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December 18, 2024
Homeless Woman's Residency Unclear In Inter-Insurer Dispute
A Michigan state appeals court has vacated a trial court order finding the insurer for a homeless woman's parents must cover injuries she suffered after being run over by a semitruck, ruling that questions remain over whether the woman had another established residence.
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December 18, 2024
FTC Wants Express Scripts' Defamation Suit Tossed
The Federal Trade Commission told a Missouri federal court that Express Scripts Inc. has no basis to challenge an interim agency report that only offered "qualified conclusions" from an ongoing study about how pharmacy benefit managers affect prescription drug prices.
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December 18, 2024
Medical Center Escapes COVID Outbreak Blame-Trading Suit
A Michigan state appeals panel nixed a wedding venue's defamation suit alleging it was falsely blamed after several guests at a reception contracted COVID-19, handing a win to a healthcare provider the venue pointed to as the source of the outbreak.
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December 18, 2024
Senate Sends $895B Defense Bill To Biden's Desk
The U.S. Senate on Wednesday easily passed an $895.2 billion defense policy and budget bill for 2025, despite criticism over a contentious clause effectively barring gender-affirming healthcare coverage for service members' transgender children.
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December 18, 2024
Yale Eyes Quick Win In $435M Conn. Hospital Purchase Suit
Yale New Haven Health Services Corp. has asked a Connecticut state court judge for permission to file a summary judgment motion in a feud with Prospect Medical Holdings Inc. over the sale of several hospitals in the state, saying Prospect's "stunning" failure to fund pensions and pay taxes resulted in property liens that breached the $435 million deal.
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December 18, 2024
SiteOne Gets $100M To Advance Non-Opioid Pain Treatments
SiteOne Therapeutics Inc., a biopharmaceutical company focusing on pain treatment, on Wednesday announced that it clinched a Series C funding round after securing $100 million from investors.
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December 18, 2024
Top Conn. Cases Of 2024: Kickbacks, Paybacks And Bribes
Judges and juries in Connecticut awarded several multimillion-dollar verdicts against companies big and small in 2024, socking Johnson & Johnson in a talc case in which the already substantial damages could multiply and ordering a pharmacy that paid kickbacks to cough up nearly four times the money it cost the state.
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December 18, 2024
Justices Will Decide If Medicaid Recipients Can Pick Providers
The U.S. Supreme Court on Wednesday partially granted the state of South Carolina's petition to review a Fourth Circuit decision blocking its Medicaid program from ending its provider agreement with Planned Parenthood, agreeing to determine if the Medicaid Act allows a beneficiary to choose a specific provider.
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December 17, 2024
NC Panel Revives Negligence Suit Against State Health Dept.
An adult care center's constitutional claims accusing the North Carolina Department of Health and Human Services of negligently asserting bogus penalties and unfairly suspending admissions at the facility are timely, a North Carolina state appellate panel ruled Tuesday, reviving a case that previously landed before the North Carolina Supreme Court.
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December 17, 2024
UNC Doctor Can't Shield Minor Transgender Patients' Records
A University of North Carolina doctor cannot assert privilege over medical records sought from the university by state Republicans fighting a suit by the physician and others seeking to enjoin a law imposing limits on transgender care for minors, a federal magistrate judge has ruled.
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December 17, 2024
11th Circ. Urged To Block Abortion Clinic Buffer Zone Law
A Florida anti-abortion group urged the Eleventh Circuit on Tuesday to give it another shot at an injunction preventing the city of Clearwater from enforcing a buffer zone ordinance that blocks the group from getting within five feet of the driveway to the city's only abortion clinic.
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December 17, 2024
Express Scripts, OptumRx Can't Ditch LA County Opioid Suit
A California judge ruled Tuesday that Los Angeles County can keep pursuing a lawsuit claiming pharmacy benefit managers Express Scripts and OptumRx colluded with drugmakers to fuel the opioid epidemic, though the county must rework its complaint to specify how regulators were allegedly deceived.
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December 17, 2024
Sandoz Cuts $275M Deal For More Price-Fixing Claims
Swiss drugmaker Sandoz said Tuesday it has reached a $275 million settlement to end claims from consumers, insurers and others in the sprawling multidistrict litigation over alleged price-fixing in the generic-drug industry.
