State of West Virginia ex rel. West Virginia Attorney-General, Medicaid Fraud Control Unit, and Nathan R. Lyle, in his Individual Capacity, and in his Capacity as an Employee of the West Virginia Attorney-General Medicaid Fraud Control Unit v. The Honorable Kenneth D. Ballard, Judge of the Circuit Court of Kanwaha County, and Hisel Bailey, and West Virginia Attorney-General, Medicaid Fraud Control Unit, and Nathan R. Lyle, in his Individual Capacity, and in his Capacity as an Employee of the West Virginia Attorney-General Medicaid Fraud Control Unit v. Hisel Bailey

West Virginia Supreme Court·Decided November 9, 2023·No. 22-779 and 22-781·Published

Opinion

IN THE SUPREME COURT OF APPEALS OF WEST VIRGINIA FILED

September 2023 Term

_____________ November 9, 2023 released at 3:00 p.m.

EDYTHE NASH GAISER, CLERK No. 22-779 SUPREME COURT OF APPEALS

_____________ OF WEST VIRGINIA

STATE OF WEST VIRGINIA EX REL.

WEST VIRGINIA ATTORNEY-GENERAL, MEDICAID FRAUD CONTROL UNIT; AND NATHAN R. LYLE, IN HIS INDIVIDUAL CAPACITY, AND IN HIS CAPACITY AS AN EMPLOYEE OF THE WEST VIRGINIA ATTORNEY-GENERAL MEDICAID FRAUD CONTROL UNIT, Petitioners,

V.

THE HONORABLE KENNETH D. BALLARD, JUDGE OF THE CIRCUIT COURT OF KANAWHA COUNTY;

AND HISEL BAILEY,

Respondents.

PETITION FOR WRIT OF PROHIBITION

WRIT GRANTED

AND

No. 22-781

WEST VIRGINIA ATTORNEY-GENERAL, MEDICAID FRAUD CONTROL UNIT; AND NATHAN R. LYLE, IN HIS INDIVIDUAL CAPACITY, AND IN HIS CAPACITY AS AN EMPLOYEE OF

THE WEST VIRGINIA ATTORNEY-GENERAL, MEDICAID FRAUD CONTROL UNIT, Defendants Below, Petitioners,

V.

HISEL BAILEY,

Plaintiff Below, Respondent.

Appeal from the Circuit Court of Kanawha County The Honorable Kenneth D. Ballard, Judge Civil Action No. 22-C-145

AFFIRMED IN PART, REVERSED IN PART, AND REMANDED

Submitted: September 13, 2023 Filed: November 9, 2023

Michael D. Dunham, Esq. John J. Brewster, Esq. Caleb B. David, Esq. Scott H. Kaminski, Esq. Tyler L. Rittenhouse, Esq. Ray, Winton & Kelley, PLLC Shuman McCuskey Slicer PLLC Charleston, West Virginia Charleston, West Virginia Attorneys for Respondent Attorneys for the Petitioners Hisel Bailey

JUSTICE BUNN delivered the Opinion of the Court.

SYLLABUS BY THE COURT

1. “Because Title 42, U.S.C.A. § 1983 (1979) does not create substantive rights, but rather provides a remedy for pre-existing rights, all claims under this section must allege a specific violation of the constitution or ‘laws’ of the United States. [To] recover damages under § 1983, a plaintiff must show that (1) the conduct complained of was committed by a person acting under color of state law; and (2) [the] conduct deprived a person of rights, privileges or immunities secured by the Constitution or laws of the United States.” Syllabus point 4, Hutchison v. City of Huntington, 198 W. Va. 139, 479 S.E.2d 649 (1996).

2. “A government-official defendant can be held liable only for his or her own misconduct. Therefore, to succeed on a claim of an alleged constitutional violation under United States Code title 42, section 1983, a plaintiff must prove that each government-official defendant, through that official’s own individual actions, has personally and directly violated the Constitution, and that such violation caused or contributed to the plaintiff’s injuries.” Syllabus point 3, Vinson v. Butcher, 244 W. Va. 144, 851 S.E.2d 807 (2020).

i

3. “A circuit court’s denial of a motion to dismiss that is predicated on qualified immunity is an interlocutory ruling which is subject to immediate appeal under the ‘collateral order’ doctrine.” Syllabus point 1, West Virginia Board of Education v. Marple, 236 W. Va. 654, 783 S.E.2d 75 (2015).

4. “To the extent that governmental acts or omissions which give rise to a cause of action fall within the category of discretionary functions, a reviewing court must determine whether the plaintiff has demonstrated that such acts or omissions are in violation of clearly established statutory or constitutional rights or laws of which a reasonable person would have known or are otherwise fraudulent, malicious, or oppressive in accordance with State v. Chase Securities, Inc., 188 W. Va. 356, 424 S.E.2d 591 (1992). In absence of such a showing, both the State and its officials or employees charged with such acts or omissions are immune from liability.” Syllabus point 11, West Virginia Regional Jail and Correctional Facility Authority v. A.B., 234 W. Va. 492, 766 S.E.2d 751 (2014).

