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November 01, 2024
Elevance Says Flawed Medicare Rating System Cost It $375M
Elevance Health Inc. has hit the Biden administration with a $375 million lawsuit in Texas federal court after the government slashed star ratings for its Medicare Advantage and Part D health plan contracts in the latest of multiple lawsuits by insurance companies challenging the government's rating system.
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November 01, 2024
Suit Says Nursing Home Let Resident Fatally Fall Down Stairs
A Pittsburgh-area nursing home failed to recognize the high level of supervision needed for a resident prone to wandering off, and left her alone long enough that she rolled her wheelchair down a flight of stairs and died, her family said in a lawsuit filed in Pennsylvania state court.
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November 01, 2024
Construction Co. Must Face 'COVID Building' Fall Suit
An Indiana appeals court has reinstated a suit against a construction company blaming it for causing a woman's injuries after she tripped on a brace that had been left after the construction of a temporary "COVID building" next to a hospital's emergency room, saying the woman's injuries were foreseeable.
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November 01, 2024
Colo. To Boost Services To End Feds' ADA Discrimination Suit
Colorado has agreed to implement new housing and support practices to ensure adults with physical disabilities have adequate help to leave nursing facilities and receive services in their own homes, as part of a settlement announced Friday to end a U.S. Department of Justice lawsuit.
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November 01, 2024
Health Data Co. Urges 4th Circ. To Keep Access Open
Nursing home data analytics company Real Time Medical Systems urged the Fourth Circuit on Friday to keep in place an order that stops electronic medical records company PointClickCare from using unsolvable captcha prompts to block access to patient records.
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November 01, 2024
Medisca Inks $22M FCA Deal Over Ingredient Pricing Scheme
Pharmaceutical chemical supplier Medisca Inc. has agreed to pay $21.75 million to resolve allegations it created false and inflated average wholesale prices for ingredients used in compound prescriptions sold to pharmacies that increased reimbursement and caused federal healthcare programs to pay more for them, the U.S. Department of Justice announced on Friday.
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November 01, 2024
UChicago Must Face Student's Disability Discrimination Claim
A University of Chicago medical student who was dismissed for creating a fake email account to send an instructor evaluations can pursue his claim that the university illegally tied his multiple mental and physical disabilities to his dismissal, but he must drop his claim that the university failed to accommodate those disabilities, an Illinois federal judge said Thursday.
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November 01, 2024
4 Appellate Arguments Benefits Attys Should Watch In Nov.
The Second Circuit will weigh battles over retirement plan fees and union benefit contributions, teachers will ask the Ninth Circuit to revive their suit over interest they say is owed on their retirement accounts and the Eleventh Circuit will mull a constitutional challenge to a Florida gender-affirming care ban. Here are four upcoming arguments that benefits lawyers should have on their radar.
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November 01, 2024
Up Next At High Court: Fed Funds And Securities Risks
The U.S. Supreme Court will return to the bench Monday for its November arguments session, which will start off with a debate over whether the Federal Communications Commission telecom subsidy program involves federal funds subject to the False Claims Act, and on Tuesday how Medicare funding should be calculated for hospitals that serve large numbers of low-income patients.
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November 01, 2024
Taxation With Representation: Kirkland, Davis Polk, Wachtell
In this week's Taxation with Representation, BC Partners sells its majority equity interest in GardaWorld, Lone Star Funds sells specialty chemicals company AOC to Nippon Paint Holdings, Crescent Biopharma takes GlycoMimetics private, and Francisco Partners buys AdvancedMD from Global Payments.
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November 01, 2024
UK Litigation Roundup: Here's What You Missed In London
This past week in London has seen two industry magnates take on the Gambling Commission, Ordinance Survey hit with a claim from a Swiss GPS maker, and China's largest oil company PetroChina face a claim from a Polish documentary maker. Here, Law360 looks at these and other new claims in the U.K.
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November 01, 2024
SC Hospital Settles Ex-Worker's Wage, Retaliation Suit
A South Carolina hospital reached a $15,000 deal with a former employee alleging she was forced to work through unpaid meal breaks and then fired shortly after filing a lawsuit, according to a joint settlement motion filed in federal court.
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November 01, 2024
Columbus Doctor Found Guilty In $1.5M Medicaid Scam
A Columbus, Ohio, doctor and his practice were found guilty of defrauding the state's Medicaid program out of $1.5 million through false reimbursement requests for medical equipment he was not actually purchasing, Ohio Attorney General Dave Yost announced.
