An Illinois teaching hospital is painting an ex-resident as disgruntled to escape his False Claims Act allegations that it let surgeons bill Medicare and Medicaid for surgeries performed with assistant surgeons and physician assistants even when qualified residents could help, the whistleblower argued Tuesday.
The Third Circuit said a lower court wrongly sealed whistleblowers' settlement of litigation over sharing proceeds from the resolution of Medicare and Medicaid billing False Claims Act lawsuits against laboratory companies, citing Wednesday the public's right to such records.
One of three clinic owners accused of sending $3.6 million of fraudulent invoices to Blue Cross Blue Shield for unnecessary chiropractic services cannot withdraw his guilty plea because of an alleged promise that he would be granted immunity for acting as an informant, an Illinois federal judge ruled Tuesday.
The Little River Band of Ottawa Indians and Blue Cross Blue Shield of Michigan both pushed for quick wins in federal court Tuesday in the tribe’s suit alleging the insurer violated the Employee Retirement Income Security Act by mismanaging a tribal employee health benefit plan.
A Miami-area hospital will pay the federal government about $12 million to resolve allegations that it violated the False Claims Act by submitting false claims to federal health care programs for medically unnecessary cardiac procedures, the U.S. Department of Justice said Wednesday.
A Maryland appeals court on Tuesday affirmed a lower court’s decision finding for a gynecology practice and a doctor in the middle of a trial stemming from an arm injury a baby sustained during delivery, holding that the baby’s mother didn’t provide sufficient evidence to support a claim of lack of informed consent.
A New York federal judge on Tuesday sentenced an Illinois man to five years behind bars after he pled guilty to concocting a $26 million investment fraud scheme and stealing the identity of a former Canadian health department official to cover his tracks.
New York firm Stein Law PC and its former client, a Florida diabetes testing supply company, continued their contentious dispute over $1 million in legal fees before the Eleventh Circuit Wednesday, asking the appeals court to reverse parts of a jury's conflicting verdict.
A Louisiana-based radiation treatment center's class action lawsuit accusing a medical group of engaging in a massive junk fax campaign that violated the Telephone Consumer Protection Act reached its conclusion Tuesday as a federal judge stamped final approval on a settlement worth nearly $9.3 million.
Anthem Inc. asked a D.C. federal judge Wednesday for permission to call its key expert witness back to the stand in an ongoing antitrust trial over its $54 billion proposed merger with Cigna Corp., saying the U.S. Department of Justice's expert raised issues for the first time on rebuttal.
A Florida federal judge on Tuesday released a western Florida surgery center from False Claims Act litigation that the Florida Society of Anesthesiologists is bringing against several providers over a variety of alleged kickback schemes that defrauded Medicare and Medicaid, following a request for voluntary dismissal by the whistleblowers.
A New Jersey appeals court on Wednesday clarified a state Survivor Act amendment imposing a two-year statute of limitations that began running at the time of death, ruling that a widow’s claims were time-barred because they stemmed from when her late husband was alive.
A former drug development executive sued Bayer Corp. in New Jersey federal court on Wednesday alleging she was robbed of a promising career after speaking up when her boss removed a pregnant worker from a project leadership role and replaced her with a man.
The former leader of a defunct Chicago hospital is asking the Seventh Circuit to overturn his conviction and 4.5-year jail sentence because he had nothing to do with a scheme to pay kickbacks to doctors referring patients to the hospital, according to arguments presented to the federal appellate court Wednesday.
The NFL Alumni Association and its president struck back at a former player’s attempt to move his suit to state court, telling a Florida federal judge on Tuesday that the move is blatant forum shopping and would require significant additional expense.
Executives for Aetna Inc. and Humana Inc. testified during an antitrust trial in D.C. federal court Tuesday that traditional Medicare serves as stiff competition to their Medicare Advantage insurance products, attempting to undercut the government’s claim that a $37 billion Aetna-Humana merger would slash competition.
