-of-state bonds. Following an audit, notices of deficiency were issued to petitioners by the Department of Taxation and Finance (hereinafter the Department) stating that they owed additional income taxes for the years at issue, plus interest and penalties. Thereafter, the Department determined that petitioners could not subtract the premiums directly from their interest income, but rather may only report such premiums as part of their itemized deduction, and ultimately issued notices of disallowance. Matter of Ciardullo v McDonnell, 2025 NY Slip Op 03365, Third Dept 6-5-25

 

June 5, 2025
https://www.newyorkappellatedigest.com/wp-content/uploads/2018/03/NYAppelateLogo-White-1.png 0 0 Bruce Freeman https://www.newyorkappellatedigest.com/wp-content/uploads/2018/03/NYAppelateLogo-White-1.png Bruce Freeman2025-06-05 13:48:212025-06-08 14:02:46THE TAX APPEALS TRIBUNAL’S DETERMINATION THAT PETITIONERS CANNOT REDUCE THEIR NEW YORK ADJUSTED GROSS INCOME BY THE AMORTIZED PREMIUMS ON THEIR OUT-STATE-BONDS UPHELD (THIRD DEPT).
Administrative Law, Constitutional Law, Education-School Law

AN ADMINISTRATIVE PROCEEDING WAS BROUGHT BY THE UNIVERSITY AGAINST PETITIONER-STUDENT BASED UPON ANOTHER STUDENT’S (THE REPORTING INDIVIDUAL’S) ALLEGATIONS SHE WAS SEXUALLY ASSAULTED; THE UNIVERSITY’S TITLE IX GRIEVANCE POLICY PROVIDES THAT WHERE, AS HERE, THE REPORTING INDIVIDUAL IS ABSENT FROM THE HEARING AND IS NOT SUBJECT TO CROSS-EXAMINATION, ANY DETERMINATION BY THE UNIVERSITY CANNOT BE BASED UPON STATEMENTS ATTRIBUTED TO THE REPORTING INDIVIDUAL; THE DETERMINATION WAS ANNULLED ON THAT GROUND (THIRD DEPT).

The Third Department, annulled the university’s determination petitioner had violated the university’s “Community Rights and Responsibilities” by sexually assaulting the reporting individual. Petitioner did not deny kissing an touching the reporting individual, but contended all the interactions were consensual. The reporting individual did not testify at the hearing. The university’s Title IX grievance policy provides that, when the reporting individual does not testify and is not subject to cross-examination, the determination cannot be based upon any statement attributed to the reporting individual. Here statements by the reporting individual were the basis for the university’s determination:

Petitioner contends that he was denied due process because he was not afforded the opportunity to question the reporting individual, who did not testify at the hearing or otherwise submit to cross-examination. Under the circumstances presented here, we agree and conclude that annulment is required. “In general, there is a limited right to cross-examine an adverse witness in an administrative proceeding, and the right to cross-examine witnesses generally has not been considered an essential requirement of due process in school disciplinary proceedings” … . Nevertheless, “[i]t is well established that once having adopted rules or guidelines establishing the procedures to be followed in relation to suspension or expulsion of a student, colleges or universities — both public and private — must substantially comply with those rules and guidelines” … . Matter of Bibler v State Univ. of N.Y. at Albany, 2025 NY Slip Op 03373, Third Dept 6-5-25

Practice Point: In a university disciplinary proceeding stemming from an allegation of sexual assault, the right to cross-examine the accuser is not considered an essential requirement of due process. However, the university is required to abide by its own rules. Here the rules stated that, where the accuser is absent from the hearing and is not cross-examined, the university’s determination cannot be based upon statements made by the accuser. The university’s failure to comply with that rule required that the determination be annulled.

 

June 5, 2025
https://www.newyorkappellatedigest.com/wp-content/uploads/2018/03/NYAppelateLogo-White-1.png 0 0 Bruce Freeman https://www.newyorkappellatedigest.com/wp-content/uploads/2018/03/NYAppelateLogo-White-1.png Bruce Freeman2025-06-05 11:11:492025-06-08 12:56:49AN ADMINISTRATIVE PROCEEDING WAS BROUGHT BY THE UNIVERSITY AGAINST PETITIONER-STUDENT BASED UPON ANOTHER STUDENT’S (THE REPORTING INDIVIDUAL’S) ALLEGATIONS SHE WAS SEXUALLY ASSAULTED; THE UNIVERSITY’S TITLE IX GRIEVANCE POLICY PROVIDES THAT WHERE, AS HERE, THE REPORTING INDIVIDUAL IS ABSENT FROM THE HEARING AND IS NOT SUBJECT TO CROSS-EXAMINATION, ANY DETERMINATION BY THE UNIVERSITY CANNOT BE BASED UPON STATEMENTS ATTRIBUTED TO THE REPORTING INDIVIDUAL; THE DETERMINATION WAS ANNULLED ON THAT GROUND (THIRD DEPT).
Administrative Law, Education-School Law

THE NYS DEPARTMENT OF EDUCATION’S CALCULATION OF THE STUDENT TUITION TO BE PAID TO CHARTER SCHOOLS UPHELD (THIRD DEPT).

