• January 18, 2018

    Class Decertified In Wage Suit Against Hospital Chain

    A Wisconsin federal judge on Wednesday dissolved a Fair Labor Standards Act collective of hospital workers bringing wage and hour claims against ThedaCare Inc. and also refused to certify a proposed class in the same suit after finding that the workers’ situations weren’t similar enough.

  • January 18, 2018

    Surgery Center Fights Sanctions Bid In Antitrust Row

    Outpatient surgical center Marion HealthCare LLC on Wednesday hit back at claims that it improperly filed confidential information in its Illinois antitrust suit against Southern Illinois Healthcare, blaming the hospital chain for the accidental disclosure of contract information.

  • January 18, 2018

    Fake Medical Pot Certifications Get Fla. Atty Disbarred

    A Florida attorney's legal career figuratively went up in smoke Thursday as the state's Supreme Court disbarred him for providing erroneous advice that led clients to believe they had legal certification to grow, possess and use medical marijuana, resulting in several arrests and a fully armed SWAT team raid.

  • January 17, 2018

    Insurer's Bid To Avoid $11M Coverage Stays Alive

    A Pennsylvania federal judge refused Wednesday to dismiss a suit seeking a declaration that Homeland Insurance Co. has no duty to help out a behavioral-health facility hit with an $11 million verdict after a patient left and shot someone, saying the claims are sufficiently pled at this stage.

  • January 17, 2018

    Aetna To Pay $17M To Settle HIV Info Disclosure Claims

    Aetna has agreed to pay $17 million and implement new "best practices" for handling policyholders' sensitive data in litigation matters to resolve a consolidated putative class action accusing the insurer of negligently exposing HIV-related information through window envelopes mailed to roughly 12,000 people, according to documents filed Tuesday in Pennsylvania federal court.

  • January 17, 2018

    US Takes Aim At Calif. Abortion Disclosure Law Dispute

    A California law that requires licensed health care providers to tell women about state-offered pregnancy-related services and unlicensed ones to say that they don’t employ licensed medical professionals is partially unconstitutional, the federal government told the U.S. Supreme Court on Tuesday.

  • January 17, 2018

    DOJ Trying To 'Eviscerate' Escobar, UnitedHealth Says

    The U.S. Department of Justice is seeking to “eviscerate” the U.S. Supreme Court’s monumental Escobar decision by arguing that the government doesn’t have to deny reimbursement to show that regulatory violations are serious, UnitedHealth Group Inc. said Tuesday.

  • January 17, 2018

    Gymnast Won't Be Fined For Speaking Of Doc's Alleged Abuse

    USA Gymnastics said Tuesday that it will not seek payment from Olympic gymnast McKayla Maroney for speaking out on sexual abuse allegations against former team doctor Larry Nassar, despite a 2016 settlement agreement allegedly giving the organization the right to do so.

  • January 17, 2018

    Calif. County Wants Tribe's Suit Over Hemp Seizure Nixed

    California’s San Joaquin County on Tuesday defended its decision to seize $77 million worth of hemp crops from a Native American tribe, a university and others, asking a California federal court to dismiss a related suit because the local ordinance it was enforcing is legal and the crops were not legal.

  • January 17, 2018

    J&J Unit Can't Nix FCA Suit Over Hip Implants Yet

    A Massachusetts federal judge on Wednesday nixed a bid from Johnson & Johnson Services Inc. and its subsidiary DePuy Orthopaedics Inc. to escape a revised version of a suit alleging they indirectly submitted false claims to the government for faulty hip replacement devices.

  • January 17, 2018

    Mich. Tribe Gets $213K In Atty Fees In Blue Cross Suit

    A Michigan federal judge on Wednesday awarded about $213,000 in attorneys’ costs and fees to the Saginaw Chippewa Indian tribe of Michigan, adding to $8.4 million it won from Blue Cross Blue Shield of Michigan over allegations that the insurer charged hidden fees while managing the tribe’s employee health care benefits plan.

  • January 17, 2018

    7th Circ. Upholds Nurse's 6-Year Sentence For $15.6M Fraud

    The former manager of a now-shuttered Chicago-area home health care provider is still facing six years in prison for an “overwhelming and massive” scheme to defraud Medicare out of $15.6 million, after the Seventh Circuit on Tuesday affirmed all parts of her sentence.

  • January 17, 2018

    Patient Qualified For Emergency Care Funding, NJ Court Says

    A New Jersey appeals court on Wednesday said a psychiatric patient didn’t have to pay for his involuntary hospital stay, ruling that his referral through a screening service triggered his eligibility for uncompensated care under a state funding program for indigent residents.

  • January 17, 2018

    EEOC Says Court Can't Set Wellness Rule Review Timeline

    The U.S. Equal Employment Opportunity Commission on Tuesday asked the D.C. federal judge who rejected its rules for incentivizing workplace wellness programs to revise his order for replacement rules, arguing he does not have the power to set the agency's schedule.

  • January 16, 2018

    Tattoo Removal Co. Mostly Escapes False Ad Class Action

    Massachusetts company Cynosure Inc., which manufactures aesthetic laser machines used in tattoo removal procedures, on Tuesday escaped the bulk of a class action brought against it by clinics who purchased the lasers, and alleged the products did not live up to what was represented in advertising materials.

