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October 17, 2024
Sen. Report Slams Insurers For Medicare Advantage Denials
A trio of major Medicare Advantage insurers are driving profits by denying coverage for patient stays at "costly but critical" facilities for those recovering from injuries and illnesses, according to a report issued Thursday by a Congressional committee.
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October 17, 2024
No Privilege For Drug Discount Co. Accused Of Faking Deal
A Colorado federal judge held Wednesday that he saw probable cause that a drug discounter hired an attorney with the intent to commit fraud, ordering that company to disclose privileged documents in a lawsuit alleging it faked an acquisition to dupe an Illinois-based pharmacy benefit company into paying higher commissions.
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October 17, 2024
Health Co. Must Face State Farm Settlement Interpretation Suit
An automobile-accident-focused healthcare company can't escape State Farm's lawsuit claiming the facility breached a settlement agreement by failing to drop hundreds of personal injury protection suits, a Florida federal court ruled.
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October 17, 2024
Seyfarth Hit With $8M Suit For Botched Wage Class Settlement
Seyfarth Shaw LLP owes a physician practice almost $8 million for negligently removing hundreds of the practice's employees from a list of those entitled to part of a $4.9 million wage and hour settlement, costing the practice another $3.6 million to correct the mistake, according to a California suit.
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October 17, 2024
Texas Sues Doctor For Providing Kids Gender-Affirming Care
The state of Texas sued a pediatrician Thursday, alleging she broke state law by providing gender-affirming care to children.
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October 16, 2024
BetterHelp Can't Ax Suit Over Sharing Data With Advertisers
A California federal judge has trimmed but refused to completely toss a consolidated putative class action accusing online counseling platform BetterHelp Inc. of unlawfully disclosing consumers' confidential information to third parties for advertising purposes, finding that newly added details boosted several of the plaintiffs' claims.
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October 16, 2024
Indiana U. Hit With Sex Abuse Claims Over Sports Doc Exams
Indiana University has been accused in a new lawsuit of turning a blind eye to the sexual misconduct of a longtime physician for the IU men's basketball team who allegedly routinely assaulted student athletes.
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October 16, 2024
Philips Says $12M Sanction Needed For Evidence Destruction
A spoliation sanctions hearing for around $12 million in royalty damages turned terse when the owner of a medical device equipment sale and servicing company seemingly hedged his statements, with a Texas federal judge saying, "Oh my gosh, just answer the question," during the Wednesday hearing.
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October 16, 2024
Conn. Nurses Sue To Block Forced Post-Contract Overtime
A union representing nurses at a Hartford HealthCare-affiliated hospital in Norwich, Connecticut, has asked a state superior court judge to block mandatory overtime assignments, arguing that a 2020 union contract requiring such shifts expired over the summer and that a 2023 state statute bans the hospital's continuing practices.
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October 16, 2024
Sudanese Men Charged With Hacking Cedars-Sinai, Microsoft
California federal prosecutors announced Wednesday that two Sudanese brothers have been charged with operating a prolific hacking group that orchestrated tens of thousands of politically motivated cyberattacks against worldwide government agencies, Los Angeles' Cedars-Sinai Medical Center and companies including Microsoft, PayPal, Google and Netflix.
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October 16, 2024
Ex-Pharma Co. Employee Traded On GSK Deal Info, SEC Says
The former director of analytical development at Canada-based drug company Bellus Health Inc. has agreed to pay the U.S. Securities and Exchange Commission over $120,000 to settle claims that he sold shares on nonpublic information about pharma giant GSK's impending takeover of his company, according to court filings.
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October 16, 2024
SEC To Settle Claims CBD Exec Took $13M From Hospital
The U.S. Securities and Exchange Commission is ready to make a deal with a former cannabidiol products executive accused of taking $13 million from a hospital after falsely promising to deliver urgently needed masks during the height of the pandemic.
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October 16, 2024
Alphatec Investor Seeks $9.5M Atty Fee After Chancery Win
A family office investment company that recently won a five-year battle over millions worth of securities purchase rights not honored by a surgical and medical device developer asked Delaware's Court of Chancery on Wednesday to shift more than $9.5 million in fees and expenses to the developer.
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October 16, 2024
Caremark, Optum Say FTC Insulin Case Gets PBMs All Wrong
Caremark Rx, Express Scripts and OptumRx continue to attack the Federal Trade Commission's in-house case accusing the country's three largest pharmacy benefit managers of artificially inflating insulin prices by relying on unfair rebate schemes, arguing the agency's case lacks authority, facts and the right targets.
