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Health
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May 8, 2013
EEOC Vows To Clarify Wellness Program Standards
The U.S. Equal Employment Opportunity Commission on Wednesday acknowledged the need to issue guidance and standards for employer wellness programs to help companies navigate a complex web of anti-discrimination and health privacy statutes, noting that adding a separate scheme to the mix could add to the confusion.
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May 8, 2013
Trustee Wants Universal Health Care To Move To Ch. 7
The Chapter 11 trustee overseeing Universal Health Care Group Inc.’s bankruptcy case asked Tuesday for the proceedings to be converted to Chapter 7 liquidation after the health maintenance organization, which is also the subject of a federal fraud investigation, tried to sell the business but couldn’t close the deal.
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May 8, 2013
Health Care REIT Drops $1B On Canadian Senior Home JV
Health Care REIT Inc. has agreed to take over a majority interest in a Canadian senior housing community joint venture with Revera Inc. for roughly $1 billion in cash and assumed debt, the Ohio-based health care facility owner said Wednesday.
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May 8, 2013
Policyholders Can Exit $5M Highmark Antitrust Settlement
A Pennsylvania federal judge on Tuesday allowed the plaintiffs in an antitrust class action against Highmark Inc. to step out of a proposed $4.8 million settlement amid claims that the insurer concealed pre-existing obligations that negated certain settlement concessions.
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May 7, 2013
Rotech DIP Hearing Delayed Upon Shareholder Objections
A Delaware bankruptcy judge on Tuesday pushed back a final hearing on Rotech Healthcare Inc.'s $30 million debtor-in-possession facility after counsel for the recently appointed shareholders committee protested that they had not received enough information to assess the loan.
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May 7, 2013
Calif. To Shelve Coordinated Care Program Until 2014
California's health department said Monday that it will delay a large-scale pilot program to test care coordination among patients who are eligible for both Medicare and Medicaid, and will start in January 2014 at the earliest.
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May 7, 2013
Lack Of Clarity On Wellness Programs Puts Employers At Risk
As the U.S. Equal Employment Opportunity Commission gears up to consider employer wellness programs, attorneys say the lack of guidance on what constitutes a voluntary program has left companies at risk of violating anti-discrimination laws by inadvertently forcing employees to participate or to divulge private medical information.
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May 7, 2013
NJ Firm Double-Dipped In Contract Row, Malpractice Suit Says
New Jersey law firm Brach Eichler LLC has been hit with a legal malpractice suit in state court alleging it duplicitously represented both parties, an anesthesiology practice and an ambulatory surgery center, in their dispute over a medical services contract.
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May 7, 2013
Chartis Avoids Covering $150M Health Plan Settlement
A Delaware state judge on Tuesday said that Chartis Specialty Insurance Co. doesn't need to cover a $150 million settlement between policyholder First Health Group Corp. and a coalition of health care providers accusing the medical service underwriter of illegally scrimping on payments.
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May 7, 2013
Minn. Appeals Court Revives Drug Overcharge Class Action
A Minnesota appeals court on Monday ruled that a state law barring pharmacies from profiting from the sale of generic drugs does not give rise to private claims, but revived a class action against several major pharmacies under a separate consumer fraud statute.
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May 7, 2013
Cigna Beats Class Action Over ACA Rebate Dodging
Cigna Corp. and a medical cost management firm on Tuesday escaped a putative class action accusing them of a conspiracy to help Cigna avoid paying Affordable Care Act-mandated rebates to patients, after a Florida federal judge ruled the plaintiff didn’t have standing to bring the suit.
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May 7, 2013
Sen. Rips Into ACA Funding As He Drops Hold On CMS Chief
Sen. Tom Harkin, D-Iowa, on Tuesday dropped a hold blocking confirmation of a permanent leader of the Centers for Medicare and Medicaid Services, but not before firing several parting shots at the Obama administration over diversion of preventive care money for funding of health reform.
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May 7, 2013
Chase Sued Over Workers' ID Theft In $77M Medicare Scam
A JPMorgan Chase Bank NA customer on Monday hit the financial giant with a $10 million lawsuit alleging some of its employees stole her identity and used it to further a $77 million Medicare money laundering scheme.
