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November 21, 2024
NBA Veteran Who Cooperated In $5M Fraud Case Avoids Jail
A Manhattan federal judge on Thursday allowed former NBA center Melvin Ely to avoid prison for taking $36,000 of illegal payouts in pro basketball's $5 million health billing fraud ring, crediting his decision to cooperate in the sprawling criminal case.
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November 21, 2024
NY Hospital GC Accuses State Of Mishandling Medicaid Funds
The general counsel of Nassau University Medical Center, who is also serving as interim president and CEO, is leading the Long Island hospital into a legal battle with the state of New York over $1 billion in federal Medicaid funds.
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November 20, 2024
CVS Can't Dodge Proposed Action Over 'Non-Drowsy' Claims
CVS Pharmacy must continue facing a proposed class action alleging it "dangerously" markets over-the-counter medicine as "non-drowsy" despite containing a substance known to cause drowsiness after a Missouri federal judge on Wednesday refused to toss claims lodged under Missouri and other states' consumer protection laws.
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November 20, 2024
Musk, Ramaswamy Say High Court Rulings OK Federal Cuts
Billionaire Elon Musk and former presidential candidate Vivek Ramaswamy, President-elect Donald Trump's picks to lead a newly created "Department of Government Efficiency," on Wednesday said two recent U.S. Supreme Court rulings will give them the authority to cut off power to regulatory agencies and conduct massive federal layoffs.
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November 20, 2024
Hospital's Med Mal Win Axed By Mich. Appeals Panel
A divided Michigan Court of Appeals panel has revived a medical malpractice lawsuit against a Michigan hospital, finding that the patient established a genuine fact dispute regarding her reasonable belief that the gynecologist treating her was acting as the hospital's agent.
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November 20, 2024
DEA Accused Of Colluding With Reform Foes In Pot Row
Cannabis reform advocates have alleged that the Drug Enforcement Administration "stacked the deck" by colluding with anti-legalization interests and giving them improper opportunities to participate in upcoming hearings on a proposal to loosen federal restrictions on the drug.
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November 20, 2024
Michigan Hospital Can't Escape Amputee's Malpractice Claims
A Michigan appeals court refused to throw out an expert opinion proffered by a patient who alleges that doctors and staffers at a Michigan hospital are responsible for the loss of his right hand, but said the trial court must fully evaluate whether the expert is qualified under state Supreme Court precedent.
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November 20, 2024
PBMs Sue To Block FTC's In-House Insulin Pricing Case
Caremark Rx, Express Scripts and OptumRx have lodged a constitutional challenge of the Federal Trade Commission's in-house case accusing the pharmacy benefits managers of artificially inflating insulin prices through unfair rebate schemes.
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November 20, 2024
3 States To Challenge Abortion Regs After Docs Drop Claims
Anti-abortion medical groups that were dealt a loss by the U.S. Supreme Court earlier this year have now dropped out of their lawsuit challenging federal approvals for mifepristone, leaving Missouri, Idaho and Kansas to carry on litigation over the abortion medication.
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November 20, 2024
Healthcare-Focused PE Firm Clinches $2.3B Buyout Fund
Healthcare-dedicated private equity shop Frazier Healthcare Partners on Wednesday announced that it closed its oversubscribed 11th buyout fund after receiving $2.3 billion of investor commitments.
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November 19, 2024
Monsanto's Bid To Pause PCB Trial Again Shot Down
A Washington state appellate commissioner on Friday again refused to undo a trial court's decision not to pause a chemical poisoning tort trial playing out in Seattle, rejecting Monsanto's contention that the court committed "obvious error" in letting the trial proceed while the state's highest court decides a similar case.
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November 19, 2024
High Court Urged To Let Courts Scrutinize Agency Rulings
District courts should be allowed to question rather than grant "absolute deference" to the Federal Communications Commission's interpretation of key statutory terms in the Telephone Consumer Protection Act, a chiropractic group contended Monday in calling on the U.S. Supreme Court to revive a junk fax class action.
