Health

Expert Analysis

• Calculating FCA Damages From PPP Fraud May Be Tricky

  

  The Paycheck Protection Program will undoubtedly give rise to False Claims Act enforcement, but the intangible nature of some contract benefits and differences in contract valuation between the circuits raise uncertainty about damages calculations, say Ellen London at Alto Litigation and Derek Adams at Potomac Law.

• Guest Feature

  5 Ways Firms Can Avoid Female Atty Exodus During Pandemic

  

  The pandemic's disproportionate impact on women presents law firms with a unique opportunity to devise innovative policies that will address the increasing home life demands female lawyers face and help retain them long after COVID-19 is over, say Roberta Liebenberg at Fine Kaplan and Stephanie Scharf at Scharf Banks.

• High Court Faces Preemption Dilemma In Drug Benefits Case

  

  The recent U.S. Supreme Court oral argument in Rutledge v. Pharmaceutical Care Management Association highlighted important questions raised by the case concerning federal preemption of state laws on health plans and pharmaceutial benefits — but the court's past application of such preemption has been hard to reconcile, says Andrew Struve at Hooper Lundy.

• What Ohio COVID-19 Liability Shield Means For Employers

  

  Because a new Ohio law that shields businesses from civil liability related to COVID-19 provides narrow protections, employers should continue to follow Occupational Safety and Health Administration, state and local guidance to demonstrate reasonable protective measures, says Jeffrey Smith at Fisher Phillips.

• How The State And Local Regulatory Landscape Is Expanding

  

  States and localities are employing creative methods to emerge as key players in regulatory enforcement traditionally dominated by the federal government, including False Claims Act investigations, unfair and deceptive acts and practices claims, and pharmaceutical sector regulation, say attorneys at Troutman Pepper.

• 5th. Circ. Medicare Ruling Could Halt Pro-Provider Trend

  

  The Fifth Circuit's recent decision in Sahara v. Azar likely forecloses the possibility of injunctive relief against recoupment for Medicare providers, ending the recent string of rulings in favor of providers seeking compensation for overpaid insurance claims, says Kent Hofmann at Locke Lord.

• Takeaways From Calif.'s New Health Insurance Rules

  

  A recently signed law fundamentally alters California's regulation of mental health and substance use disorder treatment and will likely lead to increased litigation and regulatory action based on new insurance coverage requirements, say attorneys at Manatt.

• Insurer-Friendly COVID-19 Case Law Is No Silver Bullet

  

  Three recent decisions confirm that individual or consolidated lawsuits regarding insurance coverage for business interruption caused by the pandemic will turn on their own unique circumstances, meaning that insurer-friendly decisions will not preclude coverage broadly, say Jason Rubinstein and Mark Packman at Gilbert.

• Outside Whistleblowers Are Critical To Exposing Fraud

  

  Outsiders like industry experts, competitors, public interest organizations and concerned citizens often have deep knowledge, industry data and financial incentives that put them in a better position than insiders to spot fraud, say attorneys at Youman & Caputo, Fox Rothschild, Goldstein & Russell and Herrera Purdy.

• Opinion

  Lawyers Must Fight Voter Suppression This Election Season

  

  Lawyers should use their unique skill sets, knowledge and spheres of influence to fight burdensome ID requirements and other voter suppression tactics that may influence the 2020 elections, and to participate in potential post-election litigation, say CK Hoffler and Allyce Bailey at the National Bar Association.

• Why Online Mediation May Be Here To Stay

  

  Videoconferenced mediation offers several advantages and helps cases settle faster and more cordially, making it hard to imagine going back to logistically difficult in-person dispute resolution after COVID-19 restrictions are gone, says Sidney Kanazawa at ARC.

• How Nursing Homes Can Defend COVID-19 Criminal Charges

  

  Following the first pandemic-related criminal prosecution of nursing home operators in Massachusetts, nursing homes can take steps to defend their decision-making and infection-control processes as similar cases emerge across the country, say attorneys at Hooper Lundy.

• Early Takeaways From SEC's FY 2020 Fraud Enforcement

  

  Ahead of the U.S. Securities and Exchange Commission's annual enforcement data release later this fall, emerging enforcement themes include fraud related to COVID-19, as well as individual accountability, misuse of reserves, revenue recognition, disclosure malfeasance and data analytics, say attorneys at Perkins Coie.

• Clients Have The Power To Promote Wellness At Law Firms

  

  Law firm clients can play a role in lowering mental distress in the legal profession by seeking lawyer wellness data from firms and factoring those responses into outside counsel hiring decisions, says Jonathan Prokup at Cigna.

• Opinion

  Appellate Courts Should Welcome Well-Crafted Amicus Briefs

  

  A Seventh Circuit judge's recent order granting leave for three organizations to file amicus curiae briefs in Prairie Rivers Network v. Dynegy Midwest Generation is a reminder that relevant, nonduplicative amicus briefs can provide courts with helpful perspective, important facts and legal arguments, says Lawrence Ebner at Capital Appellate Advocacy.