Health

  • December 8, 2016

    Hospital Allegedly Using Sour Grapes Excuse To Ax FCA Suit

    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.

  • December 7, 2016

    3rd Circ. Wants Whistleblowers' FCA Sharing Deal Unsealed

    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.

  • December 7, 2016

    Clinic Owner Can’t Withdraw Plea To $3.6M BCBS Fraud

    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.

  • December 7, 2016

    Mich. Tribe, Blue Cross Both Seek Wins In ERISA Suit

    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.

  • December 7, 2016

    Florida Hospital To Pay $12M To Settle FCA Claims

    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.

  • December 7, 2016

    Md. Court Upholds Toss Of Suit Over Allegedly Botched Birth

    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.

  • December 7, 2016

    Man Who Posed As Gov’t Official Gets 5 Years For $26M Fraud

    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.

  • December 7, 2016

    NY Firm, Ex-Client Ask 11th Circ. To Fix Jury's Errors

    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.

  • December 7, 2016

    Medical Group Pays $9.3M To Settle TCPA Junk Fax Claims

    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.

  • December 7, 2016

    Anthem Seeks To Call Back Expert In $54B Merger Trial

    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.

  • December 7, 2016

    Fla. Surgical Center Escapes Anesthesia Kickbacks Suit

    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.

  • December 7, 2016

    NJ Med Mal Time Limit Keys On Illness, Not Death, Court Says

    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.

  • December 7, 2016

    Doc Says Bayer Axed Her For Backing Pregnant Worker

    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.

  • December 7, 2016

    Jailed Hospital CEO Urges 7th Circ. To Overturn Fraud Verdict

    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.

  • December 7, 2016

    NFL Says Ex-Player Is Forum Shopping In Contract Dispute

    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.

  • December 6, 2016

    Aetna, Humana Execs Try To Undermine DOJ Antitrust Case

    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.

  • December 6, 2016

    Dental Clinic Operator Faces Suit Over Kids' Root Canals

    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.

  • December 6, 2016

    HHS Must Put End To Medicare Appeals Backlog

    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.

  • December 5, 2016

    Fla. Appeals Court Upholds Birth Injury Benefits Guidelines

    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.

  • December 5, 2016

    Consulting Co. Can't Escape Indian Nationals' ERISA Suit

    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.

Expert Analysis

  • Managing Intergenerational Differences Within Your Law Firm

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    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.

  • Reliable Analysis Is Key To Addressing Ascertainability

    Stephen Cacciola

    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.

  • Investor Concerns In Light Of New CMS Long-Term Care Rule

    Michael A. Witt

    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.

  • The FTC's Overreaching Regulation Of Homeopathic Drugs

    Todd A. Harrison

    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.

  • Philip Hirschkop: Quietly Making Noise For 50 Years

    Randy Maniloff

    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.

  • Judicial Treatment Of Interrelated Acts: Part 2

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    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.

  • Judicial Treatment Of Interrelated Acts: Part 1

    Rory Eric Jurman

    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.

  • The Future Of Insurance Under A Trump Administration

    Thomas G. Rohback

    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.

  • Despite Momentum, Marijuana Remains Risky Business

    John Bessonette

    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.

  • The Ethical Risks Of A Multijurisdictional Practice

    Melinda Gentile

    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.