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November 19, 2024
Judge Rejects Infosys' Bid To Seal NDAs In Trade Secrets Row
A Texas federal judge shot down Indian tech company Infosys Ltd.'s efforts to seal nondisclosure agreements involved in a trade secrets case over healthcare software, ruling that there was "nothing commercially sensitive" about them.
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November 19, 2024
CFPB's Medical Debt Guidance Faces Industry Injunction Bid
Debt collectors asked a D.C. federal court on Monday to put an immediate hold on recent Consumer Financial Protection Bureau guidance aimed at the medical debt collection market, escalating their challenge to the document ahead of its looming effective date.
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November 19, 2024
Yoga Teacher Gets 7½ Years For Defrauding Mentally Ill Doctor
A yoga instructor who helped defraud $2.7 million from a mentally ill doctor by moving into his Malibu home and feeding him psychedelic drugs was sentenced to 90 months in prison by a California federal judge Tuesday, more than twice the time recommended by prosecutors.
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November 19, 2024
Doc Says Idaho Abortion Bans Sow 'Fear' In 2nd Week Of Trial
In the trial over Idaho's strict abortion bans, a rural-based doctor testified Tuesday that the laws are leaving doctors stuck in "confusion and fear," leading to delayed care that's affecting patient safety.
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November 19, 2024
Calif. Biotech Firm Vera Taps Veteran Chief Legal Officer
Biotechnology firm Vera Therapeutics is welcoming a new chief legal officer in advance of an anticipated biologics submission to the U.S. Food and Drug Administration for a treatment targeting an autoimmune kidney disease.
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November 19, 2024
UnitedHealthcare Can't Escape Patient's Proton Beam Suit
A Florida federal judge on Tuesday refused to toss a federal benefits lawsuit from a patient who alleged that UnitedHealthcare wrongly denied him coverage for proton beam therapy to treat tongue cancer, rejecting the insurer's argument that an exclusion for unproven treatments applied.
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November 19, 2024
Insurers Urge Arbitration Of Union Fund's ERISA Claims
Elevance Health Inc. and several affiliated health insurers want a Connecticut federal judge to force arbitration of claims brought by a union fund that alleges excessive fees violated benefits law, arguing that the companies were unaware of an arbitration agreement with the plaintiff when they started litigating the early stages of a proposed class action.
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November 19, 2024
Widow Can't Get Malpractice Suit Over Husband's Fall Revived
A North Carolina appeals court on Tuesday declined to reinstate a suit by a widow alleging that nurses at Charlotte-Mecklenburg Hospital were responsible for a fall taken by her husband while he was recovering from brain surgery, saying the trial court rightly excluded her expert's testimony.
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November 19, 2024
10th Circ. Iffy On Colo.'s Remedy To Generic EpiPen Takings
A Tenth Circuit panel on Tuesday pressed Colorado regulators on whether requiring epinephrine auto-injector makers to repeatedly sue over the cost of complying with a state program provides an adequate legal remedy, with one judge saying that that route offers no finality for manufacturers.
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November 19, 2024
Trump Taps Dr. Oz For CMS Head
President-elect Donald Trump announced on Tuesday he will nominate TV personality Dr. Mehmet Oz to be administrator of the Centers for Medicare & Medicaid Services.
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November 19, 2024
McGuireWoods Lands Health Ace, Former GC From Akin In NY
A veteran healthcare and life sciences attorney who previously served as general counsel at pharmaceutical companies Novo Nordisk and Daiichi Sankyo has made the move from Akin Gump Strauss Hauer & Feld LLP to McGuireWoods LLP.
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November 19, 2024
Nonpracticing Doc Can't Testify In Med Mal Case, Court Says
A Florida state appeals court has affirmed the dismissal of a case accusing a doctor of botching two shoulder surgeries, agreeing with a lower court's findings that a physician-turned-legal-consultant wasn't qualified to testify as the plaintiff's medical expert under the law.
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November 19, 2024
5th Circ. Can't Weigh In On Decertification Bid, La. Court Rules
Sending a nurses' wage suit to the Fifth Circuit for a decision on decertifying a collective in a post-Swales world wouldn't speed up the case, a Louisiana federal judge ruled in turning down a hospital operator's interlocutory appeal bid.
