Highmark Inc. on Friday again asked a Pennsylvania federal judge to force the University of Pittsburgh Medical Center to sign a tentative settlement they had reached to end an antitrust suit over Highmark's acquisition of a hospital system, saying the court should not allow UPMC to get out of a deal it had already agreed to.
The U.S. Department of Health and Human Services balked Monday over the Chapter 11 plan for the owner of a retirement community and assisted-living facility within Florida's PGA National Resort and Spa, arguing it’s unclear how an affiliate intends to deal with its Medicare agreements.
Medicare administrators announced home health care payment changes Friday under the Affordable Care Act that would amount to $200 million in reduced payments to home health agencies in 2014, a move trade groups decried as jeopardizing the financial health of a large portion of Medicare-certified agencies.
The Supreme Court of New Jersey on Friday accepted an appeal from the recipient of a botched spinal surgery who says the surgeon’s failure to disclose his lack of medical malpractice insurance constitutes fraud by the surgeon and the hospital where the surgery took place.
Akin Gump Strauss Hauer & Feld LLP partner Stephanie Webster secured a victory for Allina Health Services hospitals and 27 other major hospitals in a fight over disproportionate share payments last year when she persuaded a D.C. court to strike down a Medicare rule that changed how the payments were calculated, earning her a spot on Law360’s list of Health Care MVPs.
The U.S. Food and Drug Administration on Monday delivered a high-profile jolt to the booming field of personalized medicine by ordering a halt to sales of genetic tests by the wife of Google Inc. co-founder Sergey Brin, putting manufacturers on notice that regulators are getting tough after years of leeway, experts say.
George Washington University on Monday defeated a long-running False Claims Act suit alleging its medical center falsely told Medicare that licensed anesthesiologists performed thousands of anesthesia procedures, with a federal judge ruling four whistleblower nurses hadn't linked specific payments to purported falsities.
The Texas Supreme Court declined Friday to revive a challenge brought by a co-op of independent pharmacies that says the state failed to set minimum reimbursement rates when it adopted rules for funneling Medicaid drug benefits through managed care organizations.
Ironshore Specialty Insurance Co. sued to disavow covering a New England Compounding Center sister pharmacy against claims from alleged victims of the NECC-linked meningitis outbreak, saying Friday that attempts to paint the insured as an NECC alter ego don’t qualify for coverage.
Aetna Inc. will pick up U.K.-based insurer InterGlobal from London private equity firm Alchemy Partners LLP in a move to expand its reach in international private medical insurance, particularly in the Middle East, Asia and Africa, the health insurer said Monday.
LabMD Inc. recently argued that the Federal Trade Commission's data breach claims against it are already covered by a federal health privacy law, a potentially potent defense that attorneys say offers the company — and by extension the industry — its best chance to limit the regulator’s authority over data security.
The U.S. Department of Health and Human Services said Friday that consumers will have an additional eight days to sign up for health insurance under the Affordable Care Act before coverage goes into effect Jan. 1.
Administrators of deceased copper heiress Huguette Clark’s $300 million estate on Monday demanded more than $140 million from Beth Israel Medical Center and Clark’s longtime doctor for allegedly wringing exorbitant donations from their captive patient over a needless 20-year hospital stay.
In the last year, Nicholas J. Pappas, a partner in Weil Gotshal & Manges LLP’s employment litigation practice group, has helped defend longtime client UnitedHealth Group Inc. from a number of high-profile employment-related lawsuits, earning him a spot on Law360's list of Health MVPs.
A D.C. federal judge mulled Friday whether to toss the Roman Catholic Archdiocese of Washington's challenge to the Affordable Care Act's contraception mandate as the church, several religious charities and the federal government argued whether new accommodations have alleviated their religious freedom concerns.
The Roman Catholic dioceses of Pittsburgh and Erie won a preliminary injunction on Thursday blocking provisions of the federal Affordable Care Act mandating that they provide contraceptive and sterilization coverage as part of insurance plans offered to employees of religiously affiliated schools and charitable entities.