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December 17, 2024
House GOP Asks CVS How Its PBM Treats Smaller Pharmacies
Lawmakers on Capitol Hill are demanding documents from CVS on its pharmacy benefit manager's treatment of independent pharmacies, continuing to press the healthcare giant over potentially anticompetitive conduct.
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December 17, 2024
The Biggest Georgia Legal Developments Of 2024
From navigating bombshell prosecutor romance allegations in the Georgia election interference case against President-elect Donald Trump and his co-defendants to vacating a $1.7 billion verdict against Ford Motor Co. in a fatal "Super Duty" rollover case, to seeing the state's longest-running criminal trial to a close, 2024 was a busy year for courts in the Peach State.
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December 17, 2024
Feds Intervene In $200M FCA Case Against CVS
The federal government has intervened in a whistleblower case accusing CVS and its subsidiaries of pocketing more than $200 million in overpayments, in order to defend the constitutionality of the False Claims Act's whistleblower provisions.
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December 17, 2024
Ariz. Families Seek Class Cert. Over Sober Home Living Scam
A group of Arizona families is seeking class certification in an effort to hold the state and its healthcare agencies accountable for the so-called sober living crisis, arguing that despite knowing the magnitude of fraud that was occurring, it continued to enable the multibillion-dollar scam.
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December 17, 2024
4 Recent Policy Developments Benefits Attys Should Know
A trio of federal agencies finalized new disclosure requirements for how health plans cover mental health treatments, states took steps to regulate pharmacy benefit managers, the U.S. Department of Labor's investment advice regulations failed in court, and Congress passed legislation to make compliance with the Affordable Care Act easier. Here, Law360 looks back at four policy-related developments in the employee benefits field from the latter half of 2024.
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December 17, 2024
IRS Finalizes Expanded 'Coverage Month' For Premium Credit
The Internal Revenue Service finalized rules Tuesday that will expand the definition of a coverage month for purposes of computing the health insurance premium tax credit.
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December 16, 2024
Merger Enforcers End Year On Upswing
The Biden administration's antitrust enforcers have boasted that one side effect of their aggressive approach to merger enforcement has been helping stop problematic deals from being cut in the first place, but the agencies also scored key court rulings blocking transactions in their final year that could have a more enduring effect.
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December 16, 2024
Health Education Biz Infringed Training Materials, NJ Suit Says
A healthcare education company has accused a rival of infringing copyright-protected training materials for medical staff working in assisted living facilities, saying in a suit filed in New Jersey federal court that the copying is "blatantly obvious."
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December 16, 2024
UnitedHealthcare Shooting Suspect Hires Ex-NYC Prosecutor
Karen Friedman Agnifilo, a former veteran prosecutor in the Manhattan District Attorney's Office, has been retained to represent the man accused of killing the CEO of UnitedHealthcare outside a hotel in midtown Manhattan earlier this month, a spokesperson for Agnifilo's firm said Monday.
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December 16, 2024
Pa. Malpractice Fund Belongs To State, 3rd Circ. Rules
The Third Circuit said Monday in a precedential ruling that Pennsylvania's medical malpractice insurance fund is an agency of the state and that it can dip into the fund's $300 million budget surplus.
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December 16, 2024
11th Circ. Appears Wary Of Doc's New Trial Bid In $27.5M Case
The Eleventh Circuit on Monday questioned whether a Georgia doctor and his medical practice should get a new trial in a $27.5 million False Claims Act case on the basis that he and an expert who wasn't allowed to testify at trial believed the thousands of treatments he billed for were medically necessary and could be covered by Medicare, saying that contention seems to contradict the doctor's prior statements.
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December 16, 2024
The Biggest Patent Decisions Of 2024
This year's notable patent decisions from the Federal Circuit provided clearer guidelines on double patenting and opened the door for new ways to invalidate design patents. Here's a look at the cases from 2024 that will shape patent litigation going forward.
Expert Analysis
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11th Circ. Kickback Ruling May Widen Hearsay Exception
In a $400 million fraud case, U.S. v. Holland, the Eleventh Circuit recently held that a conspiracy need not have an unlawful object to introduce co-conspirator statements under federal evidence rules, potentially broadening the application of the so-called co-conspirator hearsay exception, say attorneys at ArentFox Schiff.
