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November 04, 2024
DOD Trans Healthcare Denial Discriminates, Judge Rules
A Maine federal judge ruled Monday that the U.S. Department of Defense's denial of healthcare coverage for two transgender women's gender-confirmation surgeries violates the Fifth Amendment's equal protection clause, finding that the way the department applied a statutory exclusion discriminated based on sex and transgender status.
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November 04, 2024
Whistleblowers Win Cut Of Medical Kickback Settlement
Three whistleblowers who tipped off the federal government to a medical device company's multimillion-dollar kickback scheme are entitled to a cut of the $3 million in False Claims Act settlements paid by surgeons who admitted participating in the sham consulting ploy, a Boston federal judge ruled Monday.
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November 04, 2024
Sanctions Lessened Against Testing Co. That 'Duped' Judge
A California federal judge Monday lessened sanctions imposed on Natera Inc. in a false advertising case first brought by rival Guardant Health Inc., allowing some clinical cancer study evidence to be presented at a trial starting Tuesday despite his earlier finding that Natera's expert and counsel had "duped" the court.
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November 04, 2024
With Lawsuit Pending, Nebraskans To Vote On Medical Pot
A pair of initiatives to legalize medical marijuana in Nebraska and regulate its sale will appear on the ballot on Election Day, but a pending legal challenge whose trial concluded Monday means it is unclear whether the initiatives will take effect even if they do get voter approval.
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November 04, 2024
Del. Judge To Approve Avante Ch. 11 Financing
A Delaware bankruptcy judge Monday agreed to approve debtor-in-possession financing for Jordan Health, the corporate parent of medical equipment service provider Avante Health, after the debtor and DIP lender struck a deal with the official committee of unsecured creditors.
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November 04, 2024
Debt Collectors Sue Over CFPB's Guidance On Medical Debt
A debt collection trade group has sued the Consumer Financial Protection Bureau in Washington, D.C., federal court to overturn recent guidance that warned collectors about seeking payment on potentially inflated or unverified medical bills, slamming it as an "overtly political" end-run around proper rulemaking.
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November 04, 2024
Cigna Scores $7.3M Verdict Against Fla. Drug Testing Labs
A Connecticut federal jury on Monday handed Cigna Health and Life Insurance Co. a victory against three Florida boutique drug testing laboratories, finding the labs unjustly billed nearly $7.3 million for tests on substance abuse patients that the insurer declared medically unnecessary.
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November 04, 2024
NY AG Seeks Contempt For Anti-Abortion Org's 'Interference'
Counsel for the New York attorney general asked a federal judge Monday to hold an anti-abortion group in contempt for allegedly seeking to interfere with women's access to clinics despite an injunction, prompting questions about the limits of an advocate's civil rights.
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November 04, 2024
VA Accused Of Choosing 'Pass-Through' Co. For $257M Deal
A veteran-owned small business has challenged a $256.8 million U.S. Department of Veterans Affairs telehealth program support contract, saying the VA wrongly chose a small business joint venture that effectively served as a pass-through for a larger company.
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November 04, 2024
Yale Gets 2nd Circ. Win In COVID Test Reimbursement Row
A Connecticut medical practice can't sue Yale University under federal legislation enacted during the COVID-19 pandemic to recover the $1.1 million it said it incurred while providing COVID testing to university health plan members, the Second Circuit ruled Monday, finding no private cause of action existed.
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November 04, 2024
McKesson Inks $450K DOL Deal Following Hiring Bias Probe
The U.S. Department of Labor announced Monday that McKesson Medical-Surgical Inc. has agreed to pay nearly $450,000 to resolve the agency's claims that it gave hiring preferences to Asian job applicants over Black, Hispanic and white job hopefuls.
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November 04, 2024
MultiPlan Judge Raises Eyebrows At Attys' Biz Flight Billing
Counsel leading multidistrict litigation over Multiplan's pricing tools quickly revised their plans Monday for attorneys who take longer flights for the case, after an Illinois federal judge questioned why certain travelers received special treatment "arguably on the class's dime."
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November 04, 2024
Hospital Can't Undo Widow's $5M Win Over Husband's Suicide
An Illinois state appeals court won't upend a $5 million verdict awarded to a widow against a Cook County hospital in a suit over her husband's death by suicide, finding that the widow's expert testimony was enough for a jury to conclude that the doctor's negligence led to the death.
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November 04, 2024
Rehab Sued Over Staffer's Alleged Relationship With Patient
The father of a patient at a Newport Academy treatment center is alleging in federal court that one of the facility's care coordinators engaged in an inappropriate relationship while his son was a minor in the residential treatment program.
