• May 22, 2015

    Blue Cross Settles Aetna's $2B Antitrust Suit At 11th Hour

    Blue Cross Blue Shield of Michigan has reached an eleventh hour confidential deal with Aetna Inc. to end its rival’s $2 billion antitrust suit alleging Blue Cross harmed consumers by signing most-favored-nation contracts with hospitals, according to documents filed in Michigan federal court Friday.

  • May 22, 2015

    Don't Stop Discovery Over DQ'd Atty In FCA Suit, Court Hears

    Whistleblowers alleging a medical supply company overbilled Medicaid blasted its efforts to stay discovery in Florida federal court Thursday as the company seeks to have the suit tossed, arguing the disqualification of their last attorney for a conflict of interest is not nearly enough to warrant a dismissal.

  • May 22, 2015

    Bar On Abortions At Fla. Planned Parenthood Upheld

    A Florida appeals court on Friday affirmed a temporary injunction barring Planned Parenthood of Greater Orlando Inc. from performing abortions at one of its offices on the grounds that doing so would violate a restrictive covenant on the property.

  • May 22, 2015

    Former Access Exec. Seeks Leniency In Kickbacks Case

    A former executive of a health care-focused marketing company who pled guilty to altering tax files after being accused in New York federal court of taking kickbacks, should be given a light sentence because he fought through child abuse and learning disabilities to become a successful person, he claimed in a sentencing memorandum Thursday.

  • May 22, 2015

    Texas High Court Sides With Doctor In Records Access Fight

    The Texas Supreme Court on Friday said doctors seeking to bust a privilege that applies to peer review committee documents don’t have to assert antitrust claims, but simply must allege the hospital took anti-competitive actions, in a win for a Houston heart surgeon.

  • May 22, 2015

    Pa. Dems Back State's Intervention In Highmark, UPMC Row

    Democrat leaders of the Pennsylvania General Assembly fired off an amicus brief on Friday supporting the state’s bid to force the University of Pittsburgh Medical Center to reverse its decision ending a series of Medicare Advantage contracts between its hospitals and rival insurer Highmark Inc.

  • May 22, 2015

    IPC Discovery Objections Misrepresent FCA Suit, US Says

    The U.S. Department of Justice urged an Illinois federal judge Thursday to apply the same logic she used in refusing to dismiss its False Claims Act case against staffing chain IPC The Hospitalist Co. Inc. to expand its discovery abilities, saying IPC's objections misrepresent the complaint. 

  • May 21, 2015

    Ala. Court Tells Judges To Allow Same-Sex Marriage Statewide

    An Alabama federal judge on Thursday ruled that probate judges throughout the state must issue marriage licenses to same-sex couples, although she stayed the preliminary injunction while the U.S. Supreme Court considers the issue.

  • May 21, 2015

    Amerigroup Wins End To 'Toxic' Ties With NJ Care Provider

    Amerigroup New Jersey Inc. can terminate its contract with a home health care company whose workers were accused of a Medicaid scam, a New Jersey judge ruled Monday, saying the insurer fulfilled its notice requirements and that letting Confident Care Corp. keep the contract would facilitate a “clearly toxic, broken relationship.”

  • May 21, 2015

    Hospital Admin Gets 40 Years For $116M Medicare Scam

    A Texas federal court on Wednesday sentenced an assistant administrator at a Houston hospital to 40 years in prison and ordered him to pay $31 million in restitution for his role in a scheme that fraudulently charged Medicare $116 million for mental health and substance abuse treatments.

  • May 21, 2015

    Fla. High Court Says Med Mal Cap Can't Apply Retroactively

    The Florida Supreme Court refused to cut a $1.45 million noneconomic damages award to a woman whose doctor performed an unnecessary second surgery for her melanoma, saying Florida's statutory cap on medical malpractice awards cannot be applied retroactively.

  • May 21, 2015

    CVS Continues Attempts To Nix Kickback Suit Over Coupons

    CVS Caremark Corp. on Wednesday maintained that the $5 coupons it offered as part of a prescription rewards program don’t violate the Anti-Kickback Statute when given to Medicare and Medicaid enrollees, despite a False Claims Act lawsuit in Illinois federal court filed by a customer arguing otherwise.

  • May 21, 2015

    Calif. High Court To Hear Hospital Workers' Meal-Break Suit

    The California Supreme Court agreed Wednesday to hear a dispute over whether an Industrial Welfare Commission order allowing health care workers to waive a meal period on long shifts conflicts with laws forbidding the practice, in a wage suit against an Orange County hospital.

  • May 21, 2015

    SEC Proceedings Pass High Court Muster, 7th Circ. Told

    The dismissal of a former assisted living company executive’s challenge to the U.S. Securities and Exchange Commission’s in-house court should be upheld, the Seventh Circuit was told Wednesday, because a pair of U.S. Supreme Court decisions bar district courts from interfering with an administrative law process.

  • May 21, 2015

    11th Circ. Affirms Bribery Sentence For Ex-Ala. Governor

    The Eleventh Circuit on Wednesday denied former Alabama Democratic Gov. Don Siegelman a new bribery trial, finding that a lower court rightly found no continuing conflict of interest from a prosecutor after she recused herself from the case, in which Siegelman was convicted in 2006 of soliciting a $500,000 bribe.

  • May 20, 2015

    DC Circ. Won't Rehear Catholic Orgs' ACA Contraception Suits

    The D.C. Circuit on Wednesday refused to revive two suits by Catholic organizations claiming that an Affordable Care Act accommodation created for employers with religious objections to its contraception mandate was overly burdensome, although dissenting judges vehemently disagreed.