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October 16, 2024
Court Tosses Suit Against NJ Cops For Medical Pot Seizure
A New Jersey federal judge tossed a civil rights action Tuesday against a police officer who seized medical marijuana from a registered patient, noting that police could not determine at the time whether the marijuana was lawfully purchased.
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October 16, 2024
Houston Pharma Exec Found Guilty In $160M Health Fraud
A Houston man was convicted on 15 criminal charges in connection with orchestrating a massive healthcare scheme that defrauded the government out of $160 million, following a 10-day trial in which prosecutors said doctors were "bamboozled" by the conspiracy.
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October 16, 2024
Lesbian Nurse Says Ga. Hospital's Fertility Plan Is Biased
A lesbian nurse has hit a Georgia hospital and healthcare system with a proposed class action, alleging that the medical plan they offer employees discriminates against homosexual women by charging them more upfront to receive fertility care than women in heterosexual relationships.
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October 16, 2024
M&A Pros Cautious About Expected Private Equity Surge
It's an oft-repeated line that private equity activity is set to surge amid pressure to exit older investments and deploy record stores of dry powder, but mergers and acquisitions professionals recently surveyed by Dykema were cautious when asked if they expect private equity to boost deal flow in the next 12 months, with a majority saying they only "somewhat agree."
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October 16, 2024
Feds Say EMTALA Trumps Idaho Abortion Ban In Emergencies
A legal fight over a federal law governing emergency medical care and Idaho's strict abortion ban is back in the Ninth Circuit where the federal government argued that the ban conflicts with the federal statute, but only in narrow circumstances requiring emergency abortions to stabilize a pregnant woman.
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October 16, 2024
Dermatology Practice Can't Escape Fired Doctor's Bias Suit
A Pennsylvania federal judge refused Wednesday to toss a sex and age discrimination suit from a dermatologist who said she was unlawfully fired by the private equity-backed practice that bought her business, ruling she put forward enough details to keep her claims in play.
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October 15, 2024
UBH Surprise Billing Fight 'Begs' For Issue Cert., Judge Says
A California federal judge deciding whether to certify classes of patients who allege United Behavioral Health and billing contractor MultiPlan underpaid thousands of claims for out-of-network substance use disorder treatment told counsel Tuesday the case "begs" for issue certification, while adding that the U.S. medical system is "an absolute mess."
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October 15, 2024
Navajo President Asks Vice President To Resign From Office
Navajo Nation President Buu Nygren has asked Vice President Richelle Montoya to resign from her position, arguing that her efforts backing a recent petition led by the tribe's former human resources director to recall him from office is the second-in-command's "formal break" from his administration.
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October 15, 2024
Anti-Abortion Nonprofit Moves To Block NJ AG's Subpoena
An anti-abortion pregnancy center urged a New Jersey federal court Tuesday to immediately block Attorney General Matt Platkin's subpoena seeking information about its donors, arguing it will suffer irreparable harm if it is forced to comply before any of its constitutional claims are considered by the court.
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October 15, 2024
Feds Seek Court's OK On $350M Norfolk Southern Spill Deal
The federal government has asked an Ohio federal judge to approve a nearly $350 million settlement to close out the U.S. Environmental Protection Agency's legal claims against Norfolk Southern over the fiery February 2023 train derailment and toxic chemical spill in East Palestine.
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October 15, 2024
Motley Rice May Avoid DQ In Boston Opioid Case, Judge Hints
A Massachusetts federal judge on Tuesday appeared skeptical of a bid by pharmacy benefit manager OptumRX to disqualify Motley Rice LLC from representing the city of Boston in a lawsuit over the company's alleged role in the opioid crisis.
Expert Analysis
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Orange Book Warnings Highlight FTC's Drug Price Focus
In light of heightened regulatory scrutiny surrounding drug pricing and the Federal Trade Commission's activity in the recent Teva v. Amneal case, branded drug manufacturers should expect the FTC's campaign against allegedly improper Orange Book listings to continue, say attorneys at Ropes & Gray.
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Firms Must Rethink How They Train New Lawyers In AI Age
As law firms begin to use generative artificial intelligence to complete lower-level legal tasks, they’ll need to consider new ways to train summer associates and early-career attorneys, keeping in mind the five stages of skill acquisition, says Liisa Thomas at Sheppard Mullin.