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November 01, 2024
Military Escapes Bias Claims Targeting IVF Coverage Policy
A New York federal judge tossed the crux of a feminist nonprofit group's suit claiming the U.S. Department of Defense's in vitro fertilization policy disadvantages women by limiting coverage to service members who can't get pregnant because of an on-the-job injury, finding the policy applies equally across genders.
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November 01, 2024
4 States To Vote On Expanding Cannabis Or Psychedelics
On Tuesday, voters in Florida, North Dakota and South Dakota will decide whether to legalize cannabis for adult recreational use, while Massachusetts — where marijuana is already fully legal — will decide whether to decriminalize and regulate certain psychedelics.
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October 31, 2024
IP Forecast: Another Apple Watch Trial Kicks Off In California
Apple and Masimo will face off next week in their long-running feud over whether the tech giant misappropriated Masimo's trade secrets for some of the health-monitoring features used in newer versions of the Apple Watch. Here's a spotlight on that case — plus all the other major intellectual property matters on deck in the coming week.
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October 31, 2024
CVS Unit Exec's Ex-Partner Charged With Insider Trading
The former domestic partner of a top executive at Oak Street Health Inc., a primary care provider network owned by CVS Health Corp., was charged in Philadelphia federal court Thursday with insider trading on advance information about CVS' $10.6 billion deal to buy Oak Street in 2023.
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October 31, 2024
Drug Cos. To Pay $49M For State-Led Generic Pricing Claims
A contingent of state-level enforcers reached settlements totaling $49.1 million on Thursday with Heritage Pharmaceuticals Inc. and Apotex Corp. for their alleged part in a wide-ranging conspiracy to inflate the price of generic drugs.
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October 31, 2024
Masimo Sues Ex-CEO Over 'Unprecedented' $450M Demand
Masimo Corp. has sued its founder in Delaware Chancery Court, seeking a declaration that a $450 million payout triggered in part by the founder's loss of control or his ouster as CEO and chairman is unenforceable, saying the amount is "unprecedented" and shouldn't be paid by shareholders who were simply exercising their voting rights.
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October 31, 2024
Beverly Hills Agrees To Abortion-Rights Training In Settlement
The city of Beverly Hills will develop training materials and take other steps to comply with California's reproductive health laws, as part of a stipulated judgment resolving the state's allegations that it illegally pressured an abortion clinic to stay out of the city, the parties announced Thursday.
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October 31, 2024
Ill. Judge Doubts Hillrom's Bid For Rival's Communications
An Illinois federal judge signaled hesitation Thursday over hospital-bed maker Hillrom's bid for a rival's communications it asserts will show that the rival lodged untimely antitrust claims, saying the company may be "skipping a step" by asserting their importance.
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October 31, 2024
CBS Escapes Ex-Employee's Vaccine Bias Suit
CBSViacom/Paramount beat a former employee's lawsuit claiming she was fired because she requested a medical exemption to the company's COVID-19 vaccination policy, with a New York federal judge ruling she failed to fix errors previously identified by the court.
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October 31, 2024
Health District Must Face Cyberattack Suit, Wash. Judges Say
A municipal health department in Washington is back on the hook in litigation over a cyberattack that affected nearly 109,000 individuals, thanks to a precedential ruling by a state appellate court Thursday reviving claims that the department was negligent in storing patients' personal information.
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October 31, 2024
Abbott, Mead Cleared In Baby Formula Trial
A St. Louis jury cleared Abbott Laboratories and Mead Johnson of liability Thursday in the companies' first joint trial over claims their baby formula causes a serious gut condition in preterm infants.
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October 31, 2024
Health System Agrees To Resolve Retirement Plan Fee Suit
A New England health system has agreed to settle a proposed class action claiming it loaded two employee retirement plans with exceedingly high costs and underperforming investment options, according to a filing Thursday in New Hampshire federal court.
Expert Analysis
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Opinion
Expert Witness Standards Must Consider Peer Review Crisis
For nearly two decades, the so-called replication crisis has upended how the scientific community views the reliability of peer-reviewed studies, and it’s time for courts to reevaluate whether peer review is a trustworthy proxy for expert witness reliability, say Jeffrey Gross and Robert LaCroix at Reid Collins.
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Takeaways From High Court's Tribal Health Admin Cost Ruling
The U.S. Supreme Court's recent determination that the government must reimburse two Native American tribes for administrative healthcare costs will help tribes maintain equal footing with the Indian Health Service when administering programs, and continues a pattern of how the current court aligns on tribal concerns, say attorneys at Lewis Roca.
