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Health
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June 18, 2013
NJ Bill To Fund Poor Hospitals With New Fee Squeaks By Panel
A proposed bill that would impose a fee on some New Jersey hospitals to fund others that serve low-income communities barely advanced out of a New Jersey Senate committee vote on Tuesday, amid criticism the fee is an unprecedented tax that would hurt hospitals financially.
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June 18, 2013
OnCure Gets $25M Bankruptcy Loan Greenlighted For Now
A Delaware bankruptcy judge on Tuesday gave private equity-owned cancer center operator OnCure Holdings Inc. an interim go-ahead for a $25 million post-petition loan, despite the U.S. Trustee's Office's objection to how the credit facility was structured.
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June 18, 2013
Allstate Says Evidence Supports Jury's $6M RICO Award
Allstate Insurance Co. urged a Texas federal judge on Tuesday to uphold a jury's $6 million damages award in a civil RICO suit, saying the award is supported by the insurer's claims that a network of chiropractors, lawyers and telemarketers conspired to inflate billings.
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June 18, 2013
Reps. Label CMS Evasive, Push Bill To Delay Competitive Bids
A bipartisan duo of House lawmakers Tuesday sharply escalated their campaign to halt expansion of a competitive bidding program for purchases of durable medical equipment, labeling Medicare’s top official “evasive” and introducing legislation to force a delay while alternatives are explored.
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June 18, 2013
Cancer Testing Co. Blasts False Claims Suit As 'Speculation'
Cancer diagnostic company Caris Life Sciences Inc. told a Texas federal court Monday that allegations that it overbilled Medicare and gave hospitals kickbacks were based on "mistaken assumptions and speculation" from former employees who couldn't possibly have known about any false claims.
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June 18, 2013
ACA Exchanges Creating Competition, Confusion: Reports
States running their own health insurance exchanges under the Affordable Care Act are seeing sharp increases in competition that could help contain premiums, but those deferring completely or partially to the federal government have experienced potentially troublesome confusion, according to reports issued Monday.
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June 18, 2013
Rotech Equity Holders Lose Bid To Hire Moelis As Adviser
The equity committee in the Rotech Healthcare Inc. Chapter 11 case lost a bid to hire Moelis & Co. LLC as its financial adviser Tuesday, when a Delaware bankruptcy judge said Moelis' fee was too expensive for a creditor not believed to be getting any recovery.
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June 18, 2013
Dignity Health Blasts ERISA Suit Over $1.2B Pension Shortfall
Dignity Health on Monday asked a California judge to dismiss a putative class action alleging that the health care conglomerate underfunded its pension plans by $1.2 billion, arguing its status as a religious institution exempts it from the law.
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June 18, 2013
Temple U. Can't Block Fired Worker's Return, Pa. Judge Rules
A Pennsylvania state judge last week shot down a suit by Temple University Hospital seeking to overturn an arbitrator's decision allowing a worker who was fired for sexual harassment to return to her job.
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June 17, 2013
New Texas Laws Crack Down On Medicaid, Medicare Fraud
Texas Gov. Rick Perry on Friday signed a series of bills intended to clamp down on Medicaid and Medicare fraud by stepping up state enforcement and investigations, barring more bad practices and setting up procedural safeguards for health care providers accused of wrongdoing.
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June 17, 2013
Doctor Prevails In Trial Over 8-Month Erection
A Delaware state court jury on Monday said a doctor who performed a penile implant that allegedly left a patient with an eight-month erection was not guilty of medical negligence.
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June 17, 2013
GOP Subpoenas Documents On ACA's Co-Op Insurance Plans
House Republicans on Friday subpoenaed documents assessing the financial viability of nonprofit health insurance plans supported with billions of dollars in loans under the Affordable Care Act, saying the so-called co-ops aren’t being properly vetted and could cost taxpayers huge sums of cash.
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June 17, 2013
Jones Day Lures Health Care Transactions Partner In Dallas
Jones Day has beefed up its Texas health care and mergers and acquisitions practices, adding a seasoned health care transactional and regulatory partner to its Dallas office, the firm announced Monday.
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June 17, 2013
Ex-Chicago Official, Others Convicted In Bribery Conspiracy
An Illinois federal jury on Monday found a former Chicago alderman and two employees of a prescription medication provider guilty of conspiring to bribe a person they allegedly believed was a public official in order to score business from the Los Angeles County hospital system.
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June 17, 2013
Medical Services Co. Enters Ch. 11, Citing Medicare Woes
Medical business management firm OnCure Holdings Inc., along with more than 20 affiliates, filed for Chapter 11 protection Friday, saying the companies took a significant revenue hit and ran into debt trouble after reimbursements from Medicare dropped.