California’s health insurance exchange Thursday rejected the Obama administration’s proposal that consumers be allowed to renew policies that lack the Affordable Care Act’s required benefits, a win for insurers worried that the proposal would dissuade Americans from shopping in online marketplaces.
The Pennsylvania Supreme Court ruled Thursday that the state’s workers’ compensation law would allow a suburban Philadelphia hospital to reduce disability benefits paid to a former employee only if the hospital could show that jobs within the worker’s physical limitations were actually available to her.
A New York City panel of city council members and local community board chairs approved Hunter College and Memorial Sloan-Kettering Cancer Center's proposal for a 1.15-million-square-foot complex on the Upper East Side of Manhattan, Hunter College announced Friday.
The U.S. Department of Health and Human Services said Friday it's delaying by one month the deadline for insurers to file rates for the Affordable Care Act's second year, helping companies gauge whether a rocky rollout has scared off healthier customers and forced premiums to rise.
Admissibility rules, when properly applied, prevent unsupported, misleading or faulty opinions from being considered. But a California court’s recent decision in Powell v. Kleinman undermines that notion, setting relaxed admissibility standards that will allow groundless claims to progress to trial and consume already scarce judicial resources, says Brian Davies of Sedgwick LLP.
Among 10 battle-proven strategies for getting your witnesses ready for trial is to role-play the cross-examiner. For instance, if you expect the cross-examiner to yell, get in the witness’ face or use scathing sarcasm, do that during practice to minimize surprises at trial, say Dawn Solowey and Lynn Kappelman of Seyfarth Shaw LLP.
While physician interaction was no doubt subject to considerable company oversight before, the Indiana Court of Appeals' recent decision in Medtronic Inc. v. Malander provides additional incentive for device and pharmaceutical companies to erect appropriate safeguards, say Andrew Campbell and Joseph Winebrenner of Faegre Baker Daniels LLP.
Recent events, from the Westgate Mall attack in Nairobi to the Lac-Mégantic train derailment in Quebec, underscore the need for in-house counsel to keenly weigh risks and benefits for their companies doing business on a multinational scale. There are a number of best practices to consider that set the right tone for mitigating risk, whether you are doing business in one or hundreds of locations around the world, says Veta Richardson, president and CEO of the Association of Corporate Counsel.
The U.S. Supreme Court recently acted on two False Claims Act cases with pending petitions for certiorari, calling for the views of the solicitor general. If the court grants the petition in the KBR Inc. case, that would be good news for potential FCA defendants, but a review by the court of the Takeda Pharmaceuticals North America Inc. case could be bad news for potential defendants, say Dave Nadler and Joseph Berger of Dickstein Shapiro LLP.
Two recent decisions dismissing antitrust claims against health care and property insurers serve as a reminder that the filed rate doctrine remains a potentially powerful defense for insurers when plaintiffs seek damages based on rates approved by a regulatory authority, say Donald Hawthorne and Evan Lee of Axinn Veltrop & Harkrider LLP.
Under the Affordable Care Act's grace period provision, providers could end up treating a patient for two months before realizing the patient is no longer entitled to insurance payment benefits. There are, however, some safeguards that New Jersey providers can put into place to reduce risks of being left uncompensated, say Elizabeth Litten and Michael Coco of Fox Rothschild LLP.
Because those who purchase misbranded medications can be subject to criminal fines and imprisonment, physicians need to watch for the red flags these medications carry, such as product packaging and handling, say Yvonne McKenzie and Colleen Kelly of Pepper Hamilton LLP.
The general lack of state regulation regarding urgent care is likely a direct result of urgent care’s historical outgrowth of the physician practice. However, as the urgent care model continues to evolve and proliferate, and strategic buyers continue to vertically integrate with urgent care facilities as a cost containment mechanism, there is likely to be an uptick in regulation, say attorneys with McGuireWoods LLP.
As the shutdown of the federal government moves into its third week, the congressional calendar becomes all the more scrambled, delaying action on a number of issues of high priority to health care stakeholders, such as sustainable growth rate cuts and the medical device tax repeal, say Nick Manetto and Allison Durham of Faegre Baker Daniels Consulting.