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May 7, 2013
Health Clinic Therapist Cops To $63M Medicare Fraud
A former Health Care Solutions Network Inc. director and psychologist on Tuesday pled guilty to conspiring in a $63 million Medicare and Medicaid scheme in which the mental health care provider allegedly paid kickbacks in exchange for unnecessary patient referrals.
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May 7, 2013
Judge Slams HHS Over Plan B 'Administrative Filibuster'
In a hearing marked by scathing rhetoric, a New York federal judge on Tuesday accused the Obama administration of using an "administrative filibuster" to restrict access to Plan B emergency contraception, while also signaling he would let the Second Circuit decide whether to delay wider access to the morning-after pill.
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May 7, 2013
Senator Urges Fla. Gov. To Act On Heath Care Expansion
U.S. Sen. Bill Nelson, D-Fla., on Monday joined the Florida Senate Democratic Caucus' call for Gov. Rick Scott to reconvene the state legislature for a special session to reach a consensus on how to expand health care coverage for low-income Floridians.
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May 7, 2013
Hospital Trade Group Wants Clarity On ACA Navigator Plan
The Federation of American Hospitals on Monday urged the Centers for Medicare and Medicaid Services to ensure hospitals can help patients explore their health coverage options under the Affordable Care Act’s “navigator” program, saying a proposed conflict-of-interest rule doesn’t explicitly allow them to do so.
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May 7, 2013
Porter Hedges Nabs M&A Pro From Seyfarth Shaw
Houston law firm Porter Hedges LLP has landed a former Seyfarth Shaw LLP partner who specializes in corporate counseling, mergers and acquisitions, private equity, health care, and finance, the firm said Monday.
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May 6, 2013
Calif. High Court’s Pot Ruling May Stoke Statehouse Fight
The California Supreme Court’s Monday ruling that state-level statutes legalizing the use of medical marijuana don’t prevent municipalities from banning its sale could spark a legislative push to overturn such local restrictions, experts say, reigniting a fight between advocates seeking marijuana legalization and local groups that say marijuana dispensaries don't belong in their backyard.
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May 6, 2013
HHS Audit Reveals Issues With Hospice Inpatient Stays
An inspector general report released Monday found inconsistencies in Medicare billing for hospice inpatient stays — on which the agency spent $1.1 billion in 2011 — which it said raises questions about whether the stays were being billed appropriately and whether patients were receiving the right level of care.
Expert Analysis
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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.
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HIPAA Final Rule: What's A Covered Entity To Do? — Part 2
The Health Insurance Portability and Accountability Act final rule modifies certain HIPAA security and privacy rules to hold business associates directly liable for violations previously only applicable to covered entities. It also provides insight into how business associate agreements should be modified to comply with the rule, say attorneys with Frost Brown Todd LLC.
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More Inconsistency In NYC Human Rights Cases: Part 2
In recent years, New York State Appellate Division panels have issued inconsistent decisions on summary judgment standards and burdens of proof in cases concerning the New York City Human Rights Law. It would benefit all for the New York Court of Appeals to review the standards in Williams v. New York City Housing Authority, Bennett v. Health Management Systems Inc and Melman v. Montefiore Medical Center as soon as possible, say attorneys with Epstein Becker Green PC.
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Clarification From High Court On State Action Exemption
On Feb. 19, the U.S. Supreme Court reversed the Eleventh Circuit's decision in Federal Trade Commission v. Phoebe Putney Health System Inc. and found that a merger of two Georgia hospitals was not immune from the federal antitrust laws under the “state action” exemption. The ruling provides clearer guidance to municipalities and even private actors exercising authority delegated by a state, says Steven Cernak of Schiff Hardin LLP.
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5 PPACA 'Play-Or-Pay' Compliance Techniques To Consider
In response to the Patient Protection and Affordable Care Act's recent "play-or-pay" mandate, employers will, no doubt, consider many strategies for compliance. Once an employer understands what it must do, we recommend that it start considering how best to accomplish its objectives by considering the five techniques we have devised, say attorneys with Paul Hastings LLP.
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6 HIPAA Rule Takeaways For Employers
At approximately one-half the length of "War and Peace," the recently published omnibus final rule can overwhelm in-house employment, benefits and privacy counsel trying to discern the rule’s practical implications for covered entities under the Health Insurance Portability and Accountability Act. Stepping back from this superabundance of detail, employers should review the six big-picture takeaways of this rule, says Philip Gordon of Littler Mendelson PC.