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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.
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December 16, 2024
Justices Cite Loper Bright, Remand NLRB Successor Bar Case
The U.S. Supreme Court remanded an NLRB dispute Monday about a Puerto Rico hospital's liability for withdrawing recognition from a union under the agency's successor bar standard, telling the D.C. Circuit to review its deference to the board under Loper Bright.
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December 16, 2024
With Legal Battle Looming, Neb. Legalizes Medical Marijuana
Nebraska became the 39th state to legalize medical marijuana after supermajorities of voters approved ballot measures to decriminalize and regulate its sale, but the state Supreme Court has agreed to hear a challenge from state officials that could invalidate it before implementation.
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December 16, 2024
Feds Ask To Speak With Juror In Failed $34M Kickback Trial
Prosecutors on Monday asked a New Jersey federal judge if they could speak with the foreperson of a jury that acquitted a Philadelphia pharmacy executive of scheming to bilk $34 million from insurers by paying kickbacks, after the juror offered to share feedback ahead of a possible retrial.
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December 16, 2024
Conn. Justices Revive Widow's Suit Against UConn Hospital
The state of Connecticut failed to properly challenge the claims commissioner's decision to issue a late ruling that allowed a widow to sue University of Connecticut entities for medical malpractice, so the case can survive, the state's high court found Monday in overturning a trial court's dismissal.
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December 16, 2024
The Biggest Massachusetts High Court Rulings Of 2024
Massachusetts' highest court added two justices this year while taking up several novel legal issues, including one town's effort to phase out the sale of tobacco, a paralyzed Uber rider's fight against arbitration, and a dispute over whether a hospital website's use of tracking cookies violates the state wiretap statute.
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December 16, 2024
Dental Workers' Retaliation Appeal Nixed For Lack Of Docs
A California appeals court declined to revive a suit brought by two dental office workers who claimed they were fired after complaining that their boss sexually harassed them, saying they hadn't provided enough details for the court to evaluate their case.
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December 16, 2024
Hospice Director Axed For Flagging Missed OT Pay, Court Told
A hospice center promised its director of clinical services that it would pay her overtime wages for time spent performing nursing duties but failed to do so and then fired her when she asked upper management about the missed pay, she told a Georgia federal court.
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December 16, 2024
Justices Pass On TCPA Case Over Fax Promoting Webinar
The nation's top court on Monday declined to take up a healthcare technology company's appeal seeking to stave off a proposed class action accusing it of violating the Telephone Consumer Protection Act by sending faxes about a free webinar.
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December 13, 2024
UnitedHealthcare Owes $900K For Services, Provider Says
A national healthcare provider and two affiliated entities told a Minnesota federal court that UnitedHealthcare owes over $900,000 in independent dispute resolution awards entered against the carrier, accusing it of devising a scheme of denying, delaying and underpaying out-of-network providers.
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December 13, 2024
DC Circ. Upholds NLRB In Puerto Rico Hospital Layoff Case
A San Juan, Puerto Rico, hospital illegally laid off its janitors and contracted out their work without bargaining with their union, the D.C. Circuit ruled Friday, upholding the National Labor Relations Board's decision in the case.
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December 13, 2024
ND Judge Speeds Up Review Of DACA Health Coverage Block
A North Dakota federal judge agreed Friday to expedite the federal government's request to halt an order blocking the enforcement of a regulation that extends health coverage to immigrants brought to the U.S. as children without authorization.
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December 13, 2024
Aetna Analyst Says She Was Forced Out Over ADD Disability
Health insurer Aetna was hit with a disability discrimination lawsuit in Georgia federal court by a former data analyst who said she was forced out of her job by regular harassment from her supervisor over her attention deficit disorder.
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December 13, 2024
NYC Hospital System Wants Out Of REIT's $50M Campus Suit
The New York City Health and Hospitals Corp. and the New York City Economic Development Corp. asked a New York federal court Friday to dismiss a $50 million suit that accused them of being misleading when it came to the development of a floodwall that's supposed to be part of a commercial life sciences campus project.
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December 13, 2024
What's Left In $400M Skinny Label Row? A Lot, Court Says
A number of key issues remain live in the $400 million fight between Teva Pharmaceuticals and GlaxoSmithKline over whether the generic-drug maker induced healthcare providers to infringe the brand-name company's heart drug patent, including the availability of a new trial, a Delaware federal judge has said.
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December 13, 2024
Pa. Contractor Hit With $4.2M Verdict In Pot Software Row
A Pennsylvania federal jury hit a cannabis software company with a $4.2 million judgment in a lawsuit from a subcontractor claiming it was brought on to help with a government project because of its Black-owned status, then pushed out of the $10 million deal.