The Third Department, in a full-fledged opinion by Justice Ceresia, upheld the NYS Education Department’s calculation of the student tuition to be paid to petitioners, operators of charter schools in New York City. The calculation was not “arbitrary or capricious.” Matter of Coney Is. Preparatory Pub. Charter Sch. v New York State Educ. Dept., 2025 NY Slip Op 03374, Third Dept 6-5-25

 

June 5, 2025
https://www.newyorkappellatedigest.com/wp-content/uploads/2018/03/NYAppelateLogo-White-1.png 0 0 Bruce Freeman https://www.newyorkappellatedigest.com/wp-content/uploads/2018/03/NYAppelateLogo-White-1.png Bruce Freeman2025-06-05 10:55:162025-06-08 11:10:50THE NYS DEPARTMENT OF EDUCATION’S CALCULATION OF THE STUDENT TUITION TO BE PAID TO CHARTER SCHOOLS UPHELD (THIRD DEPT).
Administrative Law, Evidence

THE DEPARTMENT OF HEALTH’S BOARD FOR PROFESSIONAL MEDICAL CONDUCT PROPERLY REVOKED PETITIONER-RADIATION-ONCOLOGIST’S LICENSE TO PRACTICE MEDICINE; THE BOARD’S EXPERT OPINED THAT PETITIONER’S USE OF HIGHER “CURATIVE” RADIATION DOSES WHEN LOWER “PALLIATIVE” DOSES WERE APPROPRIATE FELL SHORT OF THE RELEVANT STANDARD OF CARE (CT APP).

The Court of Appeals, in a full-fledged opinion by Judge Troutman, determined the Department of Health’s Board for Professional Medical Conduct properly revoked petitioner’s license to practice medicine. Petitioner, a radiation oncologist, was found to have deviated from the generally accepted standard of care by administering higher “curative” doses of radiation treatment when lower “palliative” doses were appropriate. The inquiry came down to a battle of experts about what the appropriate standard of care is. The petitioner argued that the Board’s expert improperly relied solely on clinical practice guidelines for that determination:

Petitioner’s contention that the Board’s expert relied solely on clinical practice guidelines overvalues the import of the following testimony:

Counsel: “[W]hat do you mean when you say standard of care?

Expert: “We have accepted guidelines that are published by multiple societies, they include our board, [the] American College of Radiology or [the] American Board of Radiology, [and] national comprehensive cancer networks and these are fairly descriptive, prescriptive guidelines for what a physician should do in the management of cases in very specific areas. When you deviate from those, it is considered to fall short of a standard.”

This answer by the Board’s expert, and others like it, should not be viewed in isolation. The Board’s expert was well-credentialed and had over 30 years of practice in the field of radiation oncology. Rather than merely citing the clinical practice guidelines as being the standard of care, he established the standard of care as he understood it based on his years of seeing patients. For each of the seven patients at issue, the Board’s expert identified the relevant medical and scientific principles underlying the standard of care and provided detailed explanations about why that standard best served patients and why deviating from it risked causing significant harm to those patients. Thus, respondent’s expert did not rely exclusively on clinical practice guidelines. Instead, as the Appellate Division concluded, he used those guidelines as “one link in the chain” of his evaluation process … . Matter of Won Yi v New York State Bd. of Professional Med. Conduct, 2025 NY Slip Op 03103, CtApp 5-22-25

 

May 22, 2025
https://www.newyorkappellatedigest.com/wp-content/uploads/2018/03/NYAppelateLogo-White-1.png 0 0 Bruce Freeman https://www.newyorkappellatedigest.com/wp-content/uploads/2018/03/NYAppelateLogo-White-1.png Bruce Freeman2025-05-22 18:57:252025-05-27 10:23:52THE DEPARTMENT OF HEALTH’S BOARD FOR PROFESSIONAL MEDICAL CONDUCT PROPERLY REVOKED PETITIONER-RADIATION-ONCOLOGIST’S LICENSE TO PRACTICE MEDICINE; THE BOARD’S EXPERT OPINED THAT PETITIONER’S USE OF HIGHER “CURATIVE” RADIATION DOSES WHEN LOWER “PALLIATIVE” DOSES WERE APPROPRIATE FELL SHORT OF THE RELEVANT STANDARD OF CARE (CT APP).
Administrative Law, Civil Procedure, Municipal Law, Tax Law

