• September 23, 2016

    Pharmacy Head Seeks To End Long-Running Kickback Suit

    The president of a Chicago pharmacy asked an Illinois federal judge on Thursday to dismiss the remaining False Claims Act charges brought by a former employee in a long-running suit claiming the pharmacy forgave copays while still seeking maximum reimbursements from Medicare and Medicaid.

  • September 23, 2016

    Fla. High Court Limits Arbitration In Nursing Home Cases

    The Florida Supreme Court held on Thursday that nursing home residents can’t be bound by arbitration agreements in contracts signed with the home by family members, settling a dispute between several of the state’s appellate courts over the contracts and how they can be applied.

  • September 23, 2016

    Ill. Judge Points Lost-Grant Suit To Fed. Claims Court

    A judge tossed the bulk of an Illinois federal court lawsuit against the Centers for Medicare & Medicaid Services Friday, saying a former grant recipient under an Affordable Care Act program will have to seek monetary compensation in the U.S. Court of Federal Claims instead.

  • September 23, 2016

    EEOC Says Hospital Denied Religious Vaccine Exemptions

    An Erie hospital affiliated with the Allegheny Health Network was sued by the U.S. Equal Employment Opportunity Commission in Pennsylvania federal court Friday, over allegedly firing six employees after it denied their request for a religious exemption from the flu vaccine.

  • September 23, 2016

    Health Hires: BakerHostetler, Hinckley Allen, Ballard Spahr

    BakerHostetler has added a life sciences litigator from Fish & Richardson PC to its intellectual property group, Hinckley Allen & Snyder LLP has brought on a veteran federal prosecutor, and Ballard Spahr LLP has rehired a former associate who spent the last two years at University of Pennsylvania-run hospitals as counsel on privacy matters.

  • September 23, 2016

    UnitedHealth Sheds New Mexico FCA Suit

    UnitedHealth Group Inc. dodged, at least temporarily, a False Claims Act suit brought by a whistleblower who alleged the group regularly ignored false claims submitted by its subcontractors in New Mexico, with a federal judge ruling Thursday that the qui tam lawsuit was not specific enough.

  • September 23, 2016

    DOJ 'Fomenting A Breakdown' Of $54B Merger, Anthem Says

    The U.S. Department of Justice is trying to sabotage a $54 billion merger between Anthem and Cigna by publicly airing internal memos that detail strife between the two insurers, according to a new filing from Anthem in D.C. federal court.

  • September 22, 2016

    LabMD Defends Attack On 'Draconian' FTC Lawyer

    LabMD on Wednesday kept up the heat in its attempt to pause a July order from the Federal Trade Commission reviving its data security case against the lab, defending a footnote in its prior filing that called out an FTC attorney's "draconian obsession with destroying LabMD."

  • September 22, 2016

    Hospitals, CMS Clash Over $220M Pay-Cut Fix

    Hospitals are at odds with the Centers for Medicare & Medicaid Services over how much they’re owed after the agency reversed a $220 million pay cut related to its “two-midnight rule” on inpatient admissions, according to a joint filing Thursday in D.C. federal court.

  • September 22, 2016

    9th Circ. Urged To Revive Lockheed Health Co. FCA Suit

    A California federal judge used a much-too stringent evidentiary burden when gutting a False Claims Act suit accusing a Lockheed Martin health care subsidiary of only cursory review of health records, the would-be whistleblower physician told the Ninth Circuit Wednesday.

  • September 22, 2016

    Carolinas HealthCare Scoffs At DOJ Antitrust Suit

    Carolinas HealthCare System on Wednesday derided a novel antitrust suit from the U.S. Department of Justice, saying the government hasn’t shown how competition suffered when the hospital chain prevented major health insurers from steering patients to rival hospitals.

  • September 22, 2016

    Romanian National Gets Prison In Int'l Hacking Scheme

    A Romanian national received a three-year prison term Thursday for his role in an international computer hacking scheme that netted him unauthorized access to personal and financial information from retailers, medical offices, security companies and individuals in the United States, U.S. Attorney Paul Fishman announced.

  • September 22, 2016

    NJ Surgeon Didn't Prove Defamation Damages, Panel Says

    A New Jersey appeals court on Thursday upended a $65,000 award to a plastic surgeon who sued a patient over defamatory remarks made online, backing a decision that the comments were defamatory but finding that the doctor never provided actual proof of monetary damages he suffered as a result.

  • September 22, 2016

    5th Circ. Doomed Miss. Abortion Law: Planned Parenthood

    A Planned Parenthood affiliate suing Mississippi over a law that ends Medicaid funding for abortion providers has told a Mississippi federal court that a recent Fifth Circuit decision in another Planned Parenthood case requires a quick win for the nonprofit here.

  • September 21, 2016

    IRS Not Liable For New York Presbyterian FICA Settlement

    The U.S. Court of Federal Claims has tossed a suit brought by New York Presbyterian Hospital seeking repayment from the Internal Revenue Service of Federal Insurance Contribution Act tax reimbursements it was forced to pay medical residents to settle a previous class action.

  • September 21, 2016

    Psych School’s ‘Exceptional’ $11M Class Fraud Deal OK’d

    A California judge on Wednesday approved The Chicago School of Psychology’s $11.2 million settlement to resolve students' class claims that they were lured to its Los Angeles campus with false assurances about its accreditation, saying despite two objections, the payout averaging $95,000 per student was an “exceptional result.”

