The American Hospital Association’s long-awaited legal challenges this week to Medicare’s new requirement that inpatient admissions span across two midnights to qualify for reimbursement will turn on a murky legislative and regulatory history that raises many questions about judicial deference, attorneys say.
Plaintiffs in a class action accusing Compass Health Inc. of underpaying workers for overtime have asked a California federal judge to grant final approval of a $1.1 million settlement, saying no putative class members objected to the deal, according to a Monday filing.
Health insurer Cigna Corp. notched a second victory in a New Jersey federal court on Monday when a judge again denied class certification in a suit alleging the insurance company used manipulated data to reduce employer-sponsored health benefits.
Prime Healthcare Centinela LLC was hit with a proposed class action in California court Monday by an employee alleging the hospital operator failed to pay overtime and provide meal and rest breaks to 400 employees at its 12 California hospitals in accordance with state employment law.
An administrative law judge on Friday denied Kaiser Permanente’s attempt to block the public and journalists from an upcoming hearing over a $4 million fine that California had levied against the health plan provider for its deficient mental health services.
A Virginia federal judge on Monday threw out a relator’s multimillion-dollar lawsuit alleging Bon Secours Health System Inc. participated in a kickback scheme involving referrals of expensive diagnostic imaging and other lab services, saying the record doesn’t show the defendants necessarily submitted false claims.
LabMD Inc. on Friday shot back at the Federal Trade Commission's bid to block a district court from reviewing an ongoing administrative proceeding over the laboratory's allegedly lax data security, arguing its challenge to the commission's authority is vastly different from Wyndham Worldwide Corp.'s rejected bid.
Johnson & Weaver LLP accused law firms Harwood Feffer LLP and Gainey McKenna & Egleston in New York court on Thursday of breaching a fee-splitting agreement in a consolidated class action against Coventry Health Care Inc. over its retirement fund investments.
A New Jersey doctor was arrested on Friday for an array of tax charges, including the mishandling of nearly $6 million in cash, according to the U.S. Department of Justice.
The U.S. Department of Justice announced Monday it had intervened in a whistleblower suit accusing medical equipment supplier Orbit Medical Inc. of forging prescriptions for power wheelchairs billed to Medicare, saying it wanted to claw back any unwarranted payments resulting from fraud.
A Kansas clinic will pay nearly $3 million to settle False Claims Act allegations from whistleblower employees who said bogus bills were routinely submitted to Medicare and Medicaid for cancer drugs that were never provided to patients, the U.S. Department of Justice announced Monday.
A New York court last Tuesday struck down a fare reduction rule created under former New York City Mayor Michael Bloomberg’s administration to provide health care assistance for taxi drivers to meet requirements of the Affordable Care Act, ruling the city had exceeded its authority.
Every federal court to decide whether states' same-sex marriage bans pass constitutional muster since the U.S. Supreme's landmark Windsor decision has struck those prohibitions down, Virginia's attorney general told the Fourth Circuit yesterday, backing a finding that his state's ban was unconstitutional.
The U.S. Department of Health and Human Services and the University of California San Diego Medical Center have settled a case in California federal court after the hospital alleged the agency stiffed it on nearly $1 million in Medicare reimbursements, according to court documents filed on Thursday.
The D.C. Circuit on Friday upheld a U.S. Department of Health and Human Services decision denying hospital system Dignity Health a Medicare payment for allegedly inadequate depreciation taken by a hospital that it acquired, ruling the merger didn't qualify for reimbursement.
Nursing agency ReadyLink Healthcare Inc. on Thursday urged the Ninth Circuit to force a lower to court to take up its putative class action alleging the California insurance commissioner's new regulations are preempted by federal law, saying the lower court misapplied the abstention doctrine to avoid deciding the case.
The Sixth Circuit on Thursday affirmed an Ohio district court's ruling ordering Praesidium Alliance Group LLC to pay investors in its medical malpractice insurance venture a $2 million arbitration award, finding Praesidium hadn't produced enough arbitration documentation to overturn the ruling.
Two physical therapy clinic operators and three associated individuals have agreed to pay $2.78 million to settle a False Claims Act whistleblower suit in D.C. federal court alleging the companies overbilled Medicare and the U.S. military's Tricare health program, federal authorities said Wednesday.