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Justices' Intent Witness Ruling May Be Useful For Defense Bar
At first glance, the U.S. Supreme Court’s recent Diaz v. U.S. decision, allowing experts to testify to the mental state of criminal defendants in federal court, gives prosecutors a new tool, but creative white collar defense counsel may be able to use the same tool to their own advantage, say Jack Sharman and Rachel Bragg at Lightfoot Franklin.
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Eye On Compliance: New Pregnancy And Nursing Protections
With New York rolling out paid lactation breaks and extra leave for prenatal care, and recent federal legislative developments enhancing protection for pregnant and nursing workers, employers required to offer these complex new accommodations should take several steps to mitigate their compliance risks, says Madjeen Garcon-Bonneau at Wilson Elser.
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How To Grow Marketing, Biz Dev Teams In A Tight Market
Faced with fierce competition and rising operating costs, firms are feeling the pressure to build a well-oiled marketing and business development team that supports strategic priorities, but they’ll need to be flexible and creative given a tight talent market, says Ben Curle at Ambition.
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FTC Focus: Private Equity Investments In Healthcare
As the Federal Trade Commission is tightening its scrutiny of private equity investment in healthcare, the agency is finding novel grounds to challenge key focus areas, including rollup acquisitions, the flip-and-strip approach and minority investments in rival providers, say attorneys at Proskauer.
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High Court's Expert Ruling May Help Health Fraud Defendants
The U.S. Supreme Court's decision in Diaz v. U.S. appears to give the government a powerful new tool in calling its own agents as expert witnesses, but it could also benefit defense counsel in criminal healthcare fraud and other white collar criminal cases that arise in complex legal or regulatory environments, say attorneys at Holland & Knight.
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Patent Lessons From 5 Federal Circuit Reversals In June
A look at June cases where the Federal Circuit reversed or vacated decisions by the Patent Trial and Appeal Board or a federal district court highlights a potential path for branded drugmakers to sue generic-drug makers for off-label uses, potential downsides of violating a pretrial order offering testimony, and more, say Denise De Mory and Li Guo at Bunsow De Mory.
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Unpacking HHS' Opinion On Cell Therapy Refund Programs
A recent advisory opinion from the U.S. Department of Health and Human Services, determining that a biopharma company's refund program for its cell therapy will not be penalized, indicates an encouraging willingness to engage, but the regulator's assumptions about the program's limited term warrant a closer look, says Mary Kohler at Kohler Health.
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Series
Rock Climbing Makes Me A Better Lawyer
Rock climbing requires problem-solving, focus, risk management and resilience, skills that are also invaluable assets in my role as a finance lawyer, says Mei Zhang at Haynes and Boone.
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How 5 States' Deal Notification Laws Are Guiding Healthcare
Healthcare transaction notification laws at various stages of implementation in California, Illinois, Indiana, Oregon and Washington are shaping sector mergers and acquisitions, with significant transparency, continuity of care and compliance implications as providers tackle complex regulatory requirements, says Melesa Freerks at DLA Piper.
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Contract Disputes Recap: Preserving Payment Rights
Stephanie Magnell and Zachary Jacobson at Seyfarth examine three recent decisions that together illustrate the importance of keeping accurate records and adhering to contractual procedures to avoid inadvertently waiving contractual rights to cost reimbursements or nonroutine payments.
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Think Like A Lawyer: Dance The Legal Standard Two-Step
From rookie brief writers to Chief Justice John Roberts, lawyers should master the legal standard two-step — framing the governing standard at the outset, and clarifying why they meet that standard — which has benefits for both the drafter and reader, says Luke Andrews at Poole Huffman.
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Recent Settlement Shows 'China Initiative' Has Life After Death
Though the U.S. Department of Justice shuttered its controversial China Initiative two years ago, its recent False Claims Act settlement with the Cleveland Clinic Foundation demonstrates that prosecutors are more than willing to civilly pursue research institutions whose employees were previously targeted, say attorneys at Benesch.
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DOJ Innovasis Settlement Offers Lessons On Self-Disclosure
The recent $12 million settlement with Innovasis and two of its executives demonstrates the U.S. Department of Justice's continued prioritization of Anti-Kickback Statute enforcement amid the growing circuit split over causation, and illustrates important nuances surrounding self-disclosure, say Denise Barnes and Scott Gallisdorfer at Bass Berry.