The Indiana Supreme Court has ruled that Anthem Inc. is entitled to coverage for nearly all of its costs to defend and settle allegations that it failed to timely or fully pay medical reimbursement claims, largely overturning a win for reinsurers Continental Casualty Co. and Twin City Fire Insurance Co.
A medical supply company accused of overbilling Medicaid in a False Claims Act suit asked a Florida federal judge Friday to sanction a disqualified former attorney for the relators, saying he had acted in bad faith and unnecessarily prolonged the litigation.
The U.S. Department of Veterans Affairs will now determine eligibility for its Veterans Choice program based on the driving distance — rather than by a straight line — between a veteran's home and the nearest VA medical facility, the agency announced Friday.
A Florida appeals court on Friday overturned a lower court's dismissal of a petition to dissolve a same-sex couple's marriage recorded in Massachusetts, saying that the state and one of the partners in the couple failed to offer rational reasons for Florida law to block the request.
The Florida Senate on Friday rejected the House of Representatives' budget proposal, stood firm on its proposal for Medicaid expansion and indicated that the legislative session will most likely need to be extended to resolve the impasse.
The Centers for Disease Control and Prevention notified the public Friday about a health emergency in Southeastern Indiana, where 135 individuals in a county of 4,200 have tested positive for HIV in the past six months largely as a result of increased opioid use.
The Fifth Circuit on Friday smacked down a prominent GOP donor’s lawsuit claiming that the Affordable Care Act flouted the U.S. Constitution’s origination clause, finding that the complaint failed to describe harm and was filed prematurely.
The Texas Supreme Court on Friday dismissed a woman’s claim she was blinded by a nutritional supplement provided by a compounding pharmacy, holding the pharmacy is a health care provider entitled to protections from medical malpractice tort reforms.
The U.S. Supreme Court is set to hear historic oral arguments Tuesday on whether same-sex marriage is a constitutional right, and the justices will have to navigate a thicket of thorny issues to decide the matter. Here, Law360 looks at five pivotal questions to watch.
Two former employees of a Dallas hospital filed suit Thursday claiming they were fired for reporting flagrant False Claims Act and other violations, including "up-coding," false billing and texting unencrpted patient information.
A Georgia hospital system will pay nearly $3 million to resolve allegations from the state’s attorney general that it overbilled the Georgia Medicaid program for caring for newborns, the AG’s office said Thursday.
A group of 25 college professors filed an amicus brief Wednesday urging the Eighth Circuit to toss an appeal brought by Nebraska Gov. Pete Ricketts seeking to revive the state’s same-sex marriage ban, saying that marriage has served many purposes beyond procreation throughout American history.
A Pennsylvania state judge on Thursday temporarily blocked portions of an executive order by Gov. Tom Wolf that critics say make it easier for home health care workers to organize.
Sheppard Mullin Richter & Hampton LLP has added to its Orange County, California, office a former Greenberg Traurig LLP attorney with expertise in securities law and mergers and acquisitions in the health care and life sciences industries, the firm said recently.
Miami-area hospital network Baptist Hospital of Miami Inc. on Wednesday sued Humana Health Insurance Co. of Florida Inc. for allegedly underpaying for services and excluding it from the network of providers established for the insurer's plans offered through the state's health care exchange.
The relator in a $630 million False Claims Act suit against Omnicare Inc. blasted its disqualification bid over her disclosure of sealed case details, calling the move a “draconian penalty” on Wednesday and asking a Texas federal judge to reduce any eventual payout instead.
Federal prosecutors lashed out Wednesday at FedEx Corp.'s attempt to escape criminal charges that it colluded with illegal online pharmacies to deliver prescription drugs to addicts and drug dealers, arguing that FedEx knew those drugs were never prescribed and made over $800 million in the scheme.
A Pennsylvania federal judge was urged during oral arguments Thursday to dismiss a False Claims Act suit accusing Allergan Inc. of giving illegal kickbacks to doctors across the country to boost the drugmaker's eye drug sales.
A Georgia federal judge on Wednesday found that doctors recruited to testify as experts in a legal malpractice suit over a medical malpractice case gone wrong are essential witnesses, which means defendant Owen Gleaton Egan Jones & Sweeney LLP can’t claim them as its own experts or disqualify opposing counsel for speaking to them.
Natera Inc. dodged a retrial in a $3.5 million False Claims Act suit Wednesday when a California federal judge denied a whistleblower’s bid, validating the jury’s finding the in vitro fertilization tester didn’t make false statements on grant applications.
The matter of Medpoint Management LLC highlights the risks and difficulties faced not only by marijuana businesses, but by their creditors too. Despite Medpoint’s income not directly arising from marijuana and the Cromnibus Act limiting prosecution of marijuana-related offenses, the court still dismissed Medpoint’s case, says John Spires of Dinsmore & Shohl LLP.
The National Labor Relations Board's refusal to order an election in a wall-to-wall unit at Rush University Medical Center seems inconsistent with its long-held view that acute care hospitals are entitled to a special protected status, says Barry Guryan of Epstein Becker & Green PC.
The Ninth Circuit's opinion in Golden v. California Emergency Physicians Medical Group limits the scope of permissible restrictive covenants employers can include in employment contracts and settlement agreements and could void current agreements containing restrictive provisions beyond traditional noncompete clauses, says Katelyn Keegan of Schiff Hardin LLP.
The U.S. Equal Employment Opportunity Commission's recently proposed rules regarding wellness programs require employers to provide reasonable accommodations to enable individuals with disabilities to have equal access to fringe benefits and that any medical inquiries be job-related and consistent with business necessity, says Timothy Collins of Duane Morris LLP.
With all the tangible and intangible costs associated with litigation today, mediation is becoming more common as a means of resolving disputes. Yet attorneys trained and experienced in litigation do not always have the skills to guide their clients through a mediation process, says Raphael Lapin, an adjunct professor at the Whittier School of Law and principal of Lapin Negotiation Strategies.
The U.S. Food and Drug Administration has yet to designate any biosimilar products as “interchangeable” and, although the Centers for Medicare and Medicaid Services' position on the Medicaid Drug Rebate Program is broadly applicable to all biosimilars, it remains unclear whether CMS will treat all biosimilars equally under Medicare, say attorneys at King & Spalding LLP.
Critics will argue that the First Circuit is allowing the government and relators to use the False Claims Act as a vehicle to enforce increasingly minor regulations with harsh penalties. The court's approach, however, relies on the plain language of the FCA without the technical baggage that comes with the tests articulated by other U.S. appellate courts, say Sarah Kelly and Katy Meszaros of Nutter McClennen & Fish LLP.
If we were developing a system to determine legal fees from a clean slate, we would price our professional services according to quality, efficiency and results — tasks and team would be agreed upon. Instead, we have an hourly system that discourages tight management, can lead to padded bills and includes time for work that may not have been necessary, says Gerald Knapton of Ropers Majeski Kohn & Bentley PC.
Pill counts and filling out medication logs may not generate rave patient reviews or boost the earnings of a medical practice, but these mundane tasks may shorten an audit or diversion investigation by the U.S. Drug Enforcement Administration where a registrant has complied with the law, says Patrick Preston of McKay Chadwell PLLC.
The Ninth Circuit’s recent St. Luke’s decision involving the vertical acquisition of a provider group by a health system in Idaho seems to severely restrict the efficiencies defense in a fashion inconsistent with the goals of antitrust law and sound enforcement policy, say David Balto and James Kovacs of the Law Offices of David Balto.