• August 20, 2014

    Bid To Block Home Care Workers' Union Election Falls Short

    A Minnesota federal judge refused Wednesday to block an election in which thousands of in-home care providers for the elderly and disabled will decide whether to be represented by SEIU Healthcare Minnesota, calling the challenge to the ongoing election “premature.”

  • August 20, 2014

    Anthem Hit With Latest Suit Over Narrow ACA Network

    A group of California consumers on Tuesday sued Anthem Blue Cross in state court for allegedly tricking them into buying health insurance policies with small provider networks, kicking off the latest litigation over cost-cutting moves inspired by the Affordable Care Act.

  • August 20, 2014

    Pa. Diocese Wins Permanent Injunction On Contraception Rule

    A Pittsburgh-area Roman Catholic diocese won a permanent injunction on Wednesday blocking provisions of the federal Affordable Care Act mandating that it provide contraceptive and sterilization coverage as part of insurance plans offered to employees of its religiously affiliated schools and charities. 

  • August 20, 2014

    Aetna Wins $8.4M For ER Billing Fraud Conspiracy

    A Texas federal judge on Wednesday ruled that Aetna Life Insurance Co. can take $8.4 million from three health care providers, for defrauding the insurer of millions of dollars by wrongfully posing as emergency rooms to bill it at inflated rates.

  • August 20, 2014

    11th Circ. To Hear LabMD, FTC Data Security Arguments

    The Eleventh Circuit said Wednesday that it has decided to hold oral arguments on LabMD Inc.'s latest bid to halt the Federal Trade Commission from policing corporate data-security standards, a dispute which the appellate court has already once refused to entertain.

  • August 20, 2014

    Whistleblower Law No Guarantee Of Jury Trial, Pa. Court Says

    The Pennsylvania Superior Court ruled Tuesday that the state’s whistleblower law does not guarantee a right to a jury trial, upholding a judgment that a western Pennsylvania substance abuse treatment facility justly fired an employee over forging a document.

  • August 19, 2014

    Aetna Hits Indicted Medical Lab With $15M Fraud Suit

    Aetna Health Inc. has filed a $15 million fraud suit in New Jersey court against several parties, many of them doctors, charged in connection with a $100 million scheme in which a medical laboratory paid kickbacks to refer patients for unnecessary tests.

  • August 19, 2014

    Pharmacists Sue Walgreen Over Uniform, Training OT

    Walgreen Co. was hit with a proposed class action in California federal court Monday in which pharmacists alleged it violated California and federal labor law by failing to pay them minimum wage and overtime for training hours and time spent maintaining their uniforms.

  • August 19, 2014

    NY Nursing Home To Pay $2.2M To End Medicaid Fraud Suit

    Nursing home owner Ralex Services Inc. has agreed to pay $2.2 million to settle a whistleblower suit accusing it of bilking New York’s Medicaid program by overstating the level of care its residents needed, according to filings made in federal court Monday.

  • August 18, 2014

    Health Network To Pay $35M In Biggest-Ever Ariz. FCA Deal

    An Arizona hospital operator has agreed to pay $35 million to resolve allegations that it violated the False Claims Act by submitting false bills to federal health care programs for inpatient rehabilitation services, in what prosecutors say is the largest-ever FCA recovery in the state.

  • August 18, 2014

    Kindred To Pay $16.5M To Settle Workers' Wage Class Action

    Kindred Healthcare Inc. on Monday said it would pay $16.5 million to end thousands of hospital workers’ class action allegations that the hospital giant violated state labor laws by not paying for late hospital shifts and missed meal breaks.

  • August 18, 2014

    Aetna OK’d To Countersue Docs Suing Over Nixed Contract

    A California judge on Monday kept alive Aetna Health Plans of California Inc.'s breach of contract counterclaims against two doctors who filed a putative class action alleging the insurer wrongfully terminated them from its coverage network because they referred Aetna-covered patients to out-of-network providers.

  • August 18, 2014

    Walgreen Ducks FCA Suit Over Alleged Medicare Overbilling

    Walgreen Co. on Monday won dismissal in New York federal court in a False Claims Act suit alleging that the pharmacy had overbilled Medicare and Medicaid programs by failing to substitute generic drugs for brand-name ones, following the dismissal of a parallel suit against other pharmacies.

  • August 18, 2014

    6 Tips For FCA Plaintiffs Snubbed By DOJ

    Omnicare Inc.’s recent $124 million settlement of False Claims Act litigation despite the U.S. Department of Justice’s refusal to intervene underscores the plaintiffs bar’s increasing confidence in soldiering on without help from government attorneys. Here, whistleblower lawyers share six considerations when deciding whether to go it alone.

  • August 18, 2014

    Cancer Center Fraudster Pays $5.7M To End FCA Suit

    The former owner of a chemotherapy clinic sentenced to two decades in prison for defrauding Medicare, Medicaid and private insurers will pay $5.7 million to end a related whistleblower False Claims Act suit in Mississippi federal court, counsel for the relator announced Monday.

  • August 18, 2014

    Medicare Need Not Pay For Pure Research, 7th Circ. Says

    The Seventh Circuit on Monday struck down a lower court’s ruling allowing a Chicago teaching hospital Medicare compensation for its pure research costs, saying that the Affordable Care Act gave the U.S. Department of Health and Human Services the power to deny such payment.

