In the 1998 case of Jane M. Roberts, Guardian for Wanda Y. Johnson v. Galen of Virginia, Inc., formerly DBA Humana Hospital University of Louisville, DBA University of Louisville Hospital, the US Supreme Court addressed a dispute over medical malpractice and arbitration agreements in nursing home contracts. The plaintiff's guardian argued that an arbitration agreement signed upon admission to the hospital was not enforceable because it violated public policy by limiting access to courts for negligence claims and other disputes related to patient care or treatment outcomes. However, the court ruled in favor of Galen (the defendant), stating that federal law under the Federal Arbitration Act supports enforcing such agreements as long as they are "fairly negotiated" between parties with equal bargaining power and do not involve fraud or undue influence.

In the dissenting opinion for Roberts v. Galen of Virginia, Inc., Justice Ginsburg argued that the majority's decision to vacate and remand was premature and unnecessary. She contended that there were sufficient grounds for a judgment in favor of Johnson without further proceedings. The case involved an interpretation of the Emergency Medical Treatment and Active Labor Act (EMTALA), which requires hospitals to provide appropriate medical screening examinations to patients who come into emergency departments seeking treatment, regardless of their ability to pay. In this case, Johnson claimed she was transferred from Humana Hospital University because she lacked insurance coverage or funds necessary for her care - a violation under EMTALA law as it prohibits patient dumping based on financial status. However, the majority held that if a hospital has provided some form of examination but is alleged not have done enough due its economic motives then such claims are outside EMTALA’s scope thus necessitating remand back to lower court for reevaluation under this new standard set by them. Justice Ginsburg disagreed with this view stating that even though Johnson received some level of examination at Humana Hospital before being transferred does not mean they complied fully with EMTALA requirements hence no need for remanding back as per majority’s instructions.