  • September 21, 2016

    Justices Halt Church Hospital ERISA Suit Pending Review

    The U.S. Supreme Court on Wednesday granted Dignity Health’s request to stay a lower court’s decision that the nonprofit hospital chain does not qualify for a religious exemption to the Employee Retirement Income Security Act pending the high court’s decision whether to accept the case.

  • September 21, 2016

    Ill. Doc Gets Fine, Probation For Medicare Kickback Scheme

    An Illinois federal court has ordered a Chicago doctor to pay $166,000 and serve two years' probation after pleading guilty for his role in a massive Medicare kickback scheme.

  • September 21, 2016

    7th Circ. Affirms Doctor's Conviction For False Claims

    The Seventh Circuit on Wednesday upheld the conviction of a dermatologist serving seven years in prison after a jury found that he lied to Medicare and private insurers about the need for precancerous skin treatments, one day after his attorney argued that he hadn’t been able to present key evidence.

  • September 21, 2016

    SEC Pushes For Full $26.9M Repatriation In EB-5 Case

    The U.S. Securities and Exchange Commission urged a California federal court Tuesday to order two businesspeople to repatriate $26.97 million raised in a deal involving an EB-5 immigrant investor program for a cancer treatment center that never got built.

Expert Analysis

  • You Don’t Need A Data Breach To Face Regulatory Scrutiny

    Kim Peretti

    One side effect of the rise in bug bounty programs, and disclosures by security researchers and others, is a commensurate increase in publicly known security vulnerabilities that can lead to increased scrutiny from regulators and the plaintiffs bar, says Kim Peretti, co-leader of Alston & Bird LLP's cybersecurity preparedness and response team.

  • The Perils Of Parallel FCA Proceedings

    Tony Maida

    Parallel criminal and civil proceedings in False Claims Act cases raise important and troublesome issues for the defense, including protecting the defendant’s Fifth Amendment rights while mounting a robust defense in the civil case. But, as shown in recent decisions from the Eastern District of Kentucky and Southern District of New York, parallel proceedings may also prove challenging to the U.S. Department of Justice, say Tony Mai... (continued)

  • When Ambiguous Regs Preclude FCA Liability

    Taylor Chenery

    The Eighth Circuit’s opinion in U.S. v. Anesthesia Associates is the most recent in a line of cases suggesting that a provider faced with a potentially ambiguous regulation or statute can protect itself from potential False Claims Act liability by taking steps to ensure that its interpretation of the ambiguous provision is reasonable under the circumstances, says Taylor Chenery of Bass Berry & Sims PLC.

  • Practical Uses For Machine Learning In Health Care Cases

    Mihran Yenikomshian

    Machine learning can efficiently turn enormous volumes of both structured and unstructured data into something meaningful, without losing underlying details. Consultants with Analysis Group Inc. elaborate on how machine learning can be applied in the courtroom in terms of informing legal strategy, identifying relevant materials for experts, and enhancing expert testimony in health care litigation.

  • Common Regulatory Pitfalls In Health Care M&A

    Excerpt from Lexis Practice Advisor
    Matthew E. Eisler

    The health care regulatory environment can be complex and difficult to navigate for new entrants into the field and seasoned veterans alike. Depending on the type of transaction, various federal, state, local and agency rules may apply. Matthew Eisler and Russell Hedman of Hogan Lovells US LLP discuss essential steps to identify and address regulatory risk in health care acquisitions.

  • Overhauling Law Firm Records Departments For A New Reality

    Raymond Fashola

    As automation increases, so do business challenges that impact overall law firm operations. Records departments are facing roadblocks associated with antiquated processes, ever-changing regulatory requirements, and emerging technologies. As a result, firms are reassessing the needs of their records department staffing models, says Raymond Fashola of HBR Consulting.

  • Courts Are Taking Materiality Seriously Post-Escobar

    Bradley D. Wine

    Three months after the U.S. Supreme Court's Escobar decision, we can see some trends emerging in False Claims Act decisions that may give contractors a ray of hope, say Bradley Wine and Daniel Chudd of Morrison & Foerster LLP.

  • Counting FCA Penalties: It's All In The Claims

    Adam P. Feinberg

    Last month, the civil penalty range under the False Claims Act nearly doubled. Much of the conversation surrounding this development has focused on the excessive fines clause of the Eighth Amendment and the due process clause. However, it has also placed a renewed focus on the proper method for counting the number of FCA penalties, arguably an even more important issue, say attorneys at Miller & Chevalier Chartered.

  • How CMS Plans To Steady An Unstable ACA Marketplace

    Cynthia J. Borrelli

    In the wake of market instability the Centers for Medicare and Medicaid Services has proposed benefit and payment parameters for 2018 to improve risk pools and make Affordable Care Act exchanges more attractive. However, if not accompanied by other regulatory measures, these provisions would have unintended consequences for the insurance market, says Cynthia Borrelli of Bressler Amery & Ross PC.

  • 3 Steps To Successful Judgment Enforcement

    Craig Weiner

    Judgment enforcement is typically governed by the law of the state where collection is sought, which frequently means collection efforts are controlled by an arcane body of law replete with debtor-friendly roadblocks. Fortunately, there are a number of actions a judgment creditor can take to secure satisfaction of a claim, say Craig Weiner and Michael Kolcun of Robins Kaplan LLP.