• July 21, 2014

    Humana Looks To Toss Medicare Advantage FCA Suit

    Humana Inc. has asked a Florida federal judge to toss a whistleblower suit brought by a physician accusing the insurer of submitting fraudulent claims for payment through the Medicare Advantage program, claiming the suit fails to state a plausible theory demonstrating Humana’s liability under the False Claims Act.

  • July 21, 2014

    Biggest Health Care Cases Of 2014: Midyear Report

    Courts during the first half of 2014 handed down a number of important rulings that will shape the hottest topics in health care, including provider consolidation, employee benefits under the Affordable Care Act and the availability of attorney-client privilege in False Claims Act litigation.

  • July 21, 2014

    LA Sues Hospital For Spinal Implant Overbilling Scheme

    Los Angeles County sued a Long Beach hospital, its former president, and medical device company International Implants LLC in California court Friday, claiming their scheme to inflate the cost of spinal surgery equipment cost the county's workers' compensation plan millions of dollars.

  • July 21, 2014

    HHS Formalizes 340B Policy As Court Fight Continues

    The U.S. Department of Health and Human Services on Monday released a new regulation requiring drugmakers to discount so-called orphan drugs when hospitals use them for conditions that aren’t rare, hoping to skirt a recent court decision that called the 340B program policy into question.

  • July 21, 2014

    Sutter Health Beats Patient Data Theft Claims On Appeal

    A California appeals court on Monday reversed a decision holding Sutter Health accountable after a computer containing millions of patient records was stolen, finding that the plaintiffs who brought the $4 billion suit hadn't shown that unauthorized people looked at their data.

  • July 21, 2014

    Minn. Appeals Court Tosses UnitedHealth Exec's Fraud Claims

    A Minnesota appeals court on Monday ended a former UnitedHealth Group Inc. executive's bid to sue the company and former colleagues after his insider trading conviction, saying the executive waited years too long to file his claims that other executives falsely promised him aid.

  • July 21, 2014

    Johns Hopkins Settles Pelvic Exam Suits For $190M

    Johns Hopkins Hospital has agreed to pay $190 million to settle a class action filed by thousands of women who alleged they were secretly videotaped during gynecological examinations by Nikita Levy, who last year killed himself as police closed in, a plaintiff’s attorney said on Monday.

  • July 21, 2014

    Union Denies Blocking CareOne's Access To Dying Witness

    A Service Employees International Union group has bristled at CareOne LLC's bid for sanctions in its racketeering case against the union, urging a New Jersey federal court to ignore claims it intentionally blocked the deposition of a key witness who was dying of cancer.

  • July 21, 2014

    Hair Transplant Doc Sues McDonald Hopkins Over Bosley Suit

    An Illinois doctor has sued McDonald Hopkins LLC for legal malpractice, claiming the firm botched his defense of a noncompete lawsuit brought by his former employer, the hair transplant surgery provider Bosley Medical Group SC.

  • July 21, 2014

    Key Democrats Tell 5th Circ. To Nix GOP Donor's ACA Suit

    Democratic lawmakers urged the Fifth Circuit to reject a prominent Republican donor’s suit challenging the constitutionality of the Affordable Care Act, saying that Congress followed the proper legislative procedures to enact the law and that there were no such violations of the origination clause.

  • July 18, 2014

    High Court Puts Utah Same-Sex Marriages On Hold

    The U.S. Supreme Court on Friday granted an emergency stay in which Utah doesn't have to recognize 1,300 same-sex marriages performed in the state between Dec. 23 and Jan. 6 while the Tenth Circuit reviews the merits of Utah's appeal over their validity.

  • July 18, 2014

    Sterling Can't Use HIPAA To Defeat Alzheimer's Testimony

    Donald Sterling can't use medical privacy laws to strike doctors' testimony that he has Alzheimer's disease — key evidence in his wife's probate suit to take control of the Los Angeles Clippers on grounds that Sterling is mentally incapable — a California judge ruled Friday.

  • July 18, 2014

    Lehman's Bond Fight With Nonprofit Kept In Bankruptcy Court

    A New York federal judge on Friday refused to take Lehman Brothers Holdings Inc.’s suit alleging a nonprofit health care provider breached a swap agreement out of bankruptcy court, finding the right to a jury trial doesn’t matter at this stage of the case.

  • July 18, 2014

    Idaho Presses 9th Circ. To Restore Its Abortion Laws

    Idaho's deputy attorney general urged the Ninth Circuit on Friday to overturn a district court's ruling that the state's laws restricting abortions are unconstitutional, saying the case of a woman who challenged the laws is moot after criminal charges were dropped, and a replacement plaintiff lacks standing.

  • July 18, 2014

    Taxation With Representation: Cravath, Simpson Thacher

    In this week's Taxation with Representation, Simpson Thacher helps tobacco giant Reynolds American Inc. grab Lorillard Inc., while Cravath guides Mylan Inc.'s acquisition of Abbott Laboratories' non-U.S. generics businesses in a $5.3 billion blockbuster deal.

