• February 9, 2016

    EEOC, Hospital Settle ADA Case Over Worker With Narcolepsy

    The Equal Employment Opportunity Commission and an Ohio hospital it alleged violated the Americans with Disabilities Act by terminating an employee diagnosed with narcolepsy have resolved the matter, months after a federal judge castigated the agency’s “ridiculous” position on conciliation and ordered the sides to redo the proceedings.

  • February 9, 2016

    Mom Allowed To Join Mental Health ERISA Suit Against UHC

    A California federal judge on Tuesday allowed a mother, who says her son died after United Behavioral Health refused to cover rehabilitation treatment, to join a proposed class action alleging the company’s mental health coverage practices violate the Employee Retirement Income Security Act.

  • February 9, 2016

    Dave & Buster’s Can’t Duck Obamacare ERISA Class Action

    A New York federal judge on Tuesday said amusement chain Dave & Buster’s can’t duck a proposed class action over claims it slashed employees’ hours to avoid increased health care costs stemming from Obamacare, saying the employees have a case under the Employee Retirement Income Security Act.

  • February 9, 2016

    Philly Hospice Nurse Convicted In $14M Medicare Fraud

    A federal jury Monday found a Philadelphia hospice nurse guilty of health care fraud for participating in a $14.3 million scheme to bill Medicare for bogus care, but acquitted her on the majority of the charges including one for conspiracy.

  • February 9, 2016

    UnitedHealth Out Of Ammo To Fight Judge DQ Bid, Court Told

    A former doctor embroiled in litigation with UnitedHealth over the responsibility of insurers to pay for weight loss surgeries under worker health plans told a California federal court Monday that the insurer has no “valid rationale” to respond again to his push for disqualification of a judge.

  • February 9, 2016

    DC Circ. Orders Court To Take On Medicare Appeals Backlog

    The D.C. Circuit on Tuesday said a district court has jurisdiction to order the U.S. Department of Health and Human Services to cut down a massive backlog of disputed Medicare claims following complaints by the American Hospital Association.

  • February 8, 2016

    Dignity Tells 9th Circ. Church Rule Dumps $1.2B ERISA Suit

    Dignity Health on Monday urged the Ninth Circuit to dismiss a putative class action accusing the hospital chain of underfunding its pension plans by $1.2 billion, arguing it “defies ... common sense” not to exempt Dignity under the Employee Retirement Income Security Act's church plan exemption.

  • February 8, 2016

    Medicare Botched Uncompensated Care Math, Hospital Says

    Medicare shortchanged hospitals on reimbursement for uncompensated care when it partially disregarded services provided by hospitals involved in mergers, according to a complaint filed on Monday in D.C. federal court.

  • February 8, 2016

    Allied Tells 9th Circ. Hospital Owes $8M In FTC Defense Costs

    Allied World National Assurance Co. urged the Ninth Circuit Monday to reverse a district court ruling that it can’t get reimbursed for nearly $8 million in defense costs from St. Luke’s Health System Ltd. in a Federal Trade Commission antitrust suit, saying the hospital is required to repay the funds.

  • February 8, 2016

    NLRB Judge Backs Labor Charges Against NJ Nursing Home

    A administrative law judge with the National Labor Relations Board has agreed with union employees and found that a Union City, New Jersey, nursing home committed unfair labor practices by refusing to reinstate 15 workers who went on strike and threatening workers ahead of the strike.

  • February 8, 2016

    UPMC To Pay $12.5M To Settle Price Conspiracy Suit

    The University of Pittsburgh Medical Center has agreed to pay $12.5 million to settle a local hotel's class action claims that the regional health care giant, along with Highmark Inc., inflated the price of small group insurance plans through an antitrust scheme, according to a Friday filing.

  • February 8, 2016

    NY Atty Sanctioned For Bringing Insubstantial FCA Suit

    A New York federal judge on Saturday sanctioned a Buffalo attorney by dismissing his immature False Claims Act suit where he accused Allstate Insurance Co., FedEx Corp. and a slew of other companies of scheming to defraud Medicare.

  • February 8, 2016

    LabMD Says Lack Of Victims Dooms FTC's Data Security Row

    LabMD on Friday pushed the heads of the Federal Trade Commission to uphold the recent dismissal of the commission’s data security suit against the lab, arguing that the agency had failed to produce even one data breach victim or to detail what security standards govern health care companies.

  • February 8, 2016

    Wash. Birth Control Regs Hinder Religion, High Court Hears

    Trade groups, members of Congress and religious organizations are pressing the U.S. Supreme Court to strike down Washington state regulations requiring pharmacies to dispense birth control, including emergency contraception, calling them unnecessary and devoid of meaningful faith-based exceptions.

  • February 8, 2016

    Justices Asked To Mull Jurisdiction Of SEC Admin Challenges

    The former CEO of a private equity-backed assisted living provider has asked the U.S. Supreme Court to decide whether federal courts can hear constitutional challenges to the U.S. Securities and Exchange Commission’s in-house court, after the Seventh Circuit tossed her case.

  • February 8, 2016

    Anti-Abortion Group Barred From Releasing Videos

    A California federal judge has banned the Center for Medical Progress from releasing its “misleadingly edited” footage purporting to show abortion providers agreeing to sell fetal body parts for profit, finding that the raw material shows no wrongdoing and that the CMP members broke legally-binding confidentiality agreements.