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November 04, 2024
Walgreens To Pay $100M In Suit Alleging Inflated Drug Prices
Walgreens has agreed to hand over $100 million to settle claims from consumers and unions that it unlawfully overcharged insured consumers for prescription drugs while allowing members of its cost savings club to pay less, according to an Illinois federal court filing.
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November 04, 2024
NJ Health System Hits Ch. 11 With Plans To Restructure Debt
A New Jersey nonprofit that operates three hospitals filed for Chapter 11 in Delaware, saying it faced increased operating costs after COVID-19 and hopes to restructure its debt.
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November 01, 2024
COVID Death Suit Not Barred By PREP Act, 11th Circ. Affirms
A split Eleventh Circuit affirmed a lower court's decision Thursday to remand to state court a lawsuit over a nursing home resident's COVID-19 death, finding preemption may cover a defendant sued for following federal public health emergency guidelines, but not when, as in the instant case, the guidelines were allegedly unheeded.
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November 01, 2024
Elevance Says Flawed Medicare Rating System Cost It $375M
Elevance Health Inc. has hit the Biden administration with a $375 million lawsuit in Texas federal court after the government slashed star ratings for its Medicare Advantage and Part D health plan contracts in the latest of multiple lawsuits by insurance companies challenging the government's rating system.
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November 01, 2024
Suit Says Nursing Home Let Resident Fatally Fall Down Stairs
A Pittsburgh-area nursing home failed to recognize the high level of supervision needed for a resident prone to wandering off, and left her alone long enough that she rolled her wheelchair down a flight of stairs and died, her family said in a lawsuit filed in Pennsylvania state court.
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November 01, 2024
Construction Co. Must Face 'COVID Building' Fall Suit
An Indiana appeals court has reinstated a suit against a construction company blaming it for causing a woman's injuries after she tripped on a brace that had been left after the construction of a temporary "COVID building" next to a hospital's emergency room, saying the woman's injuries were foreseeable.
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November 01, 2024
Colo. To Boost Services To End Feds' ADA Discrimination Suit
Colorado has agreed to implement new housing and support practices to ensure adults with physical disabilities have adequate help to leave nursing facilities and receive services in their own homes, as part of a settlement announced Friday to end a U.S. Department of Justice lawsuit.
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November 01, 2024
Health Data Co. Urges 4th Circ. To Keep Access Open
Nursing home data analytics company Real Time Medical Systems urged the Fourth Circuit on Friday to keep in place an order that stops electronic medical records company PointClickCare from using unsolvable captcha prompts to block access to patient records.
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November 01, 2024
Medisca Inks $22M FCA Deal Over Ingredient Pricing Scheme
Pharmaceutical chemical supplier Medisca Inc. has agreed to pay $21.75 million to resolve allegations it created false and inflated average wholesale prices for ingredients used in compound prescriptions sold to pharmacies that increased reimbursement and caused federal healthcare programs to pay more for them, the U.S. Department of Justice announced on Friday.
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November 01, 2024
UChicago Must Face Student's Disability Discrimination Claim
A University of Chicago medical student who was dismissed for creating a fake email account to send an instructor evaluations can pursue his claim that the university illegally tied his multiple mental and physical disabilities to his dismissal, but he must drop his claim that the university failed to accommodate those disabilities, an Illinois federal judge said Thursday.
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November 01, 2024
4 Appellate Arguments Benefits Attys Should Watch In Nov.
The Second Circuit will weigh battles over retirement plan fees and union benefit contributions, teachers will ask the Ninth Circuit to revive their suit over interest they say is owed on their retirement accounts and the Eleventh Circuit will mull a constitutional challenge to a Florida gender-affirming care ban. Here are four upcoming arguments that benefits lawyers should have on their radar.
Expert Analysis
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Opinion
DOL's Impending Mental Health Act Regs Should Be Simplified
The U.S. Department of Labor should consider revising these six issues in its forthcoming Mental Health Parity and Addiction Equity Act regulations to ease the significant compliance hurdles for group health plan sponsors, says Alden Bianchi at McDermott.
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Parsing FY 2024 DOJ Criminal Healthcare Fraud Enforcement
While the U.S. Department of Justice's Criminal Division's strike force on healthcare fraud enforcement action shows an impressive doubling of criminal indictments, a closer look at the data offers important clues about underlying trends, including the comparably modest, accompanying increase in associated intended loss, say Roderick Thomas and Kathleen Cooperstein at Wiley.