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8 Childhood Lessons That Can Help You Be A Better Attorney
A new school year is underway, marking a fitting time for attorneys to reflect on some fundamental life lessons from early childhood that offer a framework for problems that no legal textbook can solve, say Chris Gismondi and Chris Campbell at DLA Piper.
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Navigating Complex Regulatory Terrain Amid State AG Races
This year's 10 attorney general elections could usher in a wave of new enforcement priorities and regulatory uncertainty, but companies can stay ahead of the shifts by building strong relationships with AG offices, participating in industry coalitions and more, say Ketan Bhirud and Dustin McDaniel at Cozen O’Connor.
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Sublimit And Policy Interpretation Lessons From Amtrak Case
The recently settled dispute between Amtrak and its insurers over sublimit coverage illustrates that parties with unclear manuscript policies may wish to avoid litigation in favor of settlement — as the New York federal court declined to decide the case by applying prior term interpretations, says Laura Maletta at Chartwell Law.
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Opinion
This Election, We Need To Talk About Court Process
In recent decades, the U.S. Supreme Court has markedly transformed judicial processes — from summary judgment standards to notice pleadings — which has, in turn, affected individuals’ substantive rights, and we need to consider how the upcoming presidential election may continue this pattern, says Reuben Guttman at Guttman Buschner.
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Navigating HHS' New Reproductive Healthcare Privacy Rule
The U.S. Department of Health and Human Services' new final rule regarding protections for the privacy of reproductive health information will require regulated entities to grapple with difficult questions about whether to comply with state law requirements or federal privacy prohibitions, says Christine Chasse at Spencer Fane.
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Mental Health Parity Rules: Tips For Plans And Issuers
Following federal agencies' release of final mental health parity rules, plan sponsors and health insurance issuers should develop protocols for preparing compliant nonquantitative treatment limitation comparative analyses, say attorneys at Ropes & Gray.
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Series
Playing Diplomacy Makes Us Better Lawyers
Similar to the practice of law, the rules of Diplomacy — a strategic board game set in pre-World War I Europe — are neither concise nor without ambiguity, and weekly gameplay with our colleagues has revealed the game's practical applications to our work as attorneys, say Jason Osborn and Ben Bevilacqua at Winston & Strawn.
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Mental Health First Aid: A Brief Primer For Attorneys
Amid a growing body of research finding that attorneys face higher rates of mental illness than the general population, firms should consider setting up mental health first aid training programs to help lawyers assess mental health challenges in their colleagues and intervene with compassion, say psychologists Shawn Healy and Tracey Meyers.
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Opinion
FTC's Report Criticizing Drug Middlemen Is Flawed
The Federal Trade Commission's July report, which claims that pharmacy benefit managers are inflating drug costs, does not offer a credible analysis of PBMs, and its methodology lacks rigor, says Jay Ezrielev at Elevecon.
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Series
Collecting Art Makes Me A Better Lawyer
The therapeutic aspects of appreciating and collecting art improve my legal practice by enhancing my observation skills, empathy, creativity and cultural awareness, says attorney Michael McCready.
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Plan Sponsors Must Prep For New Mental Health, Drug Rules
To comply with newly published health insurance rules requiring parity between access to mental health and substance use services compared to medical and surgical services, employers with self-insured plans will need to update third-party administrator agreements and collect data, among other compliance steps, say attorneys at Kilpatrick.
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Navigating The Complexities Of Cyber Incident Reporting
When it comes to cybersecurity incident response plans, the uptick in the number and targets of legal and regulatory actions emphasizes the necessity for businesses to document the facts underlying the assumptions, complexities and obstacles of their decisions during the incident response, say attorneys at Troutman Pepper.
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Takeaways From Novo Nordisk's Fight For Market Exclusivity
Generic competitors’ challenge to Novo Nordisk’s patents in hopes of capturing a portion of the rapidly expanding Type 2 diabetes and obesity treatment market highlights the role of abbreviated new drug application litigation, inter partes review and multidistrict litigation in patent defense, says Pedram Sameni at Patexia.
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Secret Service Failures Offer Lessons For Private Sector GCs
The Secret Service’s problematic response to two assassination attempts against former President Donald Trump this summer provides a crash course for general counsel on how not to handle crisis communications, says Keith Nahigian at Nahigian Strategies.