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Health
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May 3, 2013
IRS Closes Loophole On ACA's Employer Mandate
The Internal Revenue Service on Friday plugged a loophole that could have let companies skirt the health reform mandate that large employers provide affordable medical benefits, saying businesses that force employees to enroll in excessively expensive plans would be fined as if they hadn't offered coverage at all.
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May 2, 2013
NJ Health Commish Says State Is Preparing For Demand Spike
The commissioner of New Jersey’s Department of Health on Thursday told a state General Assembly committee her agency was preparing solutions for the expected spike in health care demand brought about by Medicaid expansions under the Affordable Care Act but admitted she couldn’t anticipate the new strain on the system.
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May 2, 2013
Pharma Cos. Smell Victory In Push For Drug-Tracking System
With gathering momentum in Congress this year, experts say the pharmaceutical industry — including drugmakers, wholesalers and pharmacies — could win its push for a nationwide system to trace drugs through the supply chain, protecting brands from counterfeiters and preempting a stricter California law set to take effect in 2015.
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May 2, 2013
Mich. High Court Won't Hear AG's Beef Over Same-Sex Benefits
The Michigan Supreme Court on Wednesday shot down state Attorney General Bill Schuette's challenge to a policy extending health care benefits to same-sex domestic partners of state workers.
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May 2, 2013
CMS Proposes $500M Payment Bump For Nursing Homes
Medicare expects to pay skilled nursing facilities about 1.4 percent more in fiscal year 2014, or about $500 million more total, the agency said Wednesday in a proposed rule setting payments to nursing homes and other facilities for 2014.
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May 2, 2013
Calif. Court Upholds Medi-Cal Limits On Psychology Claims
A California appeals court ruled Thursday that a monthly limit on Medicaid reimbursements for psychological services provided by so-called federally qualified health centers did not violate either state or federal law, overturning a lower court's decision.
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May 2, 2013
Replacement Nurses Reap $1.8M In Calif. Wage Settlement
U.S. Nursing Corp. has agreed to pay $1.8 million to settle a proposed class action alleging the company, which deploys nurses to cross picket lines and temporarily replace striking employees, didn't fully compensate its strikebreakers, according to documents filed Thursday in California federal court.
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May 2, 2013
Federal Court Can't Hear HIPAA Case, Hospital Group Says
Hospital owner Adventist Health System/Sunbelt Inc. on Thursday asked a Florida judge to toss a proposed class action alleging it violated patients’ privacy rights by failing to prevent emergency room workers from selling access to its medical records database.
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May 2, 2013
Wellness Programs Won't Help Cos. Avoid ACA Penalties: IRS
The Internal Revenue Service on Friday is scheduled to announce that most employee wellness programs won’t count toward a health insurance policy’s minimum value that large companies must provide to avoid Affordable Care Act penalties, a blow to businesses that are increasingly incentivizing workers to improve their health.
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May 2, 2013
Greenberg Traurig Gets SEC Subpoena In Insider Probe
The U.S. Securities and Exchange Commission has issued subpoenas to Greenberg Traurig LLP and health care attorney Mark Hayes amid an insider trading investigation into the firm’s dealings with a client in the political intelligence industry, according to a Thursday news report.
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May 2, 2013
UMass Medical To Pay $2.2M To End Unpaid Wages Suit
UMass Memorial Medical Center Inc. reached a proposed $2.2 million settlement of a class action by clinical employees alleging they worked through unpaid lunch breaks and did extra work before and after their shifts for which they weren’t paid, according to a motion filed Wednesday in Massachusetts federal court.
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May 2, 2013
NJ Medical Sales Reps Plead Guilty To Kickback Scheme
Two New Jersey men admitted Thursday to engaging in a conspiracy to bribe doctors to refer blood samples to Biodiagnostic Laboratory Services LLC, the medical testing lab where they used to work as sales representatives, in violation of federal corruption laws, according to a statement.
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May 2, 2013
Quest Loses Challenge To $250M LabCorp Army Contract
A federal judge has denied Quest Diagnostics Inc.'s protest of a $250 million U.S. Army medical testing contract awarded to rival Laboratory Corp. of America, according to an opinion unsealed Wednesday.
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May 2, 2013
Insurer Can't Escape Mental Health Parity Suit
In a decision hailed by mental health advocates, a Vermont federal judge on Tuesday preserved much of a New York woman's suit alleging her employer's health plan improperly restricted psychiatric treatments more than traditional medical care, saying the insurer failed to show it acted in an even-handed manner.
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May 2, 2013
Calif. Law Guides Texas Appeals Court's Anti-SLAPP Ruling
A Texas appeals court on Thursday pointed to California law in ruling that a business transaction exemption to a state statute protecting free speech did not apply to newspaper articles describing poor conditions at an assisted living facility.
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May 2, 2013
IRS Accused Of Overreach On ACA Exchange Subsidies
A group of small business owners and individuals on Thursday sued the Internal Revenue Service in Washington federal court, alleging it had unlawfully exposed them to potential penalties through a rule expanding Affordable Care Act insurance subsidies to states that don’t run their own insurance exchanges.