5. “If the plaintiff identifies a clearly established right or law which has been violated by the acts or omissions of the State, its agencies, officials, or employees, or can otherwise identify fraudulent, malicious, or oppressive acts committed by such official or employee, the court must determine whether such acts or omissions were within the scope of the public official or employee’s duties, authority, and/or employment. To the ii extent that such official or employee is determined to have been acting outside of the scope of his duties, authority, and/or employment, the State and/or its agencies are immune from vicarious liability, but the public employee or official is not entitled to immunity in accordance with State v. Chase Securities, Inc., 188 W. Va. 356, 424 S.E.2d 591 (1992) and its progeny. If the public official or employee was acting within the scope of his duties, authority, and/or employment, the State and/or its agencies may be held liable for such acts or omissions under the doctrine of respondeat superior along with the public official or employee.” Syllabus point 12, West Virginia Regional Jail and Correctional Facility Authority v. A.B., 234 W. Va. 492, 766 S.E.2d 751 (2014).

iii

BUNN, Justice:

In these consolidated proceedings, the West Virginia Attorney General’s Medicaid Fraud Control Unit (“MFCU”) and Nathan R. Lyle, a MFCU investigator, seek review of the circuit court’s denial of their motion to dismiss certain claims alleged in a civil rights action brought by Mr. Hisel Bailey. In case number 22-779, MFCU and Mr. Lyle (collectively “Petitioners”) seek a writ of prohibition to prevent the circuit court from enforcing the part of its order finding that Mr. Bailey could maintain 42 U.S.C. § 1983 claims against both MFCU and Mr. Lyle. They further seek to prevent the circuit court from allowing Mr. Bailey to go forward with a whistle-blower claim against Mr. Lyle. We grant the requested writ of prohibition. MFCU, a state agency, and Mr. Lyle in his official capacity, may not be subjected to § 1983 claims. Furthermore, Mr. Bailey’s whistle-blower claim is unsustainable because Mr. Lyle had no authority to make decisions affecting Mr. Bailey’s employment and, therefore, was not his employer.

In case number 22-781, Petitioners appeal the circuit court’s decision denying them qualified immunity from Mr. Bailey’s § 1983 claims for unreasonable seizure of the person against Mr. Lyle. These claims are based on two grounds: (1) an alleged violation of Miranda v. Arizona, 384 U.S. 436, 86 S. Ct. 1602, 16 L. Ed. 2d 694 (1966); and (2) Mr. Bailey’s potential loss of liberty from an allegedly false report Mr. Lyle submitted to the Cabell County prosecuting attorney. Petitioners also appeal the circuit court’s rulings denying them qualified and prosecutorial immunity from Mr.

Bailey’s claim of malicious prosecution. A § 1983 claim may not, as a matter of law, be founded on a Miranda violation, and the mere risk of a loss of liberty is insufficient to establish seizure of the person. Therefore, Mr. Lyle is entitled to qualified immunity from Mr. Bailey’s § 1983 claims, and the circuit court erred by concluding otherwise. As to Mr. Bailey’s malicious prosecution claim, we find that the complaint fails to allege sufficient facts to meet the required heightened pleading standard to overcome MFCU’s and Mr. Lyle’s qualified immunity, and the circuit court additionally failed to address whether Mr. Lyle was acting within the scope of his employment—an analysis necessary to determine MFCU’s entitlement to qualified immunity for any vicarious liability for Mr. Lyle’s alleged conduct. Therefore, additional proceedings before the circuit court are required. Finally, the circuit court correctly found Petitioners are not entitled to prosecutorial immunity. The circuit court’s order is affirmed in part, and reversed in part, and this case is remanded for additional proceedings consistent with this opinion.

I.

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State of West Virginia ex rel. West Virginia Attorney-General, Medicaid Fraud Control Unit, and Nathan R. Lyle, in his Individual Capacity, and in his Capacity as an Employee of the West Virginia Attorney-General Medicaid Fraud Control Unit v. The Honorable Kenneth D. Ballard, Judge of the Circuit Court of Kanwaha County, and Hisel Bailey, and West Virginia Attorney-General, Medicaid Fraud Control Unit, and Nathan R. Lyle, in his Individual Capacity, and in his Capacity as an Employee of the West Virginia Attorney-General Medicaid Fraud Control Unit v. Hisel Bailey, (W. Va. 2023).

State of West Virginia ex rel. West Virginia Attorney-General, Medicaid Fraud Control Unit, and Nathan R. Lyle, in his Individual Capacity, and in his Capacity as an Employee of the West Virginia Attorney-General Medicaid Fraud Control Unit v. The Honorable Kenneth D. Ballard, Judge of the Circuit Court of Kanwaha County, and Hisel Bailey, and West Virginia Attorney-General, Medicaid Fraud Control Unit, and Nathan R. Lyle, in his Individual Capacity, and in his Capacity as an Employee of the West Virginia Attorney-General Medicaid Fraud Control Unit v. Hisel Bailey (State of West Virginia ex rel. West Virginia Attorney-General, Medicaid Fraud Control Unit, and Nathan R. Lyle, in his Individual Capacity, and in his Capacity as an Employee of the West Virginia Attorney-General Medicaid Fraud Control Unit v. The Honorable Kenneth D. Ballard, Judge of the Circuit Court of Kanwaha County, and Hisel Bailey, and West Virginia Attorney-General, Medicaid Fraud Control Unit, and Nathan R. Lyle, in his Individual Capacity, and in his Capacity as an Employee of the West Virginia Attorney-General Medicaid Fraud Control Unit v. Hisel Bailey) — published by Counsel Stack Legal Research, free access to 12M+ legal documents.

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