• March 22, 2017

    Repeal Of ACA Essential Benefits Faces Hazy Path In Senate

    Republicans face an uncertain procedural path if they attempt to repeal the Affordable Care Act’s mandatory benefits for health insurance with a simple-majority vote in the U.S. Senate via so-called budget reconciliation, experts say.

  • March 22, 2017

    U. Of Md. Medical System Survives Med Mal Appeal

    A Maryland appellate panel on Tuesday affirmed the partial dismissal of a medical malpractice suit accusing a University of Maryland Medical System Corp. hospital of failing to prevent a man’s death from heart disease, saying the trial judge’s decision was supported by the law.

  • March 22, 2017

    Fla. Senators Delve Into Medical Marijuana Rules Proposals

    The Florida Senate took a step Wednesday toward formulating a plan for implementing a constitutional amendment legalizing medical marijuana that passed in November, with treatment center licenses, consumption methods and qualifying conditions coming up as major issues as the Health Policy Committee reviewed multiple proposals.

  • March 22, 2017

    Maryland Hospital Co. Can’t Shake FCA Suit, But Others Can

    An Illinois federal judge Wednesday dismissed a trio of health care systems from a suit alleging False Claims Act violations, but told Maryland-based MedStar Health Inc. that it couldn’t escape claims by a former employee that it billed federal insurance programs for unnecessary inpatient admissions.

  • March 22, 2017

    Wash. Tribe Freed From Ex-Health Exec's FCA Allegations

    A federal judge Tuesday tossed False Claims Act allegations that a former health executive asserted against the Sauk-Suiattle Indian Tribe of Washington, but let his claims against a health clinic and three individuals carry on.

  • March 22, 2017

    Pharma Slams Wash. City's Suit Over Illegal OxyContin Sales

    Purdue Pharma LP on Monday urged a Washington federal court to dismiss a Washington city’s lawsuit accusing the OxyContin manufacturer of allowing opioids to get in the wrong hands and hoping to recoup the costs of fighting addiction, saying the city can't hold it responsible for preventing illegal operations that were already known to local authorities.

  • March 22, 2017

    Drug Cos. Fight Bid For Quick Win In Namenda Antitrust Suit

    An Allergan PLC unit asked a New York federal judge to deny drug wholesalers’ bid for a win on a federal antitrust claim in their lawsuit over the Alzheimer’s treatment Namenda, arguing Tuesday that findings from a previously litigated case have nothing to do with the matter at hand. 

  • March 22, 2017

    Diag Human Says $325M Award Was Never Nullified

    A Liechtenstein-based medical technology company looking to enforce an arbitral award against the Czech Republic worth at least $325 million told a D.C. federal court Tuesday that the nation is wrong to characterize a 2014 panel decision as nullifying the award, urging the court to keep its claim alive.

  • March 22, 2017

    Nursing Home Subcontracted To Skirt Union, NLRB Says

    The National Labor Relations Board let stand Tuesday a ruling that a New York nursing home illegally fired certain union supporters, subcontracted work to avoid having to collectively bargain with an SEIU local the provider did not want to recognize, and steered support toward a preferred union.

  • March 22, 2017

    6th Circ. Backs Stiffer Tax Fraud Sentence For Chiropractor

    The Sixth Circuit on Wednesday affirmed a roughly two-year prison sentence for a Kentucky chiropractor who pled guilty in 2015 to tax fraud and to structuring transactions to evade reporting requirements, saying he had agreed to sentencing enhancements as part of his plea.

  • March 22, 2017

    Breast Implants Linked To Rare Cancer, 9 Deaths, FDA Says

    The U.S. Food and Drug Administration on Tuesday said that it’s received reports of nine deaths and about 360 cases of a rare type of blood cancer linked to breast implants, siding with the World Health Organization’s finding that the disease can develop after implantation.

  • March 22, 2017

    Ex-Pot Dispenser Exec Pays SEC $12M Over Fraudulent Sales

    The founder of medical marijuana dispenser Medbox Inc. agreed to pay $12.3 million to end the U.S. Securities and Exchange Commission’s allegations that he used sham transactions with a shell company run by his fiancée to fraudulently inflate Medbox’s revenues, according to a deal filed in California federal court Tuesday.

  • March 22, 2017

    9th Circ. Says Health Care Providers Can't Make ERISA Claims

    The Ninth Circuit on Wednesday affirmed a finding that health care providers couldn’t make claims under ERISA against plans run by Blue Cross Blue Shield and Anthem Inc. because they’re not beneficiaries, shutting down two suits over the plans’ collection efforts.

  • March 22, 2017

    Chiropractor Fraudulently Billed For $10M, Prosecutors Say

    A Chicago chiropractor has been indicted on charges of submitting more than $10 million in false bills to Medicare and insurance companies, federal prosecutors announced Wednesday.

  • March 22, 2017

    Damages Nixed In Generic Blood-Clot Drug Monopoly Suit

    A hospital that indirectly purchased a generic of the blood clot drug Lovenox can request declaratory relief in a proposed class action accusing Momenta Pharmaceuticals Inc. and Sandoz Inc. of conspiring to monopolize the drug’s market, but can’t seek damages, a Tennessee federal judge said Tuesday.

  • March 22, 2017

    Jury Convicts Drug Return Co., CEO In $116M Fraud Case

    A Pennsylvania federal jury on Wednesday convicted a drug refund company, its CEO and its chief financial officer on charges that they stole $116 million worth of refunds from pharmaceutical manufacturers and then obstructed a subsequent investigation into the scheme.