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June 17, 2013
Conn. High Court Slashes Coverage For Nursing Home Fire
The Connecticut Supreme Court has sharply reduced the amount of insurance available for wrongful death and injury claims stemming from a nursing home fire set off by a resident, holding in an opinion to be published Tuesday that coverage was limited to $1 million, not $10 million, as a lower court had ruled.
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June 17, 2013
ACA Medicaid Expansion Passes In Calif. Legislature
The California State Legislature voted on Saturday to expand Medicaid benefits to 1.4 million low-income residents, approving a provision of the federal Affordable Care Act.
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June 14, 2013
McKesson Dodges Warehouse Worker's Wage-Hour Action
McKesson Corp. on Friday escaped a putative class action alleging it violated meal break and seating requirements at California distribution centers, but was unable to persuade a judge that giving notice of the dismissal to potential class members would unnecessarily “stir up” the workforce.
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June 14, 2013
CMS Opens Door To Bifurcated ACA Health Exchanges
The Centers for Medicare and Medicaid Services on Friday said it will allow states to run the Affordable Care Act's health insurance exchanges for small businesses while leaving the federal government responsible for online marketplaces serving individuals, the latest bid to encourage wider participation.
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June 14, 2013
Dems Introduce Bill Giving Churches ACA Tax Credits
Two Democrat senators introduced a bill Friday that would allow churches to receive small-employer tax credits under the Affordable Care Act without changing their current health plans.
Expert Analysis
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How To Avoid Discriminatory Wellness Programs Under HIPAA
In addition to providing clear guidance for designing nondiscriminatory wellness programs, recent insight from the U.S. Departments of Treasury, Labor and Health and Human Services may also bring more outcome-based programs and new plan designs that shift costs to employees who do not participate, says Priscilla Ryan of Sidley Austin LLP.
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Takeaways From Largest Drug Safety Settlement
The recent $500 million settlement of Ranbaxy USA Inc., the largest drug safety-related settlement with a generic manufacturer to date, has broad implications for U.S. Department of Justice and Food and Drug Administration enforcement trends. However, significant questions exist regarding the basis for False Claims Act liability, say attorneys with Skadden Arps Slate Meagher & Flom LLP.
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A Stark Reality For Fair Market Value
Under cases involving health care organizations and their Stark Law violations, the government has enforced actions and settlements ranging from $10 million to nearly $40 million in the first half of 2013. These cases highlight a new effort toward Stark Law violations and ultimately, a change in the way organizations should approach fair market value issues, say attorneys with Krieg DeVault LLP.
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Is TAR Right For Your Discovery Project?
There are several critical decision factors to weigh to assess whether Technology Assisted Review is right for a discovery project — for example, the nature of the case, internal capabilities, production considerations and overall comfort with this technology, say Michele Lange and Joseph White of Kroll Ontrack Inc.
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Know Your Options Before You Pay Those Taxes
New and increased taxes that went into effect Jan. 1, 2013, are hitting employers and employees in several areas. Now is the time for employers to consider their options for qualified retirement plans, such as the individual account plan and cash balance plan, says Lee Polk of Epstein Becker & Green PC.
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Class Arbitration Is Back In Arbitrators’ Hands
Arbitrators can still interpret contracts pretty much any way they want, according to the U.S. Supreme Court’s unanimous ruling in Oxford Health Plans LLC v. Sutter. The holding should come as no great surprise as it reflects decades of federal arbitration law, yet the unanimous ruling is a surprise, given what preceded it, says Christopher King of Homer Bonner Jacobs.
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5 Lessons From Idaho State University's HIPAA Settlement
The message from Idaho State University's recent $400,000 Health Insurance Portability and Accountability Act settlement is clear — the Office of Civil Rights is serious about Security Rule compliance. Yet many, if not most, providers have ignored or do not understand the specific, technical requirements of the rule, says Kim Stanger of Holland & Hart LLP.
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Dear Mobile Medical App Developers ...
Recently, the U.S. Food and Drug Administration issued an "It Has Come to Our Attention Letter" to Biosense Technologies, the developer of a urine analyzer mobile app. Although the FDA does not indicate why it opted to publicly disclose this letter, one can assume that it did so due to the regulatory uncertainty in this area and the desire to put other app developers on notice of the issue, says Paul Rubin of Ropes & Gray LLP.
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When In Doubt, Write Your Doctor A Letter
Tietz v. Abbott Laboratories Inc. has significant implications for the future of failure-to-warn litigation involving prescription drugs as it has opened the door to the argument that a drug manufacturer has a duty to send a "Dear Doctor" letter before the letter is approved by the U.S. Food and Drug Administration, say attorneys with Morrison & Foerster LLP.
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Checklist For Your Health Insurance Navigator Program
The Affordable Care Act requires health insurance exchanges to establish a navigator program, and while it provides a general framework, the act leaves much discretion to the exchanges and states in designing their own program. In developing such a program, exchanges and states have a number of issues to consider, say attorneys with Wilson Elser Moskowitz Edelman & Dicker LLP.