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Health
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May 23, 2013
$2B Hospital Project Again Clears San Fran Panel
After nearly a year of legal and political stumbling over the environmental review of California Pacific Medical Center’s $2 billion hospital expansion plan, the project on Thursday won back expired approvals from the San Francisco planning commission.
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May 23, 2013
FTC Says High Court Case Dooms NC Dental Board Appeal
The Federal Trade Commission told the Fourth Circuit on Wednesday that a recent U.S. Supreme Court decision urging deference to agencies' interpretations of their own jurisdiction supported its efforts to pursue an antitrust case against North Carolina's dental board.
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May 23, 2013
Vaccine Distributor Antitrust Claims Should Stick, Judge Told
A Nevada clinic said Wednesday it had presented enough evidence to tie Apexus Inc. to alleged abuse of a federal drug-discount program and keep the nonprofit drug distributor in an antitrust suit that also targets GlaxoSmithKline LLC and a public health agency.
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May 23, 2013
GOP Bill Would Ease Rules On Health Savings Accounts
Republicans in both houses of Congress on Thursday introduced legislation to significantly loosen rules on tax-advantaged health savings accounts and flexible spending accounts, a push that comes as employers' increasing use of high-deductible health insurance plans makes such arrangements more common.
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May 23, 2013
Cigna Gets Heart Device Coverage Fight Sent To Arbitration
A Pennsylvania federal judge on Thursday dismissed a pair of cardiac telemetry makers' suit alleging Cigna Health Corp.'s decision to stop covering the device violates federal pension and unfair competition laws, finding the claims are subject to arbitration under each plaintiff's provider agreement with Cigna.
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May 23, 2013
Litigation Financier Can't Recoup Rival's Payout: NJ Court
A New Jersey appeals court ruled Thursday that a litigation financing company fighting a competitor over the proceeds of a hospital lawsuit can't recover the competitor's reimbursement because the competitor funded an attorney in the case, and not the litigation.
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May 23, 2013
Millennium Labs Drops Claims Over Kickback Suit Coverage
A California federal judge Tuesday approved a joint dismissal of Millennium Laboratories Inc.'s claims that two insurers wrongfully refused to pay for the company's defense in separate disputes with competitors that allegedly used kickbacks and confidential information to steal Millennium's customers.
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May 23, 2013
Aetna Wins NJ Surgical Center Coverage Row
Aetna Health Inc. on Wednesday defeated a lawsuit filed by an outpatient surgical center claiming the insurer's refusal to cover procedures violated the Employee Retirement Income Security Act, when a New Jersey federal judge ruled Aetna's decision was supported by substantial evidence.
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May 23, 2013
CMS Delays Accreditation Overhaul Amid Provider Fury
The Centers for Medicare and Medicaid Services on Thursday delayed its bid to more strongly regulate organizations that certify health care providers as eligible to bill for services, a move that comes amid complaints from hospitals and doctors that the oversight could become too heavy-handed.
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May 23, 2013
Pa. Rep. Pushes Bill To Track Fracking Health Effects
Following a hearing in which experts accused Pennsylvania regulators of inadequately protecting public health and the environment from the effects of Marcellus Shale drilling, organizer Rep. Greg Vitali, D-Delaware, announced Wednesday that he would push legislation expanding the responsibilities of the state's health agency.
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May 23, 2013
Target, CVS Sued For Slandering Docs, Voiding Prescriptions
Target Corp., Rite Aid Corp. and CVS Caremark Corp. were hit with a proposed class action in California state court Wednesday, accusing them of using a state Medicaid suspension list to wrongly void non-Medicaid prescriptions written by suspended doctors and slandering the doctors to patients.
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May 23, 2013
Senators Introduce Bill Limiting Medicare Audits
A legislative push to cap audits of hospitals' Medicare claims continued Wednesday, as two Senate lawmakers floated a companion bill to a House measure restricting the number of reviews by recovery audit contractors in order to ease the demand on hospitals and eliminate redundant programs.
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May 23, 2013
Uniform Contracts, Medicare Pilot Program ID'd For Cost Cuts
The government could save $2 billion by canceling an ineffective Medicare pilot program one year early and $82 million by streamlining military uniform purchases, the Government Accountability Office said in a report Wednesday that found more than two dozen areas ripe for cost cuts.
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May 22, 2013
NY Can't Dodge Judges' Suit Over Health Contribution Cuts
A New York judge on Tuesday refused to dismiss a suit challenging a state law that reduced New York's contribution to the health insurance premiums of current and retired state judges, finding the judges had sufficiently alleged that the law imposes an unconstitutional decrease in judges' compensation.
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May 22, 2013
Chem Rx Bosses Ask 2nd Circ. To Toss $106M Clawback Suit
Former principals at bankrupt Chem Rx Corp. urged the Second Circuit on Wednesday to kill a trustee lawsuit aimed at forcing them to give up $106 million they made in the pharmacy’s leveraged buyout.