  • August 15, 2014

    Justices Told Gosselin's Massive Fines Disrupt FCA Law

    Gosselin World Wide Moving NV filed a new brief urging the U.S. Supreme Court to take up its appeal of a potential $400 million in fines and penalties over alleged collusion to raise prices on military transportation contracts, saying the Fourth Circuit's ruling could be widely damaging to the defense and health care industries.

  • August 15, 2014

    Blue Shield Beats Suit Over Hefty HIPAA Policy Premiums

    A California judge on Friday dismissed a putative class action claiming Blue Shield of California overcharged customers for individual Health Insurance Portability and Accountability Act policies, saying the insurer’s interpretation of California’s rate cap on such policies is a reasonable reading of ambiguous state law.

  • August 15, 2014

    Docs Ask 11th Circ. To Rehear Ruling On Fla. 'Gun Gag' Law

    Doctors challenging Florida's “gun gag” law restricting them from asking patients about firearm ownership on Friday asked the Eleventh Circuit to reconsider its decision upholding the statute, arguing that it creates a new category of unprotected speech and risks the health and safety of Floridians.

  • August 15, 2014

    Mennonite Family's Co. Wins Pass On Contraception Rule

    The Mennonite owners of a Pennsylvania furniture manufacturing company do not have to pay for contraceptive services for their employees, according to a preliminary injunction granted Thursday by a Pennsylvania federal judge in light of the U.S. Supreme Court's Hobby Lobby decision on the health care law mandate.

Expert Analysis

  • How To Control Risk And Cost Of E-Discovery

    "If you follow the philosophy of saving everything you're just multiplying exponentially the costs and risks of litigation and investigations if they ever come," says Robert Owen, partner in charge of Sutherland Asbill & Brennan LLP's New York office and president of the Electronic Discovery Institute.

  • Sponsors Should Mind FDA Informed Consent Guidance

    Gail H. Javitt

    The U.S. Food and Drug Administration's draft guidance on informed consent, though nonbinding, reflects the FDA’s current thinking about what is necessary for sponsors to fulfill their legal obligations and comes as the U.S. Department for Health and Human Services considers a broad overhaul of the Common Rule, say Gail Javitt and Ryan Kaat of Sidley Austin LLP.

  • Here's How Health IT Companies Should Comply With HIPAA

    Julia R. Hesse

    Health information technology companies are enjoying a lull in Health Insurance Portability and Accountability Act regulatory activity, which provides an opportunity to comply now since regulators are aggressively enforcing the law elsewhere, especially against entities with self-identified failures in safeguards, says Julia Hesse of Choate Hall & Stewart LLP.

  • Yet Another Case Counters 6th Circ.'s Omnicare Reasoning

    John S. Durrant

    As the U.S. Supreme Court gears up to hear Omnicare, the Tenth Circuit has presented yet another case supporting the view that Section 11 claims cannot arise simply from opinions contained in securities offering documents that turn out in hindsight to be false or misleading, say attorneys with Paul Hastings LLP.

  • Is Project Labscam II On The Horizon?

    Marilyn May

    While there is no way of knowing whether — or how many — lab investigations and sealed qui tams are proceeding in U.S. attorney’s offices, there is a strong likelihood that law enforcement will be taking a closer look at a recent study from the U.S. Department of Health and Human Services' Office of Inspector General in deciding what cases are worth pursuing, say Marilyn May and Jennifer Kang of Arnold & Porter LLP.

  • An In-House Lawyer's Top 10 Tips For Outside Counsel

    Francis M. Drelling

    To this day, I have yet to see a litigation hold letter that was written by someone who understands the realities of how a business is actually run. In-house counsel cannot issue decrees to business units that read like they are issued by the king to his subjects, says Francis Drelling, in-house counsel at Specialty Restaurants Corp.

  • Big Data Can Yield Big Insights On Promotional Practices

    Paul E. Greenberg

    Rich data sets can provide the basis for detailed analysis of allegedly improper conduct by pharmaceutical and health care companies and improve scrutiny over marketing activities and provider relationships often found at the heart of improper promotion and kickback allegations, say Paul Greenberg and Tamar Sisitsky of Analysis Group Inc.

  • Inappropriate Identity Theft Charges In White Collar Cases

    John Martin

    In their effort to take full advantage of the extra juice the aggravated identity theft statute provides them, prosecutors have increasingly used the statute in run-of-the-mill white collar crime prosecutions where no one’s identity has been stolen or misappropriated. Making things worse, most courts have backed them up, says John Martin, a partner with Garfunkel Wild PC and a former federal prosecutor.

  • Law Firms May Be Violating Copyrights

    Roy Kaufman

    On average, a legal professional forwards content to 14 different people per week. Yet many attorneys and staff lack an understanding of copyright and their firm’s specific policies regarding shared third-party materials, says Roy Kaufman of Copyright Clearance Center.

  • 2 Calif. Cases Professional Liability Insurers Must Know

    James P. Koelzer

    MacRae v. HCR Manor Care Services could be seen as helpful to professional liability insurers because it makes the applicable standard for nursing hours per patient day clear, while also making it more difficult for residents to assert class action claims against these type of facilities, say James Koelzer and Charles Cannizzaro of Robins Kaplan Miller & Ciresi LLP.