A Colorado federal judge on Wednesday largely trimmed a consolidated putative class action accusing DaVita HealthCare Partners Inc. of failing to warn customers about the dangers of two dialysis products, ruling that the treatment chain's practice of reconstituting powder compounds doesn't qualify it as a manufacturer of the products.
A Texas appeals court ruled Wednesday that a district court has jurisdiction to hear all but one claim in a suit in which Planned Parenthood challenged Texas' update to its women's health program because it cut the nonprofit group's funding.
Some industry observers have speculated that the Centers for Medicare and Medicaid Services' recent release of data on Medicare reimbursement payments to health care providers will result in an increase in whistleblower claims under the False Claims Act. While that remains to be seen, "outlier" providers identified in the data may be wise to prepare for some unwanted attention, say Eric Fader and Elizabeth Kim of Day Pitney LLP.
The meteoric media rise of the “celebrity” whistleblower has shone a spotlight on the practice, with personalities such as Chelsea Manning and Edward Snowden dividing public opinion on the ethics of spilling secrets. But organizations should pay close attention to the surge in this trend beyond the headlines. Remember, whistleblowers don’t need to be popular to be effective, and opinions on their motives and morality are entirely secondary to the critical issues they potentially uncover, says Shanti Atkins of Navex Global.
While the actual breaches are unknown, Heartbleed has the potential to expose all of a lawyer's files stored or transmitted online. The bug raises professional responsibility questions and offers confirmation of the greatest anxieties that the legal industry has about online practice. In fact, the timing is poor for many legal tech providers, following a general industry warming to cloud offerings, says David Houlihan of Blue Hill Research Inc.
William Jacobsen v. New York City Health and Hospitals Corp. makes clear that, in order to escape trial and prevail on summary judgment, an employer generally must present evidence that it engaged in the "interactive process" regarding employee-requested accommodations. The decision solidifies a line of recent appellate decisions on an employer’s obligations toward disabled employees, say Robert Whitman and Courtney Stieber of Seyfarth Shaw LLP.
The lesson of Stratienko v. Chattanooga-Hamilton County Hospital Authority may be that public disclosure is like toothpaste — once it’s out of the tube, it’s out. Fraudulent acts that have been disclosed can’t be undisclosed by recharacterizing them with a different label, says Norman Tabler of Faegre Baker Daniels LLP.
Why do the majority of speakers get polite claps at the end of their talks while a few select others receive rousing applause? Having given more than 375 presentations to legal groups, bar associations, Fortune 500 companies and corporate gatherings, I’ve learned a few things about what not to do. Remember, great speakers don’t tell “war stories.” They don’t even give examples from their own practice, says Michael Rubin of McGlinchey Stafford PLLC.
What happens if an entity or person, permitted under applicable state law to engage in the cultivation, distribution or possession of marijuana, is leasing space in a building for such purposes? This scenario sheds a completely different light on some “boilerplate” lease provisions, such as compliance with all laws, because clearly, the tenant’s use will not comply with federal law, says Nadya Makenko of K&L Gates LLP.
Since the Federal Trade Commission has asserted overlapping jurisdiction on Health Insurance Portability and Accountability Act-regulated issues, there may be an increase in joint enforcement actions by the FTC and U.S. Department of Health and Human Services on patient data security after the commission's investigation of LabMD Inc. Indeed, there is already some precedent for joint enforcement, which the FTC cited in its LabMD opinion, says Miriam Straus of Kalogredis Sansweet Dearden and Burke Ltd.
In South Florida Wellness Inc. v. Allstate Insurance Co., the Eleventh Circuit ruled a plaintiff’s declaratory judgment can satisfy the Class Action Fairness Act’s amount-in-controversy requirement. The ruling continues the recent trend among federal courts of strengthening the ability of defendants to remove class actions while simultaneously limiting the ability of class action plaintiffs to avoid — or creatively plead around — federal jurisdiction, say attorneys at Alston & Bird LLP.
In the latest and most important federal court decision on data security enforcement, a New Jersey federal judge broadly upheld the Federal Trade Commission’s authority to police data security in FTC v. Wyndham Worldwide Corp., as the debate regarding the FTC’s role in regulating data security continues to evolve in both judicial channels — including the LabMD Inc. case — and legislative avenues, say attorneys with Crowell & Moring LLP.