Justia Pennsylvania Supreme Court Opinion Summaries

Appellant, a six-year-old boy diagnosed with an autism-spectrum disorder, was receiving applied behavior analysis (“ABA”), a type of autism-related service, in his home. ABA was covered by his family’s insurance policy with Appellee Independence Blue Cross. Appellant’s family requested that Blue Cross cover similar ABA services to be provided at Appellant’s elementary school in 2009. The insurer denied the request, pointing to a place-of-service exclusion in the policy which specified that no services would be covered if the care was provided at certain types of locations, including schools. This decision was unsuccessfully appealed internally. The dispute was then submitted to an independent external review agency appointed by the Pennsylvania Department of Insurance. In December 2009, that agency upheld the denial based on the policy’s place-of-service exclusion. Meanwhile, the General Assembly passed Act 62 of 2008, which, inter alia, required that health insurance policies provide coverage for the treatment of autism spectrum disorders. In 2010, Appellant filed suit seeking declaratory and injunctive relief in the form of a ruling that the policy’s place-of-service exclusion is null and void under Act 62, as well as an order directing the insurer to cover Appellant’s medically necessary treatments. Blue Cross filed responsive pleadings and Appellant requested judgment on the pleadings. The court ultimately rejected the argument that the policy’s place-of-service exclusion was a general exclusion as contemplated by Section 764h(c). Thus, it held that, under Section 764h(a), Blue Cross was required to provide coverage for school-based ABA services during the relevant time period. The common pleas court ordered the insurer to “take action consistent with this decision.” On appeal, the Superior Court, sua sponte, questioned whether the common pleas court should have entertained the appeal under Act 62. The Pennsylvania Supreme Court allowed review to consider whether individuals diagnosed with autism spectrum disorders have the right to judicial review of a denial of insurance coverage, considering the language of Act 62. "Here, we are faced with a situation in which a litigant sought a declaration of his rights under a legislative enactment, a task over which the common pleas court could have exercised jurisdiction, pursuant to the Declaratory Judgments Act, in response to the correct form of pleading. Furthermore, the complaint’s asserted basis for jurisdiction was deficient only because of the confusion created by an apparent drafting mistake by our General Assembly. Neither the court nor the defendant Insurer realized that anything was amiss in this regard and, if they had, Appellant could presumably have made any necessary formal corrections. Under these circumstances, we conclude that the common pleas court was permitted to reach the substantive claim forwarded in Appellant’s pleadings. It follows that the intermediate court should not have reversed the order of that court by sua sponte pointing to the language of Section 764h(k)(2) as a bar to Appellant’s ability to seek relief in a judicial forum, without first evaluating whether the common pleas court’s assessment of the substantive question could be justified on some other basis." View "Burke v. Independence Blue Cross" on Justia Law

Appellees Henry Daniels and Kevin Pelzer participated in a plan to kidnap and hold for ransom sixteen-year-old Alexander Porter. Appellees kidnapped the victim, bound and gagged him, and placed him in the trunk of his car. Ultimately, they determined to kill the victim. In all, the victim was held in the trunk for twenty-four hours. According to appellees' police statements and Daniels's trial testimony, appellees were unable to determine whether the youth was dead when they went to dispose of his body. Pelzer shot Porter four times in the back of the neck to remove all doubt. The jury found both appellees guilty of first-degree murder and other offenses. These cross-appeals were a continuation of their first collateral challenges to their convictions under the Post-Conviction Relief Act ("PCRA"). The Pennsylvania Supreme Court vacated the PCRA court's March 25, 2003 order, which had granted appellees a new trial. The Court reviewed three claims of trial counsel ineffectiveness, denied relief on all three claims, and remanded the case to the PCRA court for the preparation of an opinion addressing the remainder of appellees' claims. On remand, the PCRA judge retired, a new judge ordered a new penalty proceeding for each appellee, while denying guilt phase relief. The Commonwealth appealed that order, while appellees, in separate cross-appeals, sought review of additional issues upon which the PCRA court denied relief. Upon careful consideration of the record below, the Supreme Court affirmed the order of the PCRA court as it related to Kevin Pelzer, but reversed the order as it related to Henry Daniels. Thus, Pelzer was denied guilt phase relief, but the award of a new penalty phase hearing to him was affirmed, and Daniels's PCRA petition was dismissed in its entirety. View "Pennsylvania v. Daniels" on Justia Law

In an appeal by allowance, the issue before the Supreme court was whether a conviction for possession of an instrument of crime ("PIC") could be sustained when a defendant has been otherwise acquitted of related offenses involving the use of that instrument of crime, here, a firearm. Upon review of the facts of this case, the Supreme Court held that a defendant's conviction of PIC may stand under such circumstances. The Court vacated the Superior Court's order reversing Appellee James Moore's PIC conviction, and remanded to the trial court for reinstatement of Appellee's judgment of sentence. View "Pennsylvania v. Moore" on Justia Law

