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Health
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October 30, 2024
5th Circ. Keeps Most No Surprises Act Provisions Intact
The Fifth Circuit on Wednesday upheld several provisions for calculating qualifying payments under a federal law aimed at protecting Americans from surprise medical bills, saying in a published opinion that the provisions were neither inconsistent with the law nor arbitrary and capricious.
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October 30, 2024
FDA Didn't Flub Approval In Orphan Drug Case, DC Court Says
The U.S. Food and Drug Administration didn't err in determining that a rival narcolepsy treatment is not the "same drug" as Jazz Pharmaceuticals' exclusive treatment, a D.C. federal judge ruled Wednesday, holding that the FDA's approval of the rival drug didn't run afoul of the Orphan Drug Act.
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October 30, 2024
Jury Told Abbott, Mead Owe 'Astronomical' Sum Over Formula
Lawyers for a premature baby who developed a serious gut condition after being given formula made by Abbott and Mead Johnson asked a jury to deliver an "astronomical" punishment in closing arguments Wednesday while the companies said formula's only sin is it can't protect preterm infants like breast milk can.
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October 30, 2024
Class Asks Court To Revive Claims Against Florida Blue
A proposed class of Florida state employees enrolled in a Blue Cross and Blue Shield of Florida healthcare plan asked an appeals court Wednesday to revive their suit claiming the insurer designed a claims process to obstruct approval and payment of claims for mental health care.
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October 30, 2024
Doctor Denied Access To Grand Jury Materials In HIPAA Case
A Houston federal judge has denied a motion from a pediatric surgeon who asked for access to grand jury materials in his case involving alleged HIPAA violations, issuing a brief order without further explanation.
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October 30, 2024
Alleged Kickback Plotters Can Waive Conflict Over Attorney
A Colorado federal judge on Wednesday concluded that a lab testing company owner charged with participating in a kickback scheme to defraud Medicare and a man who pled guilty to participating in a connected conspiracy could waive any conflicts that might arise from both using the same attorney.
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October 30, 2024
Texas Hospital Can't Escape $3.5M Blood Clot Verdict
A Texas appellate court largely affirmed a jury's $3.5 million verdict in a suit accusing a hospital of negligently treating a patient's blood clots and causing serious injuries, saying awards for future lost earnings and medical expenses were supported by the evidence.
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October 30, 2024
Cigna Wants $16.1M, Florida Labs Seek $5.1M In Benefits Feud
Cigna should pay $5.1 million for harming three Florida laboratories by wrongfully declaring thousands of substance abuse treatment tests medically unnecessary, the labs told a Connecticut jury Wednesday, while Cigna asked to recoup $16.1 million in payouts to the labs for what it called "wasteful" tests.
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October 30, 2024
Doc Review Site Must Face Suit Over Criminal Profile Mix-Up
The owners of physician review website Healthgrades on Wednesday lost their bid to toss allegations they defamed a surgeon in mixing up his profile with a doctor by a similar name who was convicted on federal opioid-related charges.
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October 30, 2024
Conn. Justices Doubt Fertility Doc Suit Is For 'Wrongful Life'
Some justices of the Connecticut Supreme Court were skeptical Wednesday that a lawsuit accusing a fertility doctor of impregnating patients with his own sperm is a barred claim for wrongful life, pressing defense counsel on the now-grown children's allegations that they suffered psychological harm when they discovered the truth.
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October 30, 2024
Insurer Can't Cap Interest In Birth Injury Case, Patient Says
A patient suing his doctor over injuries he suffered at birth urged the Colorado Supreme Court not to limit interest on his medical malpractice damages to $1 million, arguing in a brief the doctor's insurer had chances to settle the case years ago and refused.
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October 30, 2024
3rd Circ. Told Medicare Drug Price Talks Not Voluntary
Three pharmaceutical companies told the Third Circuit on Wednesday the Medicare drug price negotiation program is anything but voluntary, arguing the appeals court should revive their challenges to the program because it is unconstitutional.
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October 30, 2024
Ga. Health Commish 'Overstepped' In Hospital Turf War
The Georgia Court of Appeals has tossed a ruling from the state's Commissioner for the Department of Community Health that would have allowed a metro Atlanta hospital system to open a new radiology center, saying Tuesday that the commissioner overstepped his review powers.
