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Health
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June 04, 2024
Ga. County Wants 11th Circ. To Rethink Trans Care Ban Ruling
A Georgia county that lost a legal challenge to a provision of its health plan that bars coverage for gender-affirming surgery has asked the full Eleventh Circuit to revisit the decision, arguing that an opinion last month wrongly found the policy discriminates against transgender people, rather than being isolated to a single procedure.
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June 04, 2024
2nd Circ. Says ERISA Blocks Cigna Bill Backpedaling Suit
The Second Circuit affirmed the dismissal of a podiatric medicine provider's suit alleging Cigna illegally backtracked on covering a patient's $200,000 bill, ruling that a lower court was right to find that federal benefits law blocks the healthcare provider's breach of contract claims.
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June 04, 2024
Benefits Plan Inks Deal To End Mental Health Coverage Suit
The employee benefits plan at Mountain Area Health Education Center became the last remaining defendant to reach a settlement in a North Carolina district court lawsuit accusing an insurer and others of refusing to cover the cost of a patient's stay at a residential treatment center.
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June 04, 2024
White House Threatens Veto Over Policy Riders In VA Bill
The White House has threatened to veto a $147.5 billion bill funding military construction and the U.S. Department of Veterans Affairs, citing partisan policy proposals it said would harm minority groups and risk patient safety at VA medical facilities.
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June 04, 2024
Nurse Staffing Exec Wants Antitrust, Fraud Charges Separated
An indicted home health care staffing executive asked a Nevada federal court to separate the antitrust charge against him for allegedly fixing nurses wages from claims that he concealed the conspiracy and government probe when selling the business for more than $10 million.
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June 04, 2024
Psychiatrist's Billing Scheme Warrants 11 Years, Feds Say
A psychiatrist convicted of billing Medicare and private insurers for $19 million worth of treatments he never provided should serve more than 11 years in prison for the "brazen, greed-fueled" fraud scheme, prosecutors have told a Boston federal judge.
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June 04, 2024
Fox Rothschild Partner Can't Testify In NJ Fraud Retrial
Fox Rothschild LLP partner Ernest E. Badway can't serve as an expert witness for a businessman facing retrial on securities fraud claims, a New Jersey federal judge ruled Tuesday, siding with the government's contention that the testimony would be irrelevant.
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June 04, 2024
Ex-Keller & Heckman Scientist Joins K&L Gates In DC
K&L Gates LLP announced Tuesday that a longtime scientist at Keller and Heckman LLP joined its Washington, D.C., office as the firm's first senior scientific adviser.
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June 04, 2024
Sens. Offer Stark Takes On Abortion Two Years Post-Dobbs
Republican and Democratic members of the Senate health committee on Tuesday offered two different views of abortion in America two years after the Dobbs Decision overturned the federal right to the procedure.
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June 03, 2024
Voir Dire With No Judge Present Persists In State Courts
Data released Friday by the National Center for State Courts revealed that voir dire conducted by lawyers with no judge present in the room persists in 7% of state court trials, but has been virtually eliminated in federal courts.
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June 03, 2024
Humana Hit With Investor Suit Over Post-COVID Costs
Health insurer Humana and two executives were hit with an investor class action on Monday, claiming they misled shareholders about the cost of pent-up demand for medical treatments once the COVID-19 pandemic subsided.
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June 03, 2024
Colo. Gov Signs Compromise Bill Raising Damages Caps
Colorado Gov. Jared Polis on Monday signed a law that will increase statutory caps on noneconomic damages for wrongful death and injury claims, as part of a deal to avoid a ballot-box fight between medical providers and personal injury lawyers.
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June 03, 2024
DC Judge Axes Ariz. Tribe's $2.6M Veteran Care Claims
A D.C. federal court judge dismissed an Arizona tribe's bid to recoup nearly $2.6 million in Native American veteran care reimbursements from the federal government, saying the tribe has not plausibly alleged that the Indian Health Services' actions in withholding the funding caused any injury.
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June 03, 2024
NY 'No-Fault' Insurance Fraudster Gets 10 Years
A federal judge on Monday sentenced the ringleader of an insurance fraud scheme to the maximum term of 10 years in prison for what prosecutors say was a bribery-fueled, 14-year, $60 million scam that exploited New York's no-fault laws.