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PBM Takeaways From Proposed Telehealth Flexibility Bill
The U.S. House of Representatives' proposal to extend certain telehealth flexibilities signals a robust commitment to expanding telehealth access, though its plan to offset additional expenses through pharmacy benefit manager reform could lead to some industry consolidation, say attorneys at Mintz.
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A Plaintiffs-Side Approach To Cochlear Implant Cases
As the number of cochlear implants in the U.S. continues to grow, some will inevitably fail — especially considering that many recalled implants remain in use — plaintiffs attorneys should proactively prepare for litigation over defective implants, says David Shoop at Shoop.
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Inside Antitrust Agencies' Rollup And Serial Acquisition Moves
The recent request for public comments on serial acquisitions and rollup strategies from the Federal Trade Commission and U.S. Justice Department mark the antitrust agencies' continued focus on actions that fall below premerger reporting thresholds, say attorneys at Paul Weiss.
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Think Like A Lawyer: Always Be Closing
When a lawyer presents their case with the right propulsive structure throughout trial, there is little need for further argument after the close of evidence — and in fact, rehashing it all may test jurors’ patience — so attorneys should consider other strategies for closing arguments, says Luke Andrews at Poole Huffman.
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Series
Playing Chess Makes Me A Better Lawyer
There are many ways that chess skills translate directly into lawyer skills, but for me, the bigger career lessons go beyond the direct parallels — playing chess has shown me the value of seeing gradual improvement in and focusing deep concentration on a nonwork endeavor, says attorney Steven Fink.
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9th Circ. Clarifies ERISA Preemption For Healthcare Industry
The Ninth Circuit's recent ruling in Bristol SL Holdings v. Cigna notably clarifies the broad scope of the Employee Retirement Income Security Act's preemption of certain state law causes of action, standing to benefit payors and health plan administrators, say attorneys at Troutman Pepper.
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Litigation Inspiration: Attys Can Be Heroic Like Olympians
Although litigation won’t earn anyone an Olympic medal in Paris this summer, it can be worthy of the same lasting honor if attorneys exercise focused restraint — seeking both their clients’ interests and those of the court — instead of merely pursuing every advantage short of sanctionable conduct, says Bennett Rawicki at Hilgers Graben.
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Unpacking NY's Revised Hospital Cybersecurity Rule Proposal
The New York State Department of Health's recently revised hospital cybersecurity rule proposal highlights increased expectations and scrutiny around cybersecurity in the healthcare sector, while adapting to both recent industry developments and public comments, say Christine Moundas and Gideon Zvi Palte at Ropes & Gray.
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Short-Term Takeaways From CMS' New Long-Term Care Rules
The Centers for Medicare & Medicaid Services' new final rule on nursing home staffing minimums imposes controversial regulatory challenges that will likely face significant litigation, but for now, stakeholders will need to prepare for increased staffing expectations and more specialized facility assessments without meaningful funding, say attorneys at Morgan Lewis.
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Updated Federal Rules Can Improve Product Liability MDLs
The recent amendment of a federal evidence rule regarding expert testimony and the proposal of a civil rule on managing early discovery in multidistrict legislation hold great promise for promoting the uniform and efficient processes that high-stakes product liability cases particularly need, say Alan Klein and William Heaston at Duane Morris.
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Lean Into The 'Great Restoration' To Retain Legal Talent
As the “great resignation,” in which employees voluntarily left their jobs in droves, has largely dissipated, legal employers should now work toward the idea of a “great restoration,” adopting strategies to effectively hire, onboard and retain top legal talent, says Molly McGrath at Hiring & Empowering Solutions.
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FDA's Data Monitoring Guidance Reveals Future Expectations
As the world of clinical research grows increasingly complex, the U.S. Food and Drug Administration's recent draft guidance on the use of data monitoring committees in clinical trials reveals how the agency expects such committees to develop, say Melissa Markey and Carolina Wirth at Hall Render.
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How Cannabis Rescheduling May Alter Paraphernalia Imports
The Biden administration's recent proposal to loosen federal restrictions on marijuana use raises questions about how U.S. Customs and Border Protection enforcement policies may shift when it comes to enforcing a separate federal ban on marijuana accessory imports, says R. Kevin Williams at Clark Hill.