Expert Analysis
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How Boards And Officers Should Prep For New Trump Admin
In anticipation of President-elect Donald Trump's proposed tariffs and mass deportation campaign, company officers and board members should pursue proactive, comprehensive contingency planning to not only advance the best interests of the companies they serve, but to also properly exercise their fiduciary duty of care, say attorneys at Winston & Strawn.
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Calif. Ruling May Shield Public Employers From Labor Claims
In Stone v. Alameda Health System, the California Supreme Court recently exempted a county hospital from state-mandated rest breaks and the Private Attorneys General Act, granting government employers a robust new bulwark against other labor statutes by undermining an established doctrine for determining if a law applies to public entities, say attorneys at Hunton.
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Health Policy Predictions For Trump's Second Administration
As President-elect Donald Trump's nominations for health policy and enforcement heads work their way through the confirmation process, healthcare organizations can look at nominee backgrounds, campaign statements and actions from Trump's previous presidency to predict incoming priorities, say attorneys at McDermott.
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Series
Flying Makes Me A Better Lawyer
Achieving my childhood dream of flying airplanes made me a better lawyer — and a better person — because it taught me I can conquer difficult goals when I leave my comfort zone, focus on the demands of the moment and commit to honing my skills, says Ivy Cadle at Baker Donelson.
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What Trump's Next Term May Mean For Biz Immigration
Leonard D'Arrigo at Harris Beach discusses the employment-based immigration policies businesses can potentially expect during President-elect Donald Trump’s second term, based on policies enacted during his first administration, statements made during his campaign and proposals in Project 2025.
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Compliance Considerations Of DOJ Data Security Rule
Under the U.S. Department of Justice's proposed rule aiming to prevent certain countries' access to bulk U.S. sensitive personal data, companies must ensure their vendor, employment and investment agreements meet strict new data security requirements — or determine whether such contracts are worth the cost of compliance, say attorneys at Eversheds Sutherland.
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Balancing Health Tech Advances And Clinical Responsibility
To maintain their clinical responsibilities and mitigate potential legal risk, health professionals should incorporate the benefits of new medical technology powered by artificial intelligence while addressing its risks and limitations, says Kathleen Fisher Enyeart at Lathrop GPM.
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Series
Circus Arts Make Me A Better Lawyer
Performing circus arts has strengthened my ability to be more thoughtful, confident and grounded, all of which has enhanced my legal practice and allowed me to serve clients in a more meaningful way, says Bailey McGowan at Stinson.
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Opinion
Weak Reasoning Underlies Fla. Judge's Bold Qui Tam Ruling
U.S. District Judge Kathryn Mizelle's groundbreaking decision in U.S. ex rel. Zafirov v. Florida Medical Associates LLC, holding that qui tam provisions of the False Claims Act are unconstitutional, relies on weak logic to reach a conclusion that differs from every other court that has ruled on the issue, says Ethan Greenberg at Anderson Kill.
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When Investigating An Adversary, Be Wary Of Forged Records
Warnings against the use of investigators who tout their ability to find an adversary’s private documents generally emphasize the risk of illegal activity and attorney discipline, but a string of recent cases shows an additional danger — investigators might be fabricating records altogether, says Brian Asher at Asher Research.
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3 Ways To Train Junior Lawyers In 30 Minutes Or Less
Today’s junior lawyers are experiencing a skills gap due to pandemic-era disruptions, but firms can help bring them up to speed by offering high-impact skill building content in bite-sized, interactive training sessions, say Stacey Schwartz at Katten, Diane Costigan at Winston & Strawn and Lauren Tierney at Freshfields.
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Medicare Overpayment Rules Are A Mixed Bag For Providers
The Centers for Medicare & Medicaid Services' updated rules for handling agency overpayments adopt a more reasonable definition of what it means to have "identified" an overpayment, which is a win for providers, but their new time frame for investigating related overpayments is unrealistic, says Susan Banks at Holland & Knight.
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Navigating Decentralized Clinical Trials With FDA's Guidance
The U.S. Food and Drug Administration's recently finalized guidance on conducting decentralized clinical trials, while not legally binding, can serve as a road map for sponsors, investigators and others to ensure trial integrity and participant safety, say attorneys at Phillips Lytle.
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The Bar Needs More Clarity On The Discovery Objection Rule
Almost 10 years after Federal Rule of Civil Procedure 34 was amended, attorneys still seem confused about what they should include in objections to discovery requests, and until the rules committee provides additional clarity, practitioners must beware the steep costs of noncompliance, says Tristan Ellis at Shanies Law Office.
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Expect More State-Level Scrutiny Of Noncompetes Ahead
Despite the nationwide injunction against the Federal Trade Commission’s noncompete ban, and the incoming Republican administration, employers should anticipate that state legislatures will continue to focus on laws that limit or ban noncompetes, including those that target certain salary thresholds or industries, says Benjamin Fryer at FordHarrison.