  • May 20, 2015

    Judge Kills Suit Over Fickle Medicare Pay Policies

    A D.C. federal judge on Wednesday swatted down a challenge to Medicare’s use of private contractors to set regional payment policies, finding that a beneficiary hadn’t suffered an injury allowing her to sue and that a California lab group improperly raced to the courthouse.

  • May 20, 2015

    Frontier Seeks $2.8M Prejudgment In Amedisys Contract Row

    A hospice operator sought $2.8 million in a prejudgment award against home health provider Amedisys Inc. and an affiliate in Connecticut federal court Tuesday, saying it will likely succeed on accusations Amedisys lied about illegal Medicare overbilling in a hospice sale.

  • May 20, 2015

    NJ AG, Allstate Beat Doc’s Case Over Criminal Probes

    A New Jersey federal judge on Tuesday dismissed a doctor’s claims that state attorney general illegally outsourced criminal investigations to Allstate New Jersey Insurance Co., but denied the state’s request to impose sanctions on him.

  • May 20, 2015

    Atty Sanctioned $1M Takes Fight To Pa. Appeals Court

    A judge disregarded principles of due process when he slapped a Philadelphia-area defense attorney with an unprecedented fine nearing $1 million for violations of a pre-trial order by an expert witness in a medical malpractice case, a state appeals court was told on Tuesday.

Expert Analysis

  • Blurred Lines Remain On Health Care Liability In Texas

    David M. Walsh IV

    The Supreme Court of Texas' ruling in Ross v. St. Luke’s Episcopal Hospital leaves unanswered questions surrounding the nonexclusive, seven-factor test analyzing the relationship between health care liability claims and the provision of care, and does not create a “bright red line” clearly defining state tort law, says David Walsh IV of Chamblee Ryan Kershaw & Anderson PC.

  • For NY Medicaid, It's Health Reform Vs. Antitrust Law

    Dionne Lomax

    At the heart of the Federal Trade Commission and New York State Department of Health's disagreement over the state's Medicaid program is the mounting tension between health care reform — which focuses on transformative health care models that seek to curb costs and improve care through coordinated and integrated systems — and antitrust law, say attorneys at Mintz Levin Cohn Ferris Glovsky and Popeo PC.

  • Physician Anti-Solicitation Clauses: A Case Study

    Joseph M. Gorrell

    Public interest demands that when physicians leave a medical practice and are subject to an anti-solicitation clause patients remain informed of their physician’s new location and contact information. Irrespective of the financial interest of the physicians involved, the patient’s right to be cared for by the physician of his or her choice and continuity of care demand nothing less, says Joseph Gorrell of Brach Eichler LLC.

  • Attorneys Play Vital Role In Structured Settlement Annuities

    Joseph Barnet

    An overall lack of understanding continues to restrict growth in the structured settlement arena. With expanded awareness among attorneys, judges, mediators and legislators, more physical injury and wrongful death claimants might experience the many benefits structured settlements have to offer, says Joseph Barnet, vice president and head of Prudential Structured Settlements.

  • Will NY Expand The Scope Of Providers' Duty Of Care?

    Jena R. Rotheim

    The central issue on appeal before the New York Court of Appeals in Davis v. South Nassau Communities Hospital is whether the state’s highest court is willing to significantly expand the scope of individuals to whom providers owe a duty, and specifically whether the administration of narcotics and subsequent discharge of a patient creates a special relationship between providers and the public, say Laurie Cohen and Jena Rotheim of ... (continued)

  • Lobbying The EU: New Requirements For A 'Voluntary' Regime

    Charles Borden

    While parties that lobby in the United States are generally subject to mandatory lobbyist registration and reporting obligations at every level of government, parties that lobby European Union institutions traditionally have only been subject to a “voluntary” registration and disclosure regime. That gap now appears to be closing, say attorneys with Allen & Overy LLP.

  • Nonprofits In The Zone Of Insolvency: 2 Cautionary Tales

    Christopher M. Desiderio

    The nebulous zone of insolvency for nonprofits demands the exercise of proper corporate governance, but for whose benefit? Lemington III is a warning that the insolvency zone can span years during which directors’ actions will be scrutinized. Sweet Briar College, on the other hand, is a demonstration of the difficulties directors face when they perceive the rapid approach of financial calamity and act as they see fit, say attorneys... (continued)

  • Sweet Home No More, Innovator Liability Leaves Alabama

    James W. Huston

    The pharmaceutical industry will find Alabama's recent law overturning the state supreme court's ruling in Wyeth Inc. v. Weeks on innovator liability helpful in reducing liability exposure where the innovator drug company had no role in manufacturing the drug that caused the underlying injury, say attorneys of Morrison & Foerster LLP.

  • Consider 5 Things Before Choosing An E-Discovery Provider

    Barry O’Melia

    There has been a rapid and robust growth in the number of companies offering electronically stored information collection, management and processing services. But a recent survey indicated that not all service providers offer the level of expertise needed in today’s world of big data, the cloud and mobile devices, says Barry O’Melia, chief operations officer at Digital WarRoom.

  • 3rd Circ. Offers A Defense In Data Breach Class Actions

    Nicholas Ranjan

    A growing body of case law in the Third Circuit on Article III standing over data breach litigation offers a simple lesson: Companies that find themselves as defendants in data breach class actions should determine whether plaintiffs have alleged any injuries in fact and, if not, move to dismiss the litigation at the outset, say Nicholas Ranjan and Syed Ali of K&L Gates LLP.