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June 03, 2024
Surgeons Denied Early Exit From GEICO's Bogus Injury Suit
A pair of orthopedic surgeons can't escape GEICO's lawsuit claiming they conspired with a personal injury attorney to file inflated insurance claims for car accident victims based on bogus medical documents, a North Carolina federal judge ruled Monday.
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June 03, 2024
Drug Cos. Can Depose DC AG In Drug Price-Fixing Row
A Connecticut federal judge reluctantly ordered the District of Columbia Attorney General's Office to be deposed by the drug companies wrapped up in more than 40 states' claims over an alleged price-fixing conspiracy, noting that he would not have done so but for the case being remanded from a sprawling multidistrict litigation in Pennsylvania.
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June 03, 2024
DOL Fights Injunction Bid In Data-For-Insurance Fight
The U.S. Department of Labor pushed back against two companies' permanent injunction bid in a lawsuit that had challenged a now-vacated finding from the agency that a data-for-insurance health plan offering wasn't covered by federal benefits law, arguing a Texas federal court should instead end proceedings in the case.
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June 03, 2024
4 Mass. Rulings You Might Have Missed In May
Massachusetts state court judges rejected a law firm's effort to fight malpractice claims by pointing the finger at a Rhode Island judge, and ruled that an online booking platform can boot the owner of Bali vacation villas from its site, among other under-the-radar decisions handed down in May.
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June 03, 2024
Amazon, Wondery Want Out Of ICE Doc's Defamation Suit
Amazon.com LLC, Wondery LLC and Morbid: A True Crime Podcast LLC asked a Georgia federal judge on Friday to dismiss a former immigration prison doctor's lawsuit alleging he was defamed by the release of a true-crime podcast episode that accused him of performing forced hysterectomies on detainees.
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June 03, 2024
Ex-SoftBank GC Joins Foley & Lardner As Partner In SF
Foley & Lardner LLP has hired SoftBank Investment Advisers' former general counsel, who has over a decade of experience in private practice and serving as in-house counsel overseeing SoftBank's legal team, which structured and monitored more than 300 portfolio companies worth more than $130 billion.
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June 03, 2024
Jury Trials Dwindle In State Courts; Fall Started Before COVID
Jury trials have continued to "vanish" from state courts, despite seeing a slight bump following the pandemic shutdowns, with 2021 seeing fewer than half the number of jury trials as 2019 and one-third the number held in 2007, according to a new report from the National Center for State Courts.
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June 03, 2024
House COVID Panel Questions Fauci Over Pandemic Origins
Anthony Fauci, the former director of the National Institute of Allergy and Infectious Disease responsible for overseeing the pandemic response, was pressed by a U.S. House COVID-19 panel Monday about recent allegations that a senior official tried to evade open records laws regarding the origins of the pandemic.
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June 03, 2024
Ropes & Gray Guides Becton On $4.2B Edwards Unit Buy
Ropes & Gray LLP is guiding Becton Dickinson and Co. on a deal that will see the medical technology company pay $4.2 billion for Edwards Lifesciences' critical care product group, which focuses on patient monitoring using artificial intelligence, the companies said Monday.
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June 03, 2024
Senate To Vote On Right To Contraception
The Senate will vote later this week on a bill to codify a statutory right to contraception, ahead of the two-year anniversary of the U.S. Supreme Court's overturning of Roe v. Wade.
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June 03, 2024
Nursing Home Co. LaVie Hits Ch. 11 In Ga. With $1.1B Debt
Nursing home operator LaVie Care Centers LLC hit Chapter 11 on Monday in Georgia with $1.1 billion in debt, saying it has not been able to recover from the COVID-19 pandemic.
Expert Analysis
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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.
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Skirting Anti-Kickback Causation Standard Amid Circuit Split
Amid the federal circuit court split over the causation standard applicable to False Claims Act cases involving Anti-Kickback Statute violations, which the First Circuit will soon consider in U.S. v. Regeneron, litigators aiming to circumvent the heightened standard should contemplate certain strategies, say Matthew Modafferi and Terence Park at Frier Levitt.