A young girl and her guardian slapped a company that operates nearly a dozen dental clinics in California with a state-court suit Monday, contending that Children’s Dental Group performed unnecessary root canals on children’s baby teeth, opening kids up to infection and other complications in the process of maximizing insurance payments.
The U.S. Department of Health and Human Services will have to eradicate its million-claim backlog of Medicare billing appeals by 2021, after a D.C. federal judge on Monday approved the American Hospital Association’s proposed timeline in a suit over the appeal delays.
A Florida appeals court on Monday rejected a constitutional challenge to the state's Neurological Injury Compensation Act, upholding distinct minimum weight requirements for infants from single and multiple births who suffer brain injuries at birth to qualify for benefits.
An Illinois federal judge allowed a putative class action brought against consulting firm Capgemini North America Inc. by a group of its employees to move forward Sunday, rejecting Capgemini's efforts to poke holes in the employees' claims they were cheated out of health insurance benefits.
We are privileged to be part of an employment market that hosts employees from various generations. While “differences” may imply inherent conflict, intergenerational differences can actually be used to an advantage for organizations — especially law firms, say William Martucci of Shook Hardy & Bacon LLP and Najmeh Mahmoudjafari, founder of ImmigraTrust Law.
There has been much discussion recently about the circuit court split on the ascertainability requirement in class certification. Given the uncertainty regarding which standard will ultimately prevail, and the heightened scrutiny of ascertainability by some federal courts, it is crucial for both plaintiffs and defendants to address these issues at the class certification stage, say Stephen Cacciola and Stephen Fink of Analysis Group Inc.
While the increasing need for development of housing alternatives for the growing population of older Americans has created new opportunities for investors to provide capital to owner-operators of long-term care facilities, a new rule revising the requirements for LTC Medicare and Medicaid participation could have a direct impact on potential investors, say Michael Witt and Kyle Molidor of Duane Morris LLP.
Recently, the U.S. Federal Trade Commission decided once again to force itself into the U.S. Food and Drug Administration's ill-fitting shoes, establishing safety and effectiveness standards for over-the-counter homeopathic drugs. The FTC is only obfuscating the already-strained regulatory framework for homeopathic drugs, say attorneys from Venable LLP.
The first paragraph of Philip Hirschkop’s obituary is going to contain the word "Loving." That’s undeniable. But many of Hirschkop’s other cases are just as groundbreaking in their own right. They aren’t household names like Loving, but they have affected millions in the nation’s households, says Randy Maniloff of White and Williams LLP.
Whether or not courts regard multiple acts, errors, omissions or claims as interrelated or related is very fact-specific and highly dependent on the language of the policy in question. In the second part of this article, Rory Jurman and Steven Cula primarily explore how Florida courts have interpreted related claim provisions.
Courts have reached varying conclusions regarding the extent to which claims must be related in order to constitute a single claim under an insurancy policy. Rory Jurman and Steven Cula of Fowler White Burnett PA explain the question of interrelatedness and discuss how various states have approached the issue.
Currently, little is known for certain about how Trump's administration will influence the insurance industry. However, Thomas Rohback and Patricia Carreiro of Axinn Veltop & Harkrider LLP discuss some of the potential challenges and opportunities likely to arise once Trump comes into office.
Voters in eight states legalized marijuana last month and more than one-fifth of Americans now live in states with legal recreational marijuana markets. But marijuana companies still lack adequate access to capital and financial services, say attorneys with Kramer Levin Naftalis & Frankel LLP.
As law firms and clients conduct more business on a regional or national scale, multijurisdictional practice is becoming more prevalent for practicing attorneys. Attorneys engaged in both private practice and as in-house counsel need to be aware of the ethical risks of practicing across jurisdictions — including the implications of engaging in the unauthorized practice of law, say Melinda Gentile and Monique Cardenas of Peckar & Abramson PC.