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October 30, 2024
Yale Researcher's Suit Over Loss Of 'Life's Work' Transferred
A Connecticut state court judge in Fairfield is passing on a researcher's lawsuit accusing Yale School of Medicine of destroying two decades of research worth $28 million, transferring the case to the complex litigation docket in Hartford.
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October 30, 2024
COVID-19 Order Could Save Med Mal Suit, Ga. Judges Say
A mistake made by a paralegal working for former Georgia state representative Robbin Shipp may have been saved by a recent Peach State high court ruling that a pandemic-era judicial emergency order can toll the deadline to file medical malpractice suits, the state appeals court found Tuesday.
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October 30, 2024
AIG Tells Del. Justices Texas Medicaid Case 'Steeped In Fraud'
An attorney for insurers who brought a mid-case appeal in a tangled suit focused on a Texas Medicaid claims processor's battles over its alleged errors and omissions in orthodontia billings told Delaware's Supreme Court Wednesday that the original case was "steeped in fraud" and propped up by negligence claims.
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October 30, 2024
Ohio PBM Case Will Wait For High Court Ruling
The Sixth Circuit agreed to pause a case from Ohio state enforcers accusing Express Scripts and Prime Therapeutics of driving up prescription drug prices while the U.S. Supreme Court decides another case dealing with federal versus state jurisdiction.
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October 30, 2024
Access To 'Dreamer' Info Limited In Suit Over HHS Rule
A North Dakota magistrate judge has imposed limits on who can see the names and addresses of 130 Deferred Action for Childhood Arrivals recipients after the court ordered the Biden administration to hand that data over to the state attorney general.
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October 30, 2024
Animal Med Distributor To Pay $1.1M For Lax Opioid Oversight
Veterinary supplier Covetrus North America will pay $1.125 million to settle allegations that it ignored warning flags on 35 suspicious orders of opioids from a Cape Cod veterinarian's practice and shipped the drugs anyway, the Massachusetts U.S. Attorney's Office announced Wednesday.
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October 30, 2024
DLA Piper's FDA Regulation Vice Chair Joins White & Case
The former vice chair of DLA Piper's FDA regulatory practice has joined White & Case LLP's global life sciences and healthcare group and intellectual property practice.
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October 30, 2024
Texas Sues Another Doc For Violating Trans Care Ban
The state of Texas announced Wednesday it launched another lawsuit accusing a physician of violating a state law barring healthcare providers from offering gender transition services to minors.
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October 30, 2024
Sheppard Mullin Adds Former NY Health Agency Leader
Sheppard Mullin Richter & Hampton LLP announced on Wednesday that it has hired a former New York State Department of Health deputy commissioner as a healthcare partner in New York.
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October 30, 2024
Kirkland-Led Francisco Paying $1.1B For AdvancedMD
Kirkland & Ellis LLP is guiding Francisco Partners on an agreement disclosed Wednesday to buy medical payments company AdvancedMD from Global Payments for $1.125 billion.
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October 29, 2024
NY Judge Tosses $14B Decongestant MDL
A New York federal judge threw out a streamlined complaint in a multidistrict litigation accusing companies such as Target and Bayer of making and selling ineffective over-the-counter decongestants, finding Tuesday the state claims are expressly preempted, and the proposed class lacks standing on a federal racketeering claim as indirect purchasers.
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October 29, 2024
NY Health Provider To Boost Data Security To End AG's Probe
An Albany-based healthcare provider has agreed to pay $2.75 million in penalties and data security enhancements to resolve the New York attorney general's claims it failed to protect private medical data that was exposed in a pair of 2023 cyberattacks, the regulator said Tuesday.
Expert Analysis
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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.
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How Orange Book Antitrust Scrutiny Is Intensifying
Pharmaceutical patent holders should be reviewing Orange Book listing practices, as the Federal Trade Commission takes a more aggressive antitrust approach with actions such as the Teva listing probe, and the U.S. Food and Drug Administration calls attention to potentially improper listings, say attorneys at McDermott.