WHERE, AS HERE, PLAINTIFFS ALLEGE THE CONTESTED SALES TAX STATUTE IS “WHOLLY INAPPLICABLE” TO THEM, AND PLAINTIFFS SEEK A DECLARATORY JUDGMENT TO THAT EFFECT, THE “EXHAUSTION OF ADMINISTRATIVE REMEDIES” REQUIREMENT IS NOT RELEVANT (THRID DEPT). ​

The Third Department, reversing (modifying) Supreme Court, determined some of the plaintiffs had not failed to exhaust their administrative remedies in this action contesting the imposition of sales tax on the construction and demolition inspection services provided by plaintiffs. There is an exception to the “exhaustion of administrative remedies” requirement where, as here, plaintiffs claim the tax statute at issue is “wholly inapplicable” to them:

… [T]he remaining plaintiffs did not, as Supreme Court held, fail to exhaust their administrative remedies. Generally, a taxpayer must utilize statutory administrative remedies prior to commencing an action against the taxing entity … . That said, there is an exception to this requirement when, as relevant here, a tax statute is attacked as wholly inapplicable to the plaintiff … . “To challenge a statute as wholly inapplicable, the taxpayer must allege that the agency had no jurisdiction over it or the matter that was taxed” … . “This exception to the rule [mandating exhaustion of administrative remedies] is limited to those cases where no factual issue is raised” concerning the subject matter of the tax dispute … .

The remaining plaintiffs qualify for the “wholly inapplicable” exception, as the complaint alleges that DTF [Department of Taxation and Finance] lacks jurisdiction because Tax Law § 1105 (c) (8) does not apply to their site safety services. Further, there are no factual issues at play here. * * * … [T]he complaint simply seeks a declaration that site safety services, as specifically defined in the New York City Building Code, are exempt from sales tax … . Site Safety LLC v New York State Dept. of Taxation & Fin., 2025 NY Slip Op 02255, Third Dept 4-17-25

Practice Point: Here plaintiffs alleged the relevant sales-tax statute was wholly inapplicable to them and sought a declaratory judgment to that effect. The proceeding therefore is excepted from the “exhaustion of administrative remedies” requirement.

 

April 17, 2025
https://www.newyorkappellatedigest.com/wp-content/uploads/2018/03/NYAppelateLogo-White-1.png 0 0 Bruce Freeman https://www.newyorkappellatedigest.com/wp-content/uploads/2018/03/NYAppelateLogo-White-1.png Bruce Freeman2025-04-17 11:00:092025-04-20 11:26:08WHERE, AS HERE, PLAINTIFFS ALLEGE THE CONTESTED SALES TAX STATUTE IS “WHOLLY INAPPLICABLE” TO THEM, AND PLAINTIFFS SEEK A DECLARATORY JUDGMENT TO THAT EFFECT, THE “EXHAUSTION OF ADMINISTRATIVE REMEDIES” REQUIREMENT IS NOT RELEVANT (THRID DEPT). ​
Administrative Law, Family Law, Social Services Law

THE OFFICE OF CHILDREN AND FAMILY SERVICES (OCFS) DID NOT EXCEED ITS AUTHORITY IN CREATING THE HOST FAMILY PROGRAM FOR TEMPORARY PLACEMENT OF CHILDREN AND FAMILIES (THIRD DEPT).

The Third Department, in a full-fledged opinion by Justice Garry, over a two-justice dissenting opinion, determined the Office of Children and Family Services (OCFS) did not exceed its authority when creating the Host Family Home program for temporary placement of children and families. The appellants argued the Host Family Home program was essentially a foster care program without the legislative foster-care safeguards:

The subject regulations established the Host Family Home program (see 18 NYCRR 444.1), which aims to provide “supportive services . . . to children and their families . . . for the purpose of: assisting a family in need of day-to-day community-based supports by peers, arranging for parents and children to be temporarily cared for together in a host family home, and/or temporarily supporting a family when a parent has determined that he/she is temporarily unable to care for their child . . . as a way to avert the need for more formal child welfare intervention” … . * * *

Petitioners’ argument that OCFS exceeded its authority when it created the Host Family Home program is unpersuasive. “Administrative agencies have all the powers expressly delegated to them by the Legislature, and are permitted to adopt regulations that go beyond the text of their enabling legislation, so long as those regulations are consistent with the statutory language and underlying purpose” … . “While an administrative agency may not, in the exercise of rule-making authority, engage in broad-based public policy determinations, the cornerstone of administrative law is the principle that the Legislature may declare its will, and after fixing a primary standard, endow administrative agencies with the power to fill in the interstices in the legislative product by prescribing rules and regulations consistent with the enabling legislation” … . * * *