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May 2, 2013
Steward Accuses Blue Cross Of Blocking $40M Hospital Deal
Private equity-owned Steward Health Care System LLC on Wednesday hit Blue Cross Blue Shield of Rhode Island with an antitrust suit in state court, alleging the insurer had blocked a $40.1 million hospital acquisition deal to maintain its market power in the state.
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May 1, 2013
GOP Lawmakers Release Medicaid Reform Plan
A pair of senior Republican lawmakers on Wednesday released a plan to reform the Medicaid program by putting more control in state hands, saying such a change would reduce costs while improving flexibility for states and outcomes for beneficiaries.
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May 1, 2013
Medicaid Must Update Improper Payment Estimates, GAO Says
The federal Medicaid agency has made progress in accurately measuring the rate of improper payments, but needs to take steps to make sure it is using the most up-to-date data possible, the U.S. Government Accountability Office said in a report Wednesday.
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May 1, 2013
Fla. House Sends Medical Malpractice Reform Bill To Gov.
The Florida Legislature sent a bill to Gov. Rick Scott on Wednesday that alters the state’s medical liability system by placing stricter requirements on plaintiffs pursuing medical malpractice claims and allowing doctors or providers to more actively participate in defending themselves against these lawsuits.
Expert Analysis
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A New Trend In Health Care Fraud Settlements
For the first time, companies have been placed on probation, under the supervision of federal courts and the U.S. Department of Justice, as part of health care fraud settlements. Companies may be exposed to more significant criminal penalties when the terms of a corporate integrity agreement are imposed as conditions of probation, say Jack Cinquegrana and Consuelo Valenzuela Lickstein of Choate Hall & Stewart LLP.
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A Victory For State-Action Doctrine Critics
On Feb. 19, 2013, the U.S. Supreme Court visited a corner of the antitrust map that it last glimpsed during the Reagan administration — the state-action doctrine. The ruling in FTC v. Phoebe Putney Health System Inc. will almost certainly be hailed as a major victory for critics of the state-action doctrine, say attorneys with Paul Hastings LLP.
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Best Practices Of Conducting An Accident Investigation
When an accident claim arises, it is crucially important to follow a thorough accident investigation protocol to ensure that the company properly defends itself against an injury or death claim. Establishing an accident investigation team is one of the several practices companies should follow to minimize exposure in such claims or litigation, says Jen Mountcastle of Thompson Hine LLP.
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The Pressure Is On For 340B Entities
When it comes to the 340B drug pricing program, the days of benign neglect are over as the Health Resources and Services Administration's audits and oversight of 340B entities dramatically increase. But increased oversight alone may not end the drumbeat for 340B program reform, says Ellyn Sternfield of Mintz Levin Cohn Ferris Glovsky and Popeo PC.
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Unforeseen Consequences Of The ACA
The recent proposed regulation under the Affordable Care Act started the one-year clock for employers to implement workforce management in preparation for shared responsibility requirements. Employers should proceed with caution, however, as workforce management efforts could have unforeseen impacts, say attorneys with Epstein Becker Green PC.
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Coming Soon To SCOTUS: Technicalities Of Saying 'I Do'
The U.S. Supreme Court’s decision to accept two cases addressing same-sex marriage, Windsor v. United States and Hollingsworth v. Perry, has raised questions about the potential consequences for employers, insurers, health care providers and others. The most significant impact of these decisions may be on employee benefits governed by the Employee Retirement Income Security Act, say attorneys with Faegre Baker Daniels LLP.
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6 Areas Often Underestimated In Law Firm Mergers
While mergers in other industries are driven by cost efficiencies or economies of scale, law firm mergers are typically focused on the potential to leverage clients and the overall quality of the attorney population, branding and market position. As a result, full disclosure of third-party vendor or support function operating costs can be a secondary concern until after the deal closes. Firms need to hit the ground running the moment the merger is inked, says Matthew Sunderman of HBR Consulting LLC.
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ACA Success May Require Immigration Reform
While the comprehensive immigration reform debate has focused on how to handle the country’s undocumented population and the business community’s need for highly skilled workers, the demands of an aging population coupled with health care reform mean that better immigration policy also may be essential to the success of the Affordable Care Act, say attorneys with Epstein Becker Green PC.
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The Next Big Thing In Securities Litigation
The New York Times recently reported that a Chinese military unit had hacked more than 140 organizations over the last several years, stealing valuable intellectual property such as technology blueprints, proprietary manufacturing processes, business plans and pricing documents. The revelation raises the possibility of a new wave of U.S. Securities and Exchange Commission enforcement actions, class actions and derivative lawsuits related to cybersecurity, say attorneys with King & Spalding LLP.
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Firing Employees Who Refuse Flu Shots Has Hidden Risks
As hospitals see an onslaught of flu patients, they face challenges to policies that require employees to receive a flu shot, which can create legal liability when employees are discharged because they decline the shot. To avoid discrimination lawsuits, hospitals should explore possible reasonable accommodations, such as transferring employees who refuse to get a shot until the flu threat ends or exempting them from the policy entirely, says Mark Nelson of Drinker Biddle & Reath LLP.