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November 04, 2024
Whistleblowers Win Cut Of Medical Kickback Settlement
Three whistleblowers who tipped off the federal government to a medical device company's multimillion-dollar kickback scheme are entitled to a cut of the $3 million in False Claims Act settlements paid by surgeons who admitted participating in the sham consulting ploy, a Boston federal judge ruled Monday.
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November 04, 2024
Sanctions Lessened Against Testing Co. That 'Duped' Judge
A California federal judge Monday lessened sanctions imposed on Natera Inc. in a false advertising case first brought by rival Guardant Health Inc., allowing some clinical cancer study evidence to be presented at a trial starting Tuesday despite his earlier finding that Natera's expert and counsel had "duped" the court.
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November 04, 2024
With Lawsuit Pending, Nebraskans To Vote On Medical Pot
A pair of initiatives to legalize medical marijuana in Nebraska and regulate its sale will appear on the ballot on Election Day, but a pending legal challenge whose trial concluded Monday means it is unclear whether the initiatives will take effect even if they do get voter approval.
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November 04, 2024
Del. Judge To Approve Avante Ch. 11 Financing
A Delaware bankruptcy judge Monday agreed to approve debtor-in-possession financing for Jordan Health, the corporate parent of medical equipment service provider Avante Health, after the debtor and DIP lender struck a deal with the official committee of unsecured creditors.
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November 04, 2024
Debt Collectors Sue Over CFPB's Guidance On Medical Debt
A debt collection trade group has sued the Consumer Financial Protection Bureau in Washington, D.C., federal court to overturn recent guidance that warned collectors about seeking payment on potentially inflated or unverified medical bills, slamming it as an "overtly political" end-run around proper rulemaking.
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November 04, 2024
Cigna Scores $7.3M Verdict Against Fla. Drug Testing Labs
A Connecticut federal jury on Monday handed Cigna Health and Life Insurance Co. a victory against three Florida boutique drug testing laboratories, finding the labs unjustly billed nearly $7.3 million for tests on substance abuse patients that the insurer declared medically unnecessary.
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November 04, 2024
NY AG Seeks Contempt For Anti-Abortion Org's 'Interference'
Counsel for the New York attorney general asked a federal judge Monday to hold an anti-abortion group in contempt for allegedly seeking to interfere with women's access to clinics despite an injunction, prompting questions about the limits of an advocate's civil rights.
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November 04, 2024
VA Accused Of Choosing 'Pass-Through' Co. For $257M Deal
A veteran-owned small business has challenged a $256.8 million U.S. Department of Veterans Affairs telehealth program support contract, saying the VA wrongly chose a small business joint venture that effectively served as a pass-through for a larger company.
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November 04, 2024
Yale Gets 2nd Circ. Win In COVID Test Reimbursement Row
A Connecticut medical practice can't sue Yale University under federal legislation enacted during the COVID-19 pandemic to recover the $1.1 million it said it incurred while providing COVID testing to university health plan members, the Second Circuit ruled Monday, finding no private cause of action existed.
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November 04, 2024
McKesson Inks $450K DOL Deal Following Hiring Bias Probe
The U.S. Department of Labor announced Monday that McKesson Medical-Surgical Inc. has agreed to pay nearly $450,000 to resolve the agency's claims that it gave hiring preferences to Asian job applicants over Black, Hispanic and white job hopefuls.
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November 04, 2024
MultiPlan Judge Raises Eyebrows At Attys' Biz Flight Billing
Counsel leading multidistrict litigation over Multiplan's pricing tools quickly revised their plans Monday for attorneys who take longer flights for the case, after an Illinois federal judge questioned why certain travelers received special treatment "arguably on the class's dime."
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November 04, 2024
Hospital Can't Undo Widow's $5M Win Over Husband's Suicide
An Illinois state appeals court won't upend a $5 million verdict awarded to a widow against a Cook County hospital in a suit over her husband's death by suicide, finding that the widow's expert testimony was enough for a jury to conclude that the doctor's negligence led to the death.
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November 04, 2024
Rehab Sued Over Staffer's Alleged Relationship With Patient
The father of a patient at a Newport Academy treatment center is alleging in federal court that one of the facility's care coordinators engaged in an inappropriate relationship while his son was a minor in the residential treatment program.
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November 04, 2024
Walgreens To Pay $100M In Suit Alleging Inflated Drug Prices
Walgreens has agreed to hand over $100 million to settle claims from consumers and unions that it unlawfully overcharged insured consumers for prescription drugs while allowing members of its cost savings club to pay less, according to an Illinois federal court filing.
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November 04, 2024
NJ Health System Hits Ch. 11 With Plans To Restructure Debt
A New Jersey nonprofit that operates three hospitals filed for Chapter 11 in Delaware, saying it faced increased operating costs after COVID-19 and hopes to restructure its debt.
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November 01, 2024
COVID Death Suit Not Barred By PREP Act, 11th Circ. Affirms
A split Eleventh Circuit affirmed a lower court's decision Thursday to remand to state court a lawsuit over a nursing home resident's COVID-19 death, finding preemption may cover a defendant sued for following federal public health emergency guidelines, but not when, as in the instant case, the guidelines were allegedly unheeded.
