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Health
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June 14, 2024
Providers' $12M Suit Against Cigna, Multiplan Trimmed
A California federal judge trimmed a suit against Cigna and Multiplan alleging the companies lowballed reimbursement to a group of substance use disorder treatment providers seeking more than $12 million under health plans they administered, keeping a federal benefits law claim intact but dropping several state law claims.
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June 14, 2024
NC AG Wants Counterclaims Canned In Hospital Contract Suit
North Carolina's attorney general has sought to dodge counterclaims in a suit accusing a for-profit health network of reneging on promises it made when it bought an Asheville hospital, saying he should be immune and the claims are otherwise redundant.
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June 14, 2024
4 Big ERISA Decisions From The 1st Half Of 2024
A California federal court allowed a novel type of 401(k) mismanagement suit to advance to discovery, the Ninth Circuit elaborated on the pleading standard for mental health parity claims, and workers beat back an attempt to force their federal benefits suit into arbitration at the Second Circuit. Here, attorneys discuss four consequential ERISA decisions in 2024's first half.
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June 14, 2024
UK Litigation Roundup: Here's What You Missed In London
This past week in London has seen toy company Jellycat hit supermarket Aldi with an intellectual property claim, AIG start proceedings against firefighting foam company Angus International Safety Group, and the Solicitors Regulation Authority file a legal claim against the Post Office amid the ongoing Horizon IT scandal. Here, Law360 looks at these and other new claims in the U.K.
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June 13, 2024
Ex-Duke Doc Wants Panel To Redo Disability Bias Ruling
A fired Duke University hospital doctor pressed a North Carolina state appeals court to reconsider not reviving the disability claims in his suit against the hospital, arguing that the case belongs before a jury.
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June 13, 2024
Pa. Nursing Home Creditors OK With $43.7M DIP Loan
Creditors of a Pittsburgh-area nursing home network indicated Thursday they were open to $43.7 million in debtor-in-possession financing as the group prepares to potentially sell off a portion of its footprint in a Chapter 11 sale.
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June 13, 2024
Justices Hand Abortion Advocates An Incomplete Win
The U.S. Supreme Court's rejection Thursday of a challenge to the abortion drug mifepristone will do little to safeguard long-term access to the medication while suggesting that it will be up to voters, not judges, to settle some of the nation's abortion debates, attorneys say.
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June 13, 2024
Thomas Targets Group Standing In Mifepristone Ruling
U.S. Supreme Court Justice Clarence Thomas joined his colleagues Thursday to unanimously uphold broad access to the abortion medication mifepristone for now, but he wrote separately to challenge a standing rule that often serves as the key to the courthouse doors for litigants of all varieties.
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June 13, 2024
Feds Get $4.6M In Deal Over Telehealth Billing Fraud Probe
A multi-state network of behavioral health companies and their CEO have agreed to pay nearly $4.6 million to settle allegations that they submitted fraudulent claims for payment to Medicare and Connecticut's Medicaid program for telehealth services for nursing home residents, federal investigators said Thursday.
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June 13, 2024
CVS Dodges Discovery Audit In Generic Drug Collusion Suit
A federal judge declined to make CVS hire a forensic auditor to evaluate its compliance with information demands in a lawsuit alleging it colluded with drugmakers to keep Medicare beneficiaries from accessing certain generic drugs, despite a whistleblower bemoaning "woefully deficient" discovery on the pharmacy chain's part.
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June 13, 2024
Health Co. Execs Charged In $100M Adderall Sales Scheme
Two California digital healthcare company executives were charged in a first-of-its-kind case Thursday with scheming to sell Adderall through deceptive advertising, allegedly bringing in $100 million in illicit profits.
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June 13, 2024
Abortion Medication Case Ends 'With A Whimper' At High Court
A case that threatened to cut off access to a widely used abortion medication while disrupting the U.S. Food and Drug Administration's authority over drugs and medical devices ended Thursday at the U.S. Supreme Court with a decision concerned solely with challengers' right to sue.
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June 12, 2024
Ex-Rehab Biz Manager Gets Prison For Theft From Resident
The former business manager of a Connecticut rehabilitation center will serve at least nine months in prison for stealing money from an elderly resident's bank account, state prosecutors said.