  • March 22, 2017

    Calif. Hospital Loses Medicare 'Wage Index' Challenge

    A D.C. federal judge on Tuesday dismissed a California hospital’s challenge of the U.S. Department of Health and Human Services’ calculation of the “wage index” that was used to adjust Medicare payment rates in the hospital’s area in 2004, finding the provider doesn’t have standing to bring its suit.

  • March 22, 2017

    SEC Says Couple Blew Chance To Settle EB-5 Fraud Suit

    The U.S. Securities and Exchange Commission has urged the Central District of California to rule against a husband and wife facing allegations that they misappropriated the bulk of $26.9 million raised in an EB-5 immigrant investor program, as the couple purportedly have not followed through on their promises as part of a possible settlement.

  • March 22, 2017

    Texas Court Tosses Doc’s Defamation Suit Against Cox Media

    A doctor alleging that Cox Media Group's Austin American-Statesman newspaper defamed him in a report about his prescribing opioids to three patients who later died of drug overdoses didn't show that the article was false, and therefore his suit must be dismissed, a Texas appellate court held Tuesday.

  • March 22, 2017

    Plaintiffs Bar Perspective: Beasley Allen's Dee Miles

    Our civil justice system corrects civil wrongs with a measure of monetary compensation, and often times monetary punishment damages, but this is not the driving force behind a typical plaintiffs attorney. It’s the cause that drives the plaintiffs bar, says Dee Miles of Beasley Allen Crow Methvin Portis & Miles PC.

Expert Analysis

  • Why Patient Experience Data Provisions Face Elimination

    Jamie Kendall

    Under Trump's administration, the 21st Century Cures Act will continue to face scrutiny. Some may argue that the act's patient experience data provisions are unnecessary or ineffective due to their limited application and expansive required government resources, say Jamie Kendall and Alexandra Schulz of The Kendall Law Firm PC.

  • Is The End Of Individual Health Insurance Near?

    Corinne Smith

    The American Health Care Act proposes to eliminate the mandate for individuals to carry health insurance by removing the tax penalty. Eliminating the mandate, but continuing to require insurers to cover preexisting conditions, means that only sick individuals will purchase insurance, premiums will go up and far more millennials will opt out of the private health insurance market, says Corinne Smith of Strasburger & Price LLP.

  • The Latest On Statistical Sampling In FCA Cases

    Demme Doufekias

    Although the Fourth Circuit's recent Agape decision failed to provide the more definitive guidance about statistical sampling that False Claims Act practitioners on both sides were hoping for, it does offer an opportunity to look at trends emerging from recent settlements and court decisions involving sampling, say Demme Doufekias and Catherine Chapple of Morrison & Foerster LLP.

  • Monthly Column

    Gray Matters: Decision Error

    Gray Matters

    Lawyers make hundreds of decisions during the course of advising a client, consummating a transaction or litigating a case. In this new column, dispute resolution experts Bob Creo and Selina Shultz explore the theory, science and practical aspects of how decisions are made in the legal community.

  • Opinion

    MWI Case Shows The False Claims Act Needs A Change

    William E. Bucknam

    While the U.S. Supreme Court recently ended the 18-year MWI False Claims Act case, the company has absolutely no hope of ever recouping the millions of dollars in lost business or the significant legal fees it spent fighting what was deemed a meritless case brought by the government. The time has come for Congress to amend the FCA, say William Bucknam of MWI Corp. and Robert Rhoad of Sheppard Mullin Richter & Hampton LLP.

  • Law Schools And Law Firms: Seeking Common Ground

    Randy Gordon

    What we don’t know is whether the teaching and practice of law are undergoing massive structural changes or we’re still digging out from the worst economic collapse since the Depression. But what we do know is that the missions of the most forward-looking law schools and law firms are converging in ways that were unimaginable 10 years ago, says Randy Gordon, a partner at Gardere Wynne Sewell LLP and executive professor of law at Te... (continued)

  • Opinion

    DC Circ. Should Be Wary Of Efficiencies Defense In Anthem

    David Balto

    The children’s book "If You Give a Mouse a Cookie" could easily have been describing merger defendants’ efforts to push antitrust policy toward far more permissive standards in merger defenses. A perfect example of this is found in the Anthem merger case now on appeal at the D.C. Circuit, which will hear oral argument on Friday, says David Balto, former policy director of the Federal Trade Commission Bureau of Competition.

  • Opinion

    Neil Gorsuch — Judging Like It's 1868

    Priscilla Smith

    The main argument from the moderate left for confirming Gorsuch is that he isn’t the worst guy Trump could have nominated, and that he seems to view presidential power skeptically. But the Senate Judiciary Committee must establish whether this willingness to check executive power stems from a broader hostility to the assertion of federal judicial power over states, says Professor Priscilla Smith of Yale Law School.

  • NY Cybersecurity Regulations Will Affect Health Care Sector

    Tracy E. Miller

    New York state's new cybersecurity regulations are far more prescriptive than preceding regulatory schemes, including the security requirements of the Health Insurance Portability and Accountability Act. Health care providers will face significant new obligations, says Tracy Miller, co-leader of Bond Schoeneck & King PLLC's cybersecurity and data privacy practice.

  • Not From Around Here? Trying A Case As An Out-Of-Towner

    William Oxley

    The importance of authenticity is magnified when trying a case outside your home jurisdiction. While using references to local landmarks or history can help make arguments relatable, adopting local expressions or style in an attempt to ingratiate oneself with the judge and jury almost always backfires, say William Oxley and Meghan Rohling Kelly of Dechert LLP.