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9th Circ. Ruling Flags Work Harassment Risks Of Social Media
The recent Ninth Circuit ruling in Okonowsky v. Garland, holding an employer could be liable for a co-worker's harassing social media posts, highlights new challenges in technology-centered and remote workplaces, and underscores an employer's obligation to prevent hostile environments wherever their employees clock in, say Jennifer Lada and Phillip Schreiber at Holland & Knight.
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Vendor Rights Lessons From 2 Chapter 11 Cases
A Texas federal court’s recent critical vendor order in the Zachry Holdings Chapter 11 filing, as well as a settlement between Rite Aid and McKesson in New Jersey federal court last year, shows why suppliers must object to critical vendor motions that do not recognize creditors' legal rights, says David Conaway at Shumaker.
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How Cos. With Chinese Suppliers Should Prep For Biotech Bill
A proposed bill to prohibit government-affiliated life sciences companies from contracting with Chinese biotech companies of concern may necessitate switching to other sources for research and supplies, meaning they should begin evaluating supply chains now due to the long lead times of drug development, say John O'Loughlin and Christina Carone at Weil Gotshal.
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Mirror, Mirror On The Wall, Is My Counterclaim Bound To Fall?
A Pennsylvania federal court’s recent dismissal of the defendants’ counterclaims in Morgan v. Noss should remind attorneys to avoid the temptation to repackage a claim’s facts and law into a mirror-image counterclaim, as this approach will often result in a waste of time and resources, says Matthew Selmasska at Kaufman Dolowich.
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Can Chapter 15 Bankruptcy Help Cannabis Businesses?
Attorneys at Fox Rothschild consider whether Chapter 15 may be used as a tool to liquidate U.S. assets of cannabis companies in foreign bankruptcy proceedings, and look at the statutory provisions that may have a bearing on the successful liquidation of assets under the Bankruptcy Code.
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FTC's Drug Middlemen Probe Highlights Ongoing Scrutiny
The Federal Trade Commission's interim staff report on its inquiry into pharmacy benefit managers suggests that the industry will remain under an enforcement microscope for the foreseeable future due to concerns about how PBMs affect drug costs and accessibility, say attorneys at Arnold & Porter.
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Series
Playing Dungeons & Dragons Makes Me A Better Lawyer
Playing Dungeons & Dragons – a tabletop role-playing game – helped pave the way for my legal career by providing me with foundational skills such as persuasion and team building, says Derrick Carman at Robins Kaplan.
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Del. Dispatch: Director Caremark Claims Need Extreme Facts
The Delaware Court of Chancery recently dismissed Caremark claims against the directors of Centene in Bricklayers Pension Fund of Western Pennsylvania v. Brinkley, indicating a high bar for a finding of the required element of bad faith for Caremark liability, and stressing the need to resist hindsight bias, say attorneys at Fried Frank.
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Gilead Drug Ruling Creates Corporate Governance Dilemma
If upheld, a California state appellate court's decision — finding that Gilead is liable for delaying commercialization of a safer HIV drug to maximize profits on another drug — threatens to undermine long-standing rules of corporate law and exposes companies to liability for decisions based on sound business judgment, says Shireen Barday at Pallas.
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3 Leadership Practices For A More Supportive Firm Culture
Traditional leadership styles frequently amplify the inherent pressures of legal work, but a few simple, time-neutral strategies can strengthen the skills and confidence of employees and foster a more collaborative culture, while supporting individual growth and contribution to organizational goals, says Benjamin Grimes at BKG Leadership.
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E-Discovery Quarterly: Rulings On Hyperlinked Documents
Recent rulings show that counsel should engage in early discussions with clients regarding the potential of hyperlinked documents in electronically stored information, which will allow for more deliberate negotiation of any agreements regarding the scope of discovery, say attorneys at Sidley.
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Loper Bright Limits Federal Agencies' Ability To Alter Course
The U.S. Supreme Court's recent decision to dismantle Chevron deference also effectively overrules its 2005 decision in National Cable & Telecommunications Association v. Brand X, greatly diminishing agencies' ability to change regulatory course from one administration to the next, says Steven Gordon at Holland & Knight.
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What Cos. Should Note In DOJ's New Whistleblower Pilot
After the U.S. Department of Justice unveiled a new whistleblower pilot program last week — continuing its efforts to incentivize individual reporting of misconduct — companies should review the eligibility criteria, update their compliance programs and consider the risks and benefits of making their own self-disclosures, say attorneys at Skadden.