• October 5, 2015

    Fla. Judge Won't Let Health First Dodge FCA Suit

    A Florida federal judge Friday denied Health First Inc.'s request to dismiss claims that it defrauded the government of hundreds of millions of dollars by providing kickbacks to physicians who referred patients to them, calling the motion moot.

  • October 5, 2015

    Arkansas Can't Duck Planned Parenthood Medicaid Payments

    The Arkansas Department of Human Services was ordered Friday to continue honoring Planned Parenthood of the Heartland’s reinstated Medicaid contract, after the state blocked funding in the wake of controversial videos released by abortion opponents.

  • October 2, 2015

    Aetna Seeks Sanctions Over Counterclaim In $120M Fraud Suit

    Aetna demanded a Houston-area hospital and its attorneys be sanctioned over its "retaliatory" RICO counterclaim in the insurer's $120 million billing fraud and kickback suit, arguing to a Texas federal judge Friday that the claim is unsupported and copies Aetna's complaint.

  • October 2, 2015

    Nurses' Registry To Pay $16M To Settle False Claims Suit

    Kentucky-based Nurses' Registry and Home Health Corp. has agreed to pay $16 million to settle a whistleblower suit accusing it of Medicare fraud, according to a proposed stipulation filed Friday in federal court.

  • October 2, 2015

    EEOC Says Suit Over Worker Wellness Program Is Timely

    The U.S. Equal Employment Opportunity Commission on Friday urged a Wisconsin federal judge to deny Orion Energy Systems Inc.’s bid to add a "futile" statute of limitations defense to its answer to the agency's first-of-its-kind lawsuit, which claims an employee was penalized and ultimately fired for opting out of a wellness program.

  • October 2, 2015

    6th Circ. Revives Ex-Ford Worker's Denied Disability Suit

    The Sixth Circuit on Friday revived a former Ford employee’s suit against UniCare Life and Health Insurance in which she said she was intentionally denied disability benefits after being terminated.

  • October 2, 2015

    HCA Hospitals Claim Aetna Owes $16.4M In ER Payments

    Aetna Life Insurance Co. has cheated more than two dozen hospitals owned by HCA Holdings Inc. out of a combined $16.4 million for emergency services provided to patients who received Aetna coverage through the Affordable Care Act, according to a suit removed Thursday to Florida federal court.

  • October 2, 2015

    NJ Hospitals Sue CMS Over Medicare Reimbursement Rates

    A group of hospitals sued the Centers for Medicare and Medicaid Services in Washington federal court on Thursday, alleging that the agency had wrongly reduced Medicare payments to the hospitals for treating high numbers of low-income patients under a New Jersey charity program.

  • October 2, 2015

    Ex-Dartmouth Prof. Urges Toss Of LabMD's Tiversa Suit

    A former Dartmouth College professor accused by LabMD Inc. of conspiring against the company along with cybersecurity firm Tiversa Holdings urged a Pennsylvania federal judge on Friday to accept a magistrate judge’s report recommending that LabMD’s case be dismissed.

  • October 1, 2015

    Geico Suit Over Kickbacks Paused For Ringleader Sentencing

    A New Jersey federal judge on Thursday refused to toss Geico's suit accusing the owners of a group of outpatient care facilities of defrauding the insurer in a kickback scheme, but agreed to stay the proceeding until the alleged ringleaders are sentenced in a related criminal suit.

  • October 1, 2015

    Genesis Healthcare Complied With FCRA, Judge Rules

    A Pennsylvania federal judge ruled Thursday in a proposed class action that a health care provider complied with the Fair Credit Reporting Act when it obtained a potential employee's criminal history from a third party, but a jury will decide if the third party ensured that its report was as accurate as possible.

  • October 1, 2015

    In Split Decision, 5th Circ. Won't Rehear Contraception Row

    The Fifth Circuit on Wednesday declined to rehear its decision nixing religious groups’ challenge to contraceptive requirements in health insurance plans in a split decision accompanied by a dissent that called the ruling “ironic and tragic.”

  • October 1, 2015

    VA Cops Should Have Expected Video Spying, Officials Say

    The U.S. Department of Veterans Affairs’ top cop and medical director on Wednesday urged a Washington, D.C., federal court to toss a putative class action accusing them of spying on the department’s police officers, saying that the video surveillance did not include any audio recording or monitoring in restricted areas.

  • October 1, 2015

    7th Circ. Says Blue Cross Docs Aren't ERISA Beneficiaries

    Disputes between health care providers and insurers over how much in-network doctors are to be paid aren’t covered under the Employee Retirement Income Security Act, the Seventh Circuit said Thursday, reversing a lower court decision that the Blue Cross Blue Shield contractors are beneficiaries under the statute.

  • October 1, 2015

    Excess Insurers Off Hook For PIP Underpayment Claims

    Two excess insurers don't have to cover Direct General Insurance Co. in class actions and individual claims alleging it underpaid personal injury protection benefits, a Florida federal judge held Wednesday, saying those claims are related to PIP demands that predated the policies and are therefore excluded from coverage.

  • October 1, 2015

    7th Circ. Skeptical Of Bid To Revive Wis. Abortion Law

    Wisconsin may be fighting an uphill battle to reinstate a law requiring abortion providers to have admitting privileges at nearby hospitals after a panel of Seventh Circuit judges suggested Thursday that nothing has changed since the first time they blocked the law.