On balance, the Boreali factors [Boreali v Axelrod, 71 NY2d 1] lead us to the conclusion that the Host Family Home program regulations are a valid exercise of OCFS’s rulemaking authority, bringing an end to our inquiry. We emphasize that “[o]ur role in this regard is not to question the efficacy or wisdom of the means chosen by the agency to accomplish the ends identified by the [L]egislature” … . As we have also found that the regulations are consistent with the governing statutory language and its purpose, we affirm. Matter of Lawyers for Children v New York State Off. of Children & Family Servs., 2025 NY Slip Op 02115, Third Dept 4-10-25

Practice Point: Consult this opinion for an in-depth analysis of the authority of an agency to promulgate regulations.

 

April 10, 2025
https://www.newyorkappellatedigest.com/wp-content/uploads/2018/03/NYAppelateLogo-White-1.png 0 0 Bruce Freeman https://www.newyorkappellatedigest.com/wp-content/uploads/2018/03/NYAppelateLogo-White-1.png Bruce Freeman2025-04-10 07:52:482025-04-14 08:20:36THE OFFICE OF CHILDREN AND FAMILY SERVICES (OCFS) DID NOT EXCEED ITS AUTHORITY IN CREATING THE HOST FAMILY PROGRAM FOR TEMPORARY PLACEMENT OF CHILDREN AND FAMILIES (THIRD DEPT).
Administrative Law, Constitutional Law, Medicaid, Social Services Law

THE NYS DEPARTMENT OF HEALTH’S CLARIFICATION OF BILLING PRACTICES FOR PHYSICIANS WHO DISPENSE PRESCRIPTION DRUGS UNDER THE MEDICAID PROGRAM IS VALID; THE CLARIFICATION IS NOT A “RULE” AND IS NOT VOID FOR VAGUENESS (THIRD DEPT).

The Third Department, in a full-fledged opinion by Justice Garry, determined a clarification issued by the respondent NYS Department of Health, was valid, was not a rule, and was not void for vagueness. The clarification concerned the billing practices for physicians who dispense prescription drugs:

As it regularly does, respondent [NYS Department of Health] took steps to clarify appropriate billing practices. This included issuance of the July 2022 edition of its official newsletter of the New York State Medicaid Program — Medicaid Update. In a section entitled “Policy Clarification for Practitioner Dispensing” … , which purported to “supersede[ ] previous communications on this topic,” respondent stated that the state Medicaid program reimburses for drugs furnished by practitioners to their patients on the basis of the acquisition cost to the practitioner and that additional registration or ownership of a pharmacy is not required. The clarification went on to provide that practitioners billing for medications dispensed to its fee-for-service patients should use the medical claim format and that practitioners still participating in managed care should check with the patient’s health plan to determine the billing policy for prescription drugs dispensed directly to patients. Reportedly confused by the alleged change in billing practice, petitioner subsequently contacted respondent for further clarification. In response, respondent reiterated that a practitioner that dispenses drugs to their patients is not considered a pharmacy under either statutory or enrollment requirements and therefore should not be enrolled or billing as a pharmacy provider.

Petitioner then commenced this CPLR article 78 proceeding to annul the clarification as an unpromulgated rule, unconstitutionally vague, irrational and violative of section 504 the Rehabilitation Act of 1973 (see 29 USC § 794). Citing anticipated financial losses for expenses attendant to medication dispensing, that is, beyond the acquisition cost of the drugs, petitioner argued that respondent’s alleged new rule would force it to cease its physician-dispensing services altogether, thereby both irrationally depriving cancer patients from effective treatment and discriminating against them by effectively precluding them from meaningful access to the provider of their choice. Matter of North Shore Hematology-Oncology Assoc., P.C. v New York State Dept. of Health, 2025 NY Slip Op 01985, Third Dept 4-3-25

April 3, 2025
https://www.newyorkappellatedigest.com/wp-content/uploads/2018/03/NYAppelateLogo-White-1.png 0 0 Bruce Freeman https://www.newyorkappellatedigest.com/wp-content/uploads/2018/03/NYAppelateLogo-White-1.png Bruce Freeman2025-04-03 09:35:382025-04-06 10:12:47THE NYS DEPARTMENT OF HEALTH’S CLARIFICATION OF BILLING PRACTICES FOR PHYSICIANS WHO DISPENSE PRESCRIPTION DRUGS UNDER THE MEDICAID PROGRAM IS VALID; THE CLARIFICATION IS NOT A “RULE” AND IS NOT VOID FOR VAGUENESS (THIRD DEPT).
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