At issue in this case was whether appellants waived the mental health records privilege provided under the Mental Health Procedures Act (MHPA) by filing a negligence suit to recover for physical injuries sustained by James Octave upon being struck by a tractor-trailer driven by appellee David Walker. The incident occurred in 2007; based on eyewitness reports, the state police concluded James attempted to commit suicide by jumping under the truck's trailer. Appellant Susan Octave, James's wife, filed a complaint in her own right and on behalf of James, an incapacitated person, against the Pennsylvania Department of Transportation (DOT), Walker, and a number of other parties based upon their purported negligence. Because the state police concluded James was attempting to commit suicide, appellees sought discovery information regarding his mental health history and access to his mental health records, which Susan refused to provide. Appellees filed a motion for leave to access and copy sealed files pertaining to James's involuntary commitments pursuant to the MHPA and a motion to compel the execution of authorizations pertaining to his mental health and involuntary commitment records and full and complete answers to interrogatories. Thereafter, appellants filed an amended complaint, alleging James only suffered physical injuries as a result of the incident. The trial court issued denying appellees' motions, reasoning that because the amended complaint removed allegations pertaining to mental injuries, it did not place James's mental condition at issue. Appellees appealed to the Commonwealth Court, contending the trial court erred when it denied them access to James's mental health records specifically arguing the MHPA's confidentiality provisions were waived by Susan because she placed James's mental health at issue by filing the complaint. The Commonwealth Court reversed and remanded, finding "Susan Octave directly put James Octave's mental history, especially as it pertains to his previous suicide attempts, or considerations or contemplations of suicide at issue. The Supreme Court granted allocatur to address whether, given that petitioners amended their complaint to no longer raised a question of mental health, did the petitioners still put mental health at issue and impliedly waive the protections of 50 P.S. sec. 7111 though the act of filing the lawsuit. The Supreme Court held that a patient waives his confidentiality protections under the MHPA where, judged by an objective standard, he knew or reasonably should have known his mental health would be placed directly at issue by filing the lawsuit. View "Octave v. Walker" on Justia Law

The issue this case presented for the Pennsylvania Supreme Court's review centered on the viability of the historic police power of the state in validating and regulating riparian rights and remedies where it was alleged that a downstream landowner subject to federal rail-safety regulations obstructed a natural watercourse causing upstream flooding and significant damage as a result. Hotel owner David Miller and his hotel (appellants) sought to hold the Southeastern Pennsylvania Transportation Authority ("SEPTA") liable for water damage allegedly resulting from the negligent construction and/or maintenance of a nearby SEPTA-owned railroad bridge. Appellants purchased hotel property in 1996, and they claimed that the bridge thereafter obstructed the flow of a creek which ran under the bridge, causing the creek to flood appellants' upstream hotel on three separate occasions of extreme weather conditions. On each occasion, appellants experienced flooding that filled the hotel basement and first floor. In 2001, the hotel closed and appellants declared bankruptcy. "As this is an area of law that has been regulated by the Commonwealth for centuries," the Pennsylvania Court concluded that there was no clear and manifest federal congressional intention to preempt Pennsylvania law central issue of this case. The Court declined to "invalidate the rights and remedies afforded to appellants under the laws of this Commonwealth." The Court reversed the Commonwealth Court's order and remanded this case for further proceedings. View "Miller v. SEPTA" on Justia Law

Pennsylvania Supreme Court Justice Seamus McCaffery has been temporarily relieved of his responsibilities on the Court. Media reports alleged that Justice McCaffery attempted to fix traffic tickets against his wife, authorized her "to accept hundreds of thousands of dollars in referral fees from plaintiffs’ firms while she served as [his] administrative assistant, and that he may have attempted to exert influence over a judicial assignment on the Philadelphia common pleas bench outside the scope of his official duties. Adding to the controversy was the Justice's acceptance of responsibility for exchanging hundreds of sexually explicit emails with a member or members of the Office of Attorney General, which surfaced in the course of the Attorney General’s review of the handling of the Gerald Sandusky investigation. Within thirty days, the Judicial Conduct Board shall make a determination, on an emergency basis, whether there is or is not probable cause to file formal misconduct charges against Justice McCaffery concerning any of the aforementioned allegations. View "In re: Mr. Justice Seamus McCaffery" on Justia Law

In an appeal by allowance, the issue this case presented for the Supreme Court's review was, inter alia, the scope of the authority of the Department of Environmental Protection (“DEP”) to issue administrative orders under the Bituminous Coal Mine Safety Act. The Court found that the DEP acted within its authority with respect to the orders it issued regarding certain failures to report accidents, but that it improperly issued other orders with respect to requiring fire extinguishers on certain mining vehicles. Thus, the Court reversed in part, and affirmed in part, the order of the Commonwealth Court. The case was thereafter remanded for further proceedings. View "DEP, Aplt. v. Emerald Coal Resources, et al" on Justia Law

The Superior Court affirmed the trial court’s dismissal of this case for improper venue. A criminal complaint was filed in Monroe County charging appellant with criminal conspiracy, firearms not to be carried without a license, possession of firearm prohibited, and lending or giving of firearms prohibited. Venue was held improper based on a lack of factual connection to Monroe County. Upon review, the Supreme Court concluded this was error. The case was remanded to the trial court for further proceedings. View "Pennsylvania v. Gross" on Justia Law

In an appeal by allowance, the issue this case presented to the Pennsylvania Supreme Court was whether first-degree burglary constituted “violent behavior” pursuant to the Recidivism Risk Reduction Incentive Act (“RRRI Act”). The Court concluded that first-degree burglary is “violent behavior” as contemplated by the RRRI Act. Thus, the Court affirmed the decision of the Superior Court upholding Appellant Matthew Chester's sentence. View "Pennsylvania v. Chester" on Justia Law

Appellant Friends of Pennsylvania Leadership Charter School appealed an order of the Commonwealth Court which held that the retroactive real estate tax exemption provided in Section 1722-A(e)(3) of the Public School Code, 24 P.S. 17-1722-A(e)(3), was unconstitutional. Upon review, the Supreme Court affirmed (though by different reasoning), concluding that retroactive application of the real estate tax exemption of Section 1722-A(e)(3) was unconstitutional under the Pennsylvania Constitution because it violated the separation of powers doctrine. View "Friends of PaLCS v. Chester Cty Bd of Assess" on Justia Law