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June 12, 2024
Indiana Hospital Gets $11M Leg Amputation Verdict Reversed
An Indiana state appeals court has upended a $1.3 million judgment — originally an $11 million verdict — awarded to a patient whose leg was amputated allegedly due to the negligence of a hospital, its physician and nurse, citing a slew of "cumulative errors" the lower court made during the trial.
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June 12, 2024
Yale Hospital OK With Merging Suits Over Stalled $435M Sale
Yale New Haven Hospital has consented to combining two dueling lawsuits over its stalled $435 million deal to buy three Connecticut facilities operated by California-based Prospect Medical Holdings Inc., agreeing that judicial efficiency and economy is best served by consolidating both entities' claims into one proceeding.
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June 12, 2024
Texas Anesthesia Co. Appealing To Duck FTC Suit To 5th Circ.
U.S. Anesthesia Partners Inc. gave notice Wednesday that it will ask the Fifth Circuit to review a Texas federal judge's mid-May decision refusing to toss Federal Trade Commission allegations of a monopolistic "roll-up" of Lone Star State anesthesia practices.
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June 12, 2024
SEIU Unit On Hook For $6M In HCA Healthcare Strike Dispute
An arbitrator has found a Service Employees International Union affiliate liable for more than $6 million in damages for replacement worker costs from a strike, a California hospital said Wednesday, while a union representative told Law360 that the decision is "outrageous and unprecedented."
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June 12, 2024
Doctor Says Lawyer, Insurer Agreed To Backdoor Settlement
A Colorado neurosurgeon accused an attorney and an insurer of interfering with the legal services provided to him in defense of an underlying medical malpractice suit, telling a state court the underlying suit was settled without his consent, elevating the carrier and its insured's interests over his own.
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June 12, 2024
SPAC Dealmakers Expect Modest Pickup After Market Bottom
Market professionals expect a slow pickup in deals involving special-purpose acquisition companies starting in the second half of 2024, predicting on Wednesday that a leaner market will emerge following the recent crash and imposition of tighter regulations.
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June 12, 2024
'Natural' Toothpaste Brand Loaded With PFAS, Moms Say
Natural toothpaste company RiseWell LLC falsely advertised its kids toothpaste as "natural" and "safe to swallow," two mothers alleged Tuesday in a proposed class action, saying a U.S. Department of Defense-certified laboratory test found 750 times more "forever chemicals" in the toothpaste than researchers found in heavily tainted kale.
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June 12, 2024
32 AGs Urge Justices Take Up Okla. PBM Law Fight
Thirty-two attorneys general urged the U.S. Supreme Court to take up Oklahoma's petition for review of a Tenth Circuit decision holding that federal law preempted portions of a state law regulating pharmacy benefit managers, arguing the justices needed to intervene to resolve a circuit split.
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June 12, 2024
FTC Asks 4th Circ. To Pause Novant Hospital Purchase
The Federal Trade Commission has asked the Fourth Circuit to pause Novant Health's purchase of a North Carolina hospital while enforcers appeal an order from the lower court that refused to put the deal on hold for the commission's in-house merger challenge.
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June 12, 2024
Conn. Justices Nix Health Dept. Worker's Whistleblower Claim
The Connecticut Supreme Court has trounced a public health official's claim that she was fired for blowing the whistle on appointees who lacked mandatory credentials, upholding her termination but also backing her simultaneous pursuit of a union grievance and an administrative complaint.
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June 12, 2024
Transit Insurer Seeks To Limit Loss From $60M No-Fault Scam
A taxi and livery insurer told a Brooklyn federal judge Wednesday that it is pursuing settlement in its effort to recoup $3.2 million lost in a massive, $60 million no-fault scam led by a former clinic operator now headed for prison.
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June 12, 2024
Sen. Dems Seek Criminal Penalties For PE Hospital 'Looters'
A pair of Democratic senators are targeting private equity's role in the healthcare industry, introducing new legislation Tuesday that would give federal and state enforcers new tools to go after firms they say are "looting" hospital systems and other providers, including possibly jailing executives if patient deaths result.
Expert Analysis
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Opinion
Oregon Law Would Compromise Management Service Orgs
If passed, a proposed Oregon law would materially limit physician corporate practice of medicine structures, causing significant disruption to the provision of medicine and hindering professional corporations' ability to focus on the clinical components of their practice, say Christina Bergeron and William Shefelman at Ropes & Gray.