  • October 1, 2015

    Nursing Home Operators Blast Pa. AG's Hire Of Cohen Milstein

    A group of skilled nursing facilities fought to keep their Pennsylvania Commonwealth Court petition alleging state Attorney General Kathleen Kane overstepped her authority in hiring Cohen Milstein Sellers & Toll PLLC to aid in an investigation into the facilities' staffing policies, arguing the attorney general was trying to circumvent state regulators.

  • October 1, 2015

    Healogics Wound Centers Bilked Medicare, FCA Suit Says

    Florida-based Healogics Inc.'s wound care centers routinely perform unecessary hyperbaric oxygen therapy on patients in a scheme to defraud Medicare, former employees said in a False Claims Act suit unsealed Wednesday.

  • October 1, 2015

    Justices Take On Arbitration Provision In Counselors' OT Suit

    The U.S. Supreme Court will review a ruling that defense contractor Managed Health Network Inc. and its subsidiary couldn't compel arbitration of a putative class action alleging they misclassified licensed counselors working at U.S. military bases in order to avoid paying overtime wages, the court said Thursday.

  • October 1, 2015

    DOJ Asks High Court To Resolve ACA Birth Control Split

    The U.S. Department of Justice on Wednesday urged the U.S. Supreme Court to take on the religious freedom challenge to the Affordable Care Act’s contraception mandate opt-out process, after the Eighth Circuit diverged from seven others over the issue last month.

Expert Analysis

  • Privacy Risk Considerations In Health Care IT Investments

    Erin Whaley

    By whatever name you call it — health information technology, digital health, mobile health, telehealth — there is a lot of private equity and venture capital money flowing to this space. But to help mitigate the risk of your health IT investment becoming a headline, it is imperative that you carefully examine your target’s privacy and security practices, says Erin Whaley of Troutman Sanders LLP.

  • State AGs Vocal In New Supreme Court Term

    Joe Jacquot.jpg

    Justice Antonin Scalia often admits, “I’m a fed,” acknowledging that the U.S. Supreme Court is appointed, confirmed and vested with federal power. A critical counterbalance to that are state attorneys general, who uniquely, often singularly, come before the court to defend the interests of states. Here comes another big term for state AGs, says Joseph Jacquot, a partner with Foley & Lardner LLP and former deputy attorney general of Florida.

  • Specialty Pharmacy Market Ripe For Private Equity Buyers

    Richard S. Grant

    M&A activity in the specialty pharmacy sector has been quite active, as witnessed by a number of key recent deals spread across different players, including large pharmacy providers and big-box retailers. Although increased valuations are expected to follow, opportunities remain for private equity sponsors able to understand the complex regulatory framework, say attorneys with McGuireWoods LLP.

  • 11th Circ. Creates Flexibility For Courts On FLSA Suits

    Sara Soto

    The standard articulated in the Eleventh Circuit's decision in Schumann v. Collier Anesthesia PA provides courts with tremendous flexibility in determining whether unpaid interns might be entitled to wages and overtime pay. Given the incidence of internships today, the ruling heightens potential Fair Labor Standards Act concerns for employers, say Sara Soto and Joelle Simms of Bressler Amery & Ross PC.

  • Pope Francis And Pro Bono Publico


    Listening to Pope Francis last week as he made his way from Washington to New York to Philadelphia, one could be forgiven for imagining he was a poverty lawyer in robes. Again and again, he shone light on challenges that pro bono lawyers have wrestled with for years, including the death penalty, housing and homelessness, immigration and even climate change, say Kevin Curnin and Jennifer Colyer of the Association of Pro Bono Counsel.

  • A Look At The Legality Behind Daraprim's Price Spike

    Charles J. Andres

    Unilateral drug price increases alone — when not done by agreement or through collusion with competitors — are almost never actionable under U.S. antitrust law. As long as Turing Pharmaceuticals AG acted alone in raising Daraprim's price, it would be highly unlikely to face any antitrust claim or criminal antitrust penalties, say attorneys at Wilson Sonsini Goodrich & Rosati PC.

  • Lessons From Key Players In Guidant MDL

    Ten years after the Judicial Panel on Multidistrict Litigation created the Guidant Corp. Implantable Defibrillators Products Liability MDL and assigned it to Judge Donovan Frank in the District of Minnesota, the litigation’s key players returned to Minnesota to reflect on the lessons learned. See what the judges, lien administrator, and plaintiffs and defense counsel had to say.

  • FCA's Split Personality Makes Compliance A Moving Target

    David Hall

    The False Claims Act is undergoing an identity crisis. Decisions this year by the First, Fourth and Seventh Circuits have magnified a split among the federal appeals courts regarding what conduct actually constitutes a false claim under the FCA, say David Hall and Matthew Nettleton of Wiggin and Dana LLP.

  • Disease Outbreaks May Bode Ill For Your GCL Coverage

    Michael H. Sampson

    This summer in New York there was an outbreak of Legionnaires’ disease, allegedly caused by a hotel's cooling towers, that killed 12 people and made 100 others sick. If a business is hit with third-party lawsuits over a disease outbreak, are they covered by their commercial general liability policy? ask Michael Sampson and Caitlin Garber at Reed Smith LLP.

  • Rate Reductions Require HHS To Show Its Work First

    Mark D. Polston

    A D.C. federal court's recent ruling in Shands Jacksonville Medical Center v. Burwell underscores that the Centers for Medicare and Medicaid Services must detail its assumptions and methodologies before implementing Medicare inpatient hospital payment rate changes, say Mark Polston and Christopher Kenny of King & Spalding LLP.