  • July 18, 2014

    10th Circ. Strikes Okla. Same-Sex Marriage Ban

    A Tenth Circuit panel on Friday struck down Oklahoma's state prohibition on same-sex marriage, a decision that comes less than a month after the same appeals court found a similar ban in Utah unconstitutional.

  • July 18, 2014

    Affinity Health Plants HQ At New Bronx Development

    Managed care company Affinity Health Plan has signed a 95,000-square-foot lease for a new headquarters at Simone Development Cos.' Metro Center Atrium in the Bronx, New York, Simone announced Thursday.

  • July 18, 2014

    DC Circ. Says Temp Nurse Is 'Employee' In $3M Coverage Row

    The D.C. Circuit ruled Friday that a hospital's captive insurer owes $3 million to Interstate Fire & Casualty Co. for a medical malpractice settlement, finding that a temporary nurse qualified as an “employee” and thus triggered the captive insurer's policy.

  • July 18, 2014

    Medicare Eases Controversial Part D Prior Authorizations

    Facing heavy pressure from Congress and health care providers, federal regulators on Friday largely backed off directing terminally ill hospice patients to obtain prior authorizations of all medications billed to Medicare Part D, leaving the expectation intact for only four drug classes.

  • July 18, 2014

    Mass. AG Wins Delay Of Partners' Antitrust Deal Hearing

    A Massachusetts judge on Thursday granted a request by Attorney General Martha Coakley to postpone a hearing to assess public comments on an agreement letting Partners HealthCare System acquire three hospitals.

Expert Analysis

  • Lessons From Omnicare Settlement In 'Swapping' Cases

    Katherine A. Lauer

    The Omnicare settlements, while not adding to the substantive case law, do demonstrate that these swapping cases will likely become more common in the coming years as more qui tam relators are tempted by these and other large settlements, say Katherine Lauer and Amy Hargeaves of Latham & Watkins LLP.

  • EPA May Threaten Reverse Distribution Of Pharmaceuticals

    Jonathan E. Wells

    The U.S. Environmental Protection Agency may adopt starkly different approaches toward regulating nonhazardous pharmaceuticals and pharmaceuticals containing hazardous ingredients, with additional inconsistencies between health care facilities and other retailers — a regulatory nightmare for industry, say Jonathan Wells and Elise Paeffgen of Alston & Bird LLP.

  • Powerful Tools For Discovery And Litigation Strategy

    Nathalie Hofman

    Analytics offer opportunities for refining both discovery strategy and overall litigation strategy by providing information to support better informed decisions. As an added bonus, they can result in significant cost savings, say Nathalie Hofman and Carolyn Southerland of Huron Consulting Group Inc.

  • Data Breach Dismissals Continue Post-Clapper

    David M. Brown Jr.

    In re Science Applications International Corp. Backup Tape Data Theft Litigation reinforces the trend among federal courts in the aftermath of the U.S. Supreme Court's ruling in Clapper v. Amnesty International USA that the loss of data and increased risk of indentity theft from data breaches do not constitute injury, says David Brown Jr. of Montgomery McCracken Walker & Rhoads LLP.

  • Mild Financial Fallout From Uganda Anti-Homosexuality Act

    Stephanie Keene

    Despite the withholding of funds by many Western donors and initial suspicions that foreign investors might boycott Uganda in response to the Anti-Homosexuality Act, the broader economic implications of the act appear to be less significant, say attorneys at Covington & Burling LLP.

  • Bullish Behavioral Health Market Drives Investment

    Richard S. Grant

    The confluence of increased patient demand, lack of adequate services and increased availability of payment has created a market opportunity in behavioral health for private equity investors, say members of McGuireWoods LLP and private equity firm HCP & Co.

  • Fighting 'Superbugs' With Next Generation Antibiotics

    Daniel L. Spiegel

    In the face of antibiotic-resistant "superbugs," global health experts are urging a different business model for developing new antibiotics, arguing that governments may need to commit resources years in advance to defray costs and improve incentives to get new drugs to market quicker, say Daniel Spiegel and Constance Anne Pence of Covington & Burling LLP.

  • OPINION: Let's Financially Reward Law Firm Diversity

    Patricia K. Gillette

    It only took the threat of a 10 cent cost increase to make people bring their own bags to Bay Area grocery stores. What if we gave partners an extra $10,000 for increasing diversity in their firms? asks Orrick Herrington & Sutcliffe LLP partner Patricia Gillette.

  • Crucial Predictive Coding Case Law: Progressive V. Delaney

    Emily Cobb

    Any practitioner considering predictive coding should fully consider Magistrate Judge Peggy Leen’s reasoning in Progressive Casualty Insurance v. Delaney and the potential pitfalls associated with failure to consistently cooperate, say Emily Cobb and Annamaria Enenajor of Ropes & Gray LLP.

  • Calif. Drug Bill Would Frustrate Pharmacy Operations

    Roger N. Morris

    AB 2418 would add California to the growing list of states that allow patients to opt out of insurance requirements that oblige them to refill certain prescriptions through mail-order pharmacies rather than retail pharmacies, causing system and program changes for health plans, insurers and pharmacy benefit management companies, say attorneys at Quarles & Brady LLP.