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May 22, 2013
Ga. High Court Crushes Discovery Bid In Malpractice Case
The Georgia Supreme Court ruled Monday that the plaintiff in a medical malpractice action couldn't use the federal Health Insurance Portability and Accountability Act to force WellStar Health System Inc. to turn over interview transcripts, saying they were attorney-client work product.
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May 22, 2013
Kindred Healthcare Sues Landlord Over $10.5M Default Threat
Acute-care service provider Kindred Healthcare Inc. hit real estate investment company Ventas Inc. with a suit in New York state court Tuesday claiming the REIT wrongly accused Kindred of defaulting on four leases in order to extract more than $10.5 million in fees and expenses.
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May 22, 2013
BakerHostetler Lures Ex-Kutak Rock Atty To Litigation Group
BakerHostetler has added a former Kutak Rock LLP partner specializing in employment, health care and real estate law to its litigation group, the law firm announced Wednesday.
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May 22, 2013
Fla. Health Clinic Director Gets 9 Years, $24M For Fraud
A Miami federal judge on Wednesday sentenced a former health care clinic director and licensed therapist to more than nine years in prison and a personal judgment of nearly $25 million for his role in a $63 million Medicare and Medicaid fraud case.
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May 22, 2013
Feds Seek $237M False Claims Award Against SC Hospital
The federal government said Wednesday that a South Carolina hospital system should pay $237 million — the minimum recovery after a federal jury found that it defrauded Medicare — but added it was open to a smaller settlement since the system's pockets might not be deep enough.
Expert Analysis
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Uncertainty Persists In HHS Religious Health Care Rules
By modifying the definition of an exempt religious institution in the U.S. Department of Health and Human Services' latest proposals, the government may eventually moot out some of the more difficult cases brought by religious institutions. But between the lines, there are a number of practical issues that persist and may still be addressed, says Mark Chopko of Stradley Ronon Stevens & Young LLP.
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Calydial's Telehealth Lessons For US Cos.
Too often, companies try to reinvent the wheel, especially in the telehealth sector, where new models of care are constantly being tested. Fortunately for U.S. hospitals, health systems and companies, we have great examples of telehealth models that have built successful business models, such as the France-based company Calydial, says Dana Pirvu of Epstein Becker & Green PC.
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6 Ways The ACA May Increase Federal Contractors’ Costs
Federal contractors face significant cost increases and compliance requirements as a result of the health insurance reforms in the Affordable Care Act. To minimize costs and compliance risks in the future, companies should take a number of steps in the coming months, say attorneys with Arnold & Porter LLP.
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Legal Risks Behind Workplace Wellness Programs
Although more clarity is needed from administrative agencies and the courts regarding the contours of a lawful employee wellness program, it is definitely better at this point to structure such programs using rewards or incentives for participation as opposed to penalties for nonparticipation, says Kevin Kelly of Locke Lord LLP.
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Wakeup Call For Health Facilities Aiding Deaf Patients
The U.S. Department of Justice's five newly announced settlements — one with a hospital, two with rehabilitation centers and two with private specialty practices — highlight the agency's continuing focus on providers and their practices when providing medical information to deaf patients or companions, say Nathan Kottkamp and Melissa Taylormoore of McGuireWoods LLP.
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Rise Of The Machines — Predictive Coding Goes Mainstream
The pros of using predictive coding far outweigh the cons. Given the heavy pressure on law firms and in-house counsel to reduce discovery costs, as well as the Justice Department's recent stance on the subject, it appears predictive coding will continue to emerge from the obscure world of legal technology to the mainstream of legal practice, say Michael Moscato and Myles Bartley of Curtis Mallet-Prevost Colt & Mosle LLP.
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PE Investors Should Consider Behavioral Health
As demand for behavioral health services increases, and those individuals with need have insurance that will pay for it, the growth potential for behavioral health services is significant. Private equity investors are well-poised for jumping into this market to bring new business models and innovation to the industry, say attorneys with McGuireWoods LLP.
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US V. MedQuest Is Important For Health Care FCA Cases
The Sixth Circuit recently reversed an $11.1 million False Claims Act judgment in U.S. v. MedQuest Associates. The court's refusal to impose the FCA’s “extraordinary penalties” on violations of technical and local Medicare program requirements represents significant precedent for health care providers facing an FCA suit, say attorneys with Ropes & Gray LLP.
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High Court's Nassar Case — What's At Stake For Employers
The U.S. Supreme Court recently heard argument for University of Texas Southwestern Medical Center v. Nassar, and while the case seems promising for employers, it should also remind them that their best protection against retaliation claims will continue to be contemporaneous written evidence of a real reason for taking unfavorable actions against an employee, say attorneys with Seyfarth Shaw LLP.
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Yet Another Cliff-Hanging OIG Report
In its ongoing series of studies and audits, the U.S. Department of Health and Human Services' Office of Inspector General recently released its report on Medicare hospice and general inpatient care. While the report clearly shows the OIG's concern for the substantial percentage of hospices not providing GIP, it also leaves several questions unanswered, say attorneys with Morgan Lewis & Bockius LLP.