Expert Analysis
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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.
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Opinion
Expert Witness Standards Must Consider Peer Review Crisis
For nearly two decades, the so-called replication crisis has upended how the scientific community views the reliability of peer-reviewed studies, and it’s time for courts to reevaluate whether peer review is a trustworthy proxy for expert witness reliability, say Jeffrey Gross and Robert LaCroix at Reid Collins.
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Takeaways From High Court's Tribal Health Admin Cost Ruling
The U.S. Supreme Court's recent determination that the government must reimburse two Native American tribes for administrative healthcare costs will help tribes maintain equal footing with the Indian Health Service when administering programs, and continues a pattern of how the current court aligns on tribal concerns, say attorneys at Lewis Roca.
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Justices' Intent Witness Ruling May Be Useful For Defense Bar
At first glance, the U.S. Supreme Court’s recent Diaz v. U.S. decision, allowing experts to testify to the mental state of criminal defendants in federal court, gives prosecutors a new tool, but creative white collar defense counsel may be able to use the same tool to their own advantage, say Jack Sharman and Rachel Bragg at Lightfoot Franklin.
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Eye On Compliance: New Pregnancy And Nursing Protections
With New York rolling out paid lactation breaks and extra leave for prenatal care, and recent federal legislative developments enhancing protection for pregnant and nursing workers, employers required to offer these complex new accommodations should take several steps to mitigate their compliance risks, says Madjeen Garcon-Bonneau at Wilson Elser.
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How To Grow Marketing, Biz Dev Teams In A Tight Market
Faced with fierce competition and rising operating costs, firms are feeling the pressure to build a well-oiled marketing and business development team that supports strategic priorities, but they’ll need to be flexible and creative given a tight talent market, says Ben Curle at Ambition.
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FTC Focus: Private Equity Investments In Healthcare
As the Federal Trade Commission is tightening its scrutiny of private equity investment in healthcare, the agency is finding novel grounds to challenge key focus areas, including rollup acquisitions, the flip-and-strip approach and minority investments in rival providers, say attorneys at Proskauer.
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High Court's Expert Ruling May Help Health Fraud Defendants
The U.S. Supreme Court's decision in Diaz v. U.S. appears to give the government a powerful new tool in calling its own agents as expert witnesses, but it could also benefit defense counsel in criminal healthcare fraud and other white collar criminal cases that arise in complex legal or regulatory environments, say attorneys at Holland & Knight.
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Patent Lessons From 5 Federal Circuit Reversals In June
A look at June cases where the Federal Circuit reversed or vacated decisions by the Patent Trial and Appeal Board or a federal district court highlights a potential path for branded drugmakers to sue generic-drug makers for off-label uses, potential downsides of violating a pretrial order offering testimony, and more, say Denise De Mory and Li Guo at Bunsow De Mory.
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Unpacking HHS' Opinion On Cell Therapy Refund Programs
A recent advisory opinion from the U.S. Department of Health and Human Services, determining that a biopharma company's refund program for its cell therapy will not be penalized, indicates an encouraging willingness to engage, but the regulator's assumptions about the program's limited term warrant a closer look, says Mary Kohler at Kohler Health.
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Series
Rock Climbing Makes Me A Better Lawyer
Rock climbing requires problem-solving, focus, risk management and resilience, skills that are also invaluable assets in my role as a finance lawyer, says Mei Zhang at Haynes and Boone.
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How 5 States' Deal Notification Laws Are Guiding Healthcare
Healthcare transaction notification laws at various stages of implementation in California, Illinois, Indiana, Oregon and Washington are shaping sector mergers and acquisitions, with significant transparency, continuity of care and compliance implications as providers tackle complex regulatory requirements, says Melesa Freerks at DLA Piper.
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Contract Disputes Recap: Preserving Payment Rights
Stephanie Magnell and Zachary Jacobson at Seyfarth examine three recent decisions that together illustrate the importance of keeping accurate records and adhering to contractual procedures to avoid inadvertently waiving contractual rights to cost reimbursements or nonroutine payments.