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A Post-Mortem Analysis Of Stroock's Demise
After the dissolution of 147-year-old firm Stroock late last year shook up the legal world, a post-mortem analysis of the data reveals a long list of warning signs preceding the firm’s collapse — and provides some insight into how other firms might avoid the same disastrous fate, says Craig Savitzky at Leopard Solutions.
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Preparing For DOJ's Data Analytics Push In FCPA Cases
After the U.S. Department of Justice’s recent announcement that it will leverage data analytics in Foreign Corrupt Practice Act investigations and prosecutions, companies will need to develop a compliance strategy that likewise implements data analytics to get ahead of enforcement risks, say attorneys at Cozen O'Connor.
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Reducing The Risk Of PFAS False Advertising Class Actions
A wave of class actions continues to pummel products that allegedly contain per- or polyfluoroalkyl substances, with plaintiffs challenging advertising that they say misleads consumers by implying an absence of PFAS — but there are steps companies can take to minimize risk, say attorneys at Keller and Heckman.
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USCIS Fee Increases May Have Unintended Consequences
U.S. Citizenship and Immigration Services’ new fee schedule, intended to provide the agency with needed funds while minimizing the impact of higher fees on individual immigrants and their families, shifts too much of the burden onto employers, say Juan Steevens and William Coffman at Mintz.
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HR Antitrust Compliance Crucial Amid DOJ Scrutiny
The Justice Department's Antitrust Division recently announced a required human resources component for antitrust compliance programs, which means companies should evaluate their policies to prevent, detect and remediate potential violations as they add training for HR professionals, say attorneys at Morgan Lewis.
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Lessons From Rare Post-Verdict Healthcare Fraud Acquittal
A Maryland federal court recently overturned a jury verdict that found a doctor guilty of healthcare fraud related to billing levels for COVID-19 tests, providing defense attorneys with potential strategies for obtaining acquittals in similar prosecutions, says attorney Andrew Feldman.
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ChristianaCare Settlement Reveals FCA Pitfalls For Hospitals
ChristianaCare's False Claims Act settlement in December is the first one based on a hospital allegedly providing private physicians with free services in the form of hospital-employed clinicians and provides important compliance lessons as the government ramps up scrutiny of compensation arrangements, say attorneys at Sheppard Mullin.
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Texas Ruling Clarifies That Bankruptcy Shields LLC Rights
A Texas bankruptcy court’s recent ruling in In re: Envision makes it clear that the Bankruptcy Code preempts a section of Delaware state law that terminates a member’s interest in an LLC upon a bankruptcy filing, clarifying conflicting case law, say Larry Halperin and Joon Hong at Chapman and Cutler.
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Series
Coaching High School Wrestling Makes Me A Better Lawyer
Coaching my son’s high school wrestling team has been great fun, but it’s also demonstrated how a legal career can benefit from certain experiences, such as embracing the unknown, studying the rules and engaging with new people, says Richard Davis at Maynard Nexsen.
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SG's Office Is Case Study To Help Close Legal Gender Gap
As women continue to be underrepresented in the upper echelons of the legal profession, law firms could learn from the example set by the Office of the Solicitor General, where culture and workplace policies have helped foster greater gender equality, say attorneys at Ocean Tomo.
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The Latest Antitrust Areas For In-House Counsel To Watch
The U.S. Department of Justice and the Federal Trade Commission's increasingly aggressive approach to antitrust enforcement means in-house counsel should closely monitor five key compliance issues, say attorneys at Squire Patton.
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Despite Risks, AI Is A Worthy Tool For Healthcare Industry
Artificial intelligence appears to provide a productive path forward for the healthcare industry, improving economic and human health outcomes, though companies must continue to address certain technology and compliance pain points, says Sarah Abrams at Bowhead Specialty Underwriters.
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Navigating New Regulations In Healthcare And Other M&A
While notice requirements recently enacted in several states are focused on the healthcare industry for now, this trend could extend to other industries as these requirements are designed to allow regulators to be a step ahead and learn more about a transaction long before it occurs, say Kathleen Premo and Ashley Creech at Epstein Becker.
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New CMS Rule Will Change Nursing Facility Disclosures
A new rule from the Centers for Medicare & Medicaid Services significantly expands disclosure requirements for nursing facilities backed by private equity companies or real estate investment trusts, likely foreshadowing increased oversight that could include more targeted audits, say Janice Davis and Christopher Ronne at Morgan Lewis.