  • January 16, 2018

    High Court Must Weigh In On Breach Standing, CareFirst Says

    CareFirst on Friday doubled down on its bid to convince the U.S. Supreme Court to take up its dispute with policyholders over a 2014 data breach, arguing that allowing consumers to rely on the mere exposure of data to prop up their claims would "open the door to a flood of no-injury class actions."

  • January 16, 2018

    Aetna Investors Sue Over $77B Merger With CVS

    Aetna Inc. was sued Tuesday by a shareholder who says holders of Aetna stock will be shortchanged in a $77 billion transaction with CVS Health Corp., thanks to a rosy key regulatory filing that allegedly obscures an array of critical information.

  • January 16, 2018

    NJ Lab Sues Horizon Over Coverage For Women On Medicaid

    Horizon Blue Cross Blue Shield of New Jersey is discriminating against low-income women who are pregnant or may become pregnant by refusing to designate an infectious disease laboratory as an “in-network” provider for a Medicaid-managed care plan, according to a complaint filed Tuesday in New Jersey federal court.

  • January 16, 2018

    BCBS Agrees To Settle Mental Health Coverage Suit For $7M

    Blue Cross Blue Shield of California has agreed to pay $7 million to settle allegations that it refused to cover residential and outpatient treatment for mental health or substance use-related disorders, a putative class of customers told a California federal judge on Monday.

  • January 16, 2018

    Insurers Accused Of Blocking Allergy Testing Competition

    A company that helps primary care providers test for and treat allergies accused two Blue Cross units and Humana in Louisiana federal court on Friday of conspiring to shut it down by refusing to pay for testing and treatment not conducted by specialists or a lab.

Expert Analysis

  • Fraud Section Under New Management: Takeaways From 2017

    Kevin Muhlendorf

    The U.S. Department of Justice’s "Fraud Section Year in Review" report provides a useful overview of what the Criminal Division’s largest litigating section accomplished in 2017, comparisons to years past, and important hints at what the future holds for individuals and entities whose activities come within the Fraud Section’s broad reach, say Kevin Muhlendorf and Madeline Cohen of Wiley Rein LLP.

  • 2017 Health Care Enforcement Review: Materiality Under FCA

    Laurence Freedman

    As expected, the U.S. Supreme Court's Escobar decision triggered a spate of litigation over how to apply the materiality standard in False Claims Act cases. Throughout 2017, the lower courts built upon the standard, but we expect courts to continue to grapple with the issue through 2018, say Laurence Freedman and Jordan Cohen of Mintz Levin Cohn Ferris Glovsky and Popeo PC.

  • What It Means If States Can Set Medicaid Work Requirements

    Caroline Brown

    In a long-anticipated move, the Centers for Medicare & Medicaid Services recently announced that it will allow states to implement Medicaid work requirements, representing a major shift in the agency's policy. However, the move will only impact a small percentage of the Medicaid population, say Caroline Brown and Philip Peisch of Covington & Burling LLP.

  • 2017 Health Care Enforcement Review: FCA Case Law

    Brian Dunphy

    Last year, courts issued numerous health care-related decisions interpreting the legal standards under the False Claims Act and assessing the viability of a multitude of FCA liability theories. These decisions will affect the prosecution and defense of FCA cases for years to come, says Brian Dunphy of Mintz Levin Cohn Ferris Glovsky and Popeo PC.

  • America's Shifting Views On Marijuana Post-Cole Memo

    Jonathan Robbins

    Although Attorney General Jeff Sessions' rescission of the Cole memo does not change federal law, negative response to the rescission across the cannabis sector and political landscape was strong, swift and bipartisan, which may lead to congressional action in the future, say Jonathan Robbins and Joshua Mandell of Akerman LLP.

  • 2017 Health Care Enforcement Review: Trends In FCA Cases

    Kevin McGinty

    The volume of health care-related qui tam litigation under the False Claims Act remained robust last year. In the first of four articles on health care enforcement in 2017, Kevin McGinty of Mintz Levin Cohn Ferris Glovsky and Popeo PC discusses the important takeaways from a number of trends.

  • How Tax Reform Will Change FCA Settlements

    Douglas Baruch

    Little attention has been paid to a provision of the new tax law that requires federal agencies to specify, at the time of settlement of government claims, the portion of the settlement that may be deductible as a business expense. This is sure to impact False Claims Act and other settlements involving the government going forward, say attorneys with Fried Frank Harris Shriver & Jacobson LLP.

  • A Survey Of In-House Attorney Views On Trade Secrets

    David Almeling

    In an attempt to peek behind the corporate curtain and pick the brains of those with unrivaled access to their companies’ trade secrets, we surveyed 81 in-house attorneys who work on trade secret issues. We discovered many interesting findings — and one alarming trend, say attorneys with O’Melveny & Myers LLP.

  • NJ’s Evolving Health Care Arena: Trends To Watch In 2018

    John Fanburg

    New Jersey is one of the most competitive and heavily regulated states in terms of health care, making it a good barometer for how the industry is evolving nationally. As physicians and medical groups deal with issues like flat reimbursement from insurance providers and the rapidly rising costs of operating a medical practice, the ways in which doctors deliver health care will continue to change in 2018, says John Fanburg of Brach Eichler LLC.

  • 6 E-Discovery Predictions For 2018

    Erich Potter

    Erich Potter, discovery counsel with Oles Morrison Rinker & Baker LLP, discusses six ways e-discovery will continue to excite and confound in 2018.