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

CourtWest Virginia Supreme Court
DecidedNovember 9, 2023
Docket22-779 and 22-781
StatusPublished

This text of 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) is published on Counsel Stack Legal Research, covering West Virginia Supreme Court primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
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).

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,

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.

1 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.

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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, Counsel Stack Legal Research, https://law.counselstack.com/opinion/state-of-west-virginia-ex-rel-west-virginia-attorney-general-medicaid-wva-2023.