  • February 5, 2016

    UnitedHealth Accused Of Deceiving Court In Lap-Band Suit

    An ex-physician being sued by UnitedHealth as part of larger litigation over whether the insurer must pay for certain weight-loss surgeries under employee health plans told a California federal court Friday that the insurer committed fraud on the court when it opposed his attempt to disqualify the judge.

  • February 5, 2016

    Full 11th Circ. To Rehear Fight Over Fla. 'Gun Gag' Law

    The Eleventh Circuit has agreed to rehear en banc a free speech case challenging a Florida law forbidding doctors from entering information about gun ownership into medical records of most patients, brought by physicians who have thrice lost in the appeals court.

  • February 5, 2016

    Cohen & Malad To Lead Medical Informatics Breach MDL

    An Indiana judge on Thursday tapped Irwin B. Levin of Cohen & Malad LLP as interim lead counsel in multidistrict litigation against Medical Informatics Engineering over a data breach affecting 3.9 million patients, saying he picked one attorney to keep fees down.

  • February 5, 2016

    Illinois ACA Co-Op Hit With Class Action For Cutting Provider

    An Illinois nonprofit insurer created under the Affordable Care Act has been hit with a class action in state court over its decision to boot the University of Chicago from its network of providers after patients had already signed up with the expectation of being attended to by the university’s doctors.

Expert Analysis

  • OPINION: The Road To Partnership Must Keep Evolving

    Daniel L. Butcher

    In a recent Law360 article it was suggested that promotion to partner was a competition between associates and that taking maternity, paternity or family medical leave could impact an associate's chances at promotion. But this sort of ethos — which may have contributed to law firms’ success in the past — is not the best way to secure the industry's future, says Daniel Butcher, managing partner of Strasburger & Price LLP.

  • Litigation In The Marijuana Industry Lights Up

    Abby Sacunas

    The country’s first marijuana products liability class action hit Colorado state court in October, alleging that LivWell Inc. used a pesticide on their plants not approved for use on tobacco products — but while it may be tempting to consider cannabis products in conjunction with tobacco products, the industries are at very different stages of regulation and development, say Abby Sacunas and Leigh Ann Benson at Cozen O’Connor.

  • How Pharma Cos. Can Lessen The Risk Of Gov't Action

    Charles Andres jpg.jpg

    Certain actions, like off-label promotion, and violations of broad health care laws, like the Sunshine Act, can make life sciences companies and individuals targets of government enforcement action — but there are steps companies can take to minimize this risk, say attorneys at Wilson Sonsini Goodrich & Rosati PC.

  • An Uphill Battle For Providers Contesting Network Exclusion

    Fred A. Smith

    As the trend toward more narrow managed care networks continues in the U.S., provider lawsuits concerning exclusions and removals from networks and managed care entities are likely to increase as well. However, a recent decision by an Illinois court demonstrates that courts are hesitant to engage in micromanaging staff and network membership decisions that are made by payors, say attorneys at Sedgwick LLP.

  • Getting Payors On Board With Telehealth

    Anthea R. Daniels

    Telehealth has the potential to lower health care costs, improve access, and enhance quality and patient outcomes. However, it is currently limited by reimbursement systems such as Medicare, state Medicaid programs and commercial payors, says Anthea Daniels, a shareholder at Baker Donelson Bearman Caldwell & Berkowitz PC.

  • New Insights For ERISA Standards On Benefit Determinations

    Roy W. Breitenbach

    In Josephson v. Oxford, the New York State Supreme Court found that the health plan’s conflict of interest did, indeed, affect certain of the health plan’s benefit determinations. The ruling provides a useful analysis of the Employee Retirement Income Security Act standards involved in determining whether benefit determinations are arbitrary and capricious, say attorneys at Garfunkel Wild PC.

  • Health Care Deal Trends Emerge From JP Morgan 2016

    Amber McGraw Walsh

    After more than 50 structured conversations with health care private equity and investment banking professionals at the recent J.P. Morgan health care conference, we can conclude that there is a deep — almost ubiquitous — interest in finding and structuring the next provider services consolidation, say attorneys with McGuireWoods LLP.

  • FDA's Strategy For Interoperable Medical Device Regulation

    Mark Mansour

    In order to balance the competing priorities of developing new and innovative interoperable medical devices and protecting patient safety and privacy laid out in its recent guidance, the U.S. Food and Drug Administration should conduct a fact-based technical analysis to assess the costs and potential burdens for medical device manufacturers and others in the health information technology marketplace, say attorneys at Mayer Brown LLP.

  • A New Era Of Health Care Privacy And Security Enforcement

    Eric D. Fader

    Although no data breach or privacy violations were alleged, the Federal Trade Commission's involvement in the recent health care matter involving Henry Schein Practice Solutions Inc. may foretell a new era of cooperation by the FTC in cracking down on those in the health care field who are perceived as not taking their obligations to patients seriously enough, says Eric D. Fader of Day Pitney LLP.

  • Unexpected Uncertainty For The 340B Drug Pricing Program

    Alyce Katayama

    The Bipartisan Budget Act of 2015 poses an unexpected threat to the 340B Drug Pricing Program — even though it doesn't even mention the program — as it changes the way new off-campus hospital outpatient departments are paid, which could have a substantial impact on 340B Program child site eligibility. But covered entities shouldn't throw in the towel just yet, say Alyce Katayama and Elizabeth Gebarski at Quarles & Brady LLP.