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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.
Expert Analysis
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E-Discovery Quarterly: Rulings On Hyperlinked Documents
Recent rulings show that counsel should engage in early discussions with clients regarding the potential of hyperlinked documents in electronically stored information, which will allow for more deliberate negotiation of any agreements regarding the scope of discovery, say attorneys at Sidley.
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Loper Bright Limits Federal Agencies' Ability To Alter Course
The U.S. Supreme Court's recent decision to dismantle Chevron deference also effectively overrules its 2005 decision in National Cable & Telecommunications Association v. Brand X, greatly diminishing agencies' ability to change regulatory course from one administration to the next, says Steven Gordon at Holland & Knight.
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What Cos. Should Note In DOJ's New Whistleblower Pilot
After the U.S. Department of Justice unveiled a new whistleblower pilot program last week — continuing its efforts to incentivize individual reporting of misconduct — companies should review the eligibility criteria, update their compliance programs and consider the risks and benefits of making their own self-disclosures, say attorneys at Skadden.
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Motion To Transfer Venue Considerations For FCA Cases
Several recent decisions highlight the importance for practitioners of analyzing as early as possible whether a False Claims Act case warrants a change of venue, and understanding how courts weigh certain factors for defendants versus whistleblowers, say Ellen London at London & Stout, and Li Yu and Corey Lipton at DiCello Levitt.
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A Primer On EU's Updated Human Substance Regulations
The European Union's updated standards regarding quality and safety of substances of human origin meant for human application carry significant implications for companies that work with cells and tissues, and U.S. companies active in the EU market should pay particular attention to the import and export rules, say Geneviève Michaux and Georgios Symeonidis at King & Spalding.
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Series
After Chevron: New Lines Of Attack For FCA Defense Bar
Loper Bright has given defense counsel new avenues to overcome the False Claims Act elements of falsity and scienter, as any FCA claim based upon ambiguous statutory terms can no longer stand solely on agency regulations to establish the statute's meaning, which is itself necessary to satisfy the FCA's basic requirements, says Elisha Kobre at Bradley Arant.
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CFPB's Medical Debt Proposal May Have Side Effects
The Consumer Financial Protection Bureau’s recent proposal to prevent medical debt information from appearing on consumer reports and creditors from basing lending decisions on such information may have initial benefits for some consumers, but there are potential negative consequences that should also be considered, say attorneys at Cooley.
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Series
Teaching Scuba Diving Makes Me A Better Lawyer
As a master scuba instructor, I’ve learned how to prepare for the unexpected, overcome fears and practice patience, and each of these skills – among the many others I’ve developed – has profoundly enhanced my work as a lawyer, says Ron Raether at Troutman Pepper.
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15 Areas That Would Change Under Health Data Rule Proposal
If finalized, the Office of the National Coordinator for Health Information Technology's proposed rule will significantly progress its efforts to advance interoperability, respond to stakeholder concerns and clarify compliance with the health IT certification program, say attorneys at Ropes & Gray.
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The Road Ahead For Regulation Of Digital Twins In Healthcare
Digital replicas of cells, organs and people — known as digital twins — can facilitate clinical trials for new drugs by reducing the number of patients required, but data limitations can create logistical hurdles and regulatory efforts addressing digital twins are still in early stages, say consultants at Keystone Strategy.
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3 Ways To Lower Insider Trading Risk After First 10b5-1 Case
In light of the U.S. Department of Justice's insider trading prosecution against the former CEO of Ontrack based on alleged abuse of a Rule 10b5-1 safe harbor plan — designed to allow executives to sell their companies' securities without liability — companies and individuals should take steps to avoid enacting similar plans in bad faith, say attorneys at Jenner & Block.
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Lawyers Can Take Action To Honor The Voting Rights Act
As the Voting Rights Act reaches its 59th anniversary Tuesday, it must urgently be reinforced against recent efforts to dismantle voter protections, and lawyers can pitch in immediately by volunteering and taking on pro bono work to directly help safeguard the right to vote, says Anna Chu at We The Action.
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PE Firms Should Prepare For Increased False Claims Scrutiny
The impact private equity firms may have over medical decisions and care is increasingly attracting potential liability under the False Claims Act and attention from states and the federal government, so investors should follow best practices including conducting due diligence both before and after acquisitions, say attorneys at K&L Gates.
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3 Healthcare FCA Deals Provide Self-Disclosure Takeaways
Several civil False Claims Act settlements of alleged healthcare fraud violations over the past year demonstrate that healthcare providers may benefit substantially from voluntarily disclosing potential misconduct to both the U.S. Department of Justice and the U.S. Department of Health and Human Services, say Brian Albritton and Raquel Ramirez Jefferson at Phelps Dunbar.
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Series
After Chevron: ERISA Challenges To Watch
The end of Chevron deference makes the outcome of Employee Retirement Income Security Act regulatory challenges more uncertain as courts become final arbiters of pending lawsuits about ESG investments, the definition of a fiduciary, unallocated pension forfeitures and discrimination in healthcare plans, says Evelyn Haralampu at Burns & Levinson.