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Policy & Compliance

  • June 10, 2024

    'Four Tops' Singer Sues ER Staff Who Ordered Psych Test

    The lead singer of Motown group The Four Tops has sued a hospital in Michigan federal court, claiming in a complaint filed Monday that hospital staff treated him as if he was mentally ill when he said he was a famous singer.

  • June 10, 2024

    3 Takeaways From Cigna's Win In 9th Circ. Rehab Claim Fight

    The Ninth Circuit's recent decision finding Cigna is off the hook for $8.6 million in out-of-network mental health and substance use disorder treatment claims against employee benefit plans administered by the insurer could discourage similar litigation, benefits attorneys say. Here are three key takeaways from the decision.

  • June 10, 2024

    FTC To Fight Go-Ahead Order On Novant $320M Hospital Deal

    Just days after a district court loss, the Federal Trade Commission said Monday it will ask the Fourth Circuit to step in and block Novant Health from buying two North Carolina hospitals in a $320 million deal the agency contends would harm competition.

  • June 10, 2024

    Mass. Nursing Home To Pay Record $4M Over Neglect Claims

    A Massachusetts nursing home operator has agreed to pay a total of $4 million and hire an independent monitor to settle allegations that understaffing at its 16 facilities led to substandard care and patients being harmed, the attorney general’s office announced Monday. Next Step Healthcare LLC has agreed pay $750,000 directly to the state and dedicate the remaining $3.25 million toward increasing staffing levels.

  • June 10, 2024

    High Court To Review HHS Hospital Pay Formula

    The U.S. Supreme Court on Monday agreed to review a D.C. Circuit decision siding with the Department of Health and Human Services over how the agency applies a formula for calculating disproportionate share hospital payments for Supplemental Security Income benefits.

  • June 07, 2024

    Conn. Judge Pushes State For Proof In $11M Kickback Case

    The Connecticut state judge presiding over an $11 million false claims and kickbacks case against a compounding pharmacy appeared unconvinced Friday that the defendants submitted false claims for payment, peppering the government's counsel with requests to support assertions with case law and evidence that was put on at trial.

  • June 07, 2024

    Chicago-Area Man Charged With $60M COVID Test Fraud

    A suburban Chicago man is facing healthcare fraud and money laundering charges over more than $60 million in Medicare reimbursement claims for over-the-counter COVID-19 test kits that were allegedly never provided, including thousands of tests for dead people.

  • June 07, 2024

    7 Health Insurers Eye Rate Hikes In Connecticut

    Seven health insurers have asked Connecticut state regulators to approve rate hikes of 7.4% to 12.5% for individual market plans and 5.1% to 13.6% for small groups, averaging out to a lesser increase than last year's, according to an announcement Friday.

  • June 06, 2024

    Chronic Care Co. To Pay $14.9M To End DOJ False Claims Suit

    A provider of chronic disease management services across several states has reached a $14.9 million settlement with the U.S. Department of Justice, resolving a False Claims Act suit alleging it defrauded Medicare and Medicaid by "upcoding" healthcare claims.

  • June 06, 2024

    Justices Say Feds Liable For Tribes' Healthcare Admin Costs

    A split U.S. Supreme Court on Thursday held that the federal government is required to reimburse two Native American tribes millions of dollars in administrative healthcare costs, saying the spending is necessary for the communities to operate programs assumed from the Indian Health Service.

  • June 05, 2024

    House Votes To Block Vets' Access To Gender-Affirming Care

    The U.S. House of Representatives on Wednesday passed a $147.5 billion spending bill along mostly party lines funding military construction and the U.S. Department of Veterans Affairs, which would block veterans' access to gender-affirming care and which the White House has already threatened to veto.

  • June 05, 2024

    Calif. Wage Hike To Cover Nearly All Healthcare Workplaces

    Nearly all workers at healthcare facilities in California will be entitled to a higher minimum wage beginning July 1 regardless of whether they're involved in patient care. One expert called the increase a sweeping change, partly due to broad definitions of what employees and facilities are covered.

  • June 04, 2024

    Divided 9th Circ. Reverses Sutter Health Antitrust Trial Victory

    A split Ninth Circuit panel on Tuesday overturned Sutter Health's win in insurance plan purchasers' $400 million antitrust suit, ruling that the lower court wrongly excluded "highly relevant" evidence — including admissions by Sutter executives — that would've helped the purchasers potentially prove claims they overpaid thanks to Sutter's anticompetitive conduct.

  • June 04, 2024

    Texas Justices Fuel Confusion Over Abortion Ban Exceptions

    The Texas Supreme Court recently ruled that doctors may perform abortions only when "reasonable medical judgment" says a patient's life is in danger — a decision attorneys say puts doctors in the position of weighing the lives of their patients against the risk of criminal prosecution.

  • June 04, 2024

    FDA Advisers Rebuff Bid To Treat PTSD With MDMA

    A panel of public health experts on Tuesday dealt a blow to a historic effort to regulate MDMA therapy for post-traumatic stress disorder, saying although the positive effects shown in clinical trials are promising, the proposal was hindered by too many confounding factors.

  • June 04, 2024

    HHS Guidance, Feud Over FCA Evidence, And A Deposed AG

    States sue the Biden administration over nondiscrimination guidance. A False Claims Act case sees a tussle over evidence. A Connecticut federal judge allows drugmakers to depose the office of D.C.'s attorney general. Here, Law360 Healthcare Authority looks at notable developments in healthcare litigation over the past week.

  • 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.

  • 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.

  • June 04, 2024

    5th Circ. Medical 'Disinformation' Decision: 5 Things To Know

    A divided 5th Circuit gave a conservative medical group that says it was hurt by a campaign to suppress criticism of Dr. Anthony Fauci another shot at its free-speech claims. Here are five things you should know about the case.

  • 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.

  • June 04, 2024

    What Clinical Trial Attys Want From FDA Diversity Guidance

    Impending federal guidance on diversifying clinical trial participation marks the latest push to address the historic homogeneity of clinical research. Here, clinical trial attorneys share with Law360 Healthcare Authority the questions they hope the FDA will answer.

  • 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.

  • 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.

  • June 04, 2024

    NM Cannabis Co. Says Insurers Can't Toss Medical Weed Row

    A group of insurers can't escape a proposed class action demanding they cover medical marijuana costs, a cannabis company and several of its patients said, telling a New Mexico federal court that medical cannabis is a medically necessary behavioral health service that must be covered.

  • 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.

Expert Analysis

  • Preparing Law Students For A New, AI-Assisted Legal World

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    As artificial intelligence rapidly transforms the legal landscape, law schools must integrate technology and curricula that address AI’s innate challenges — from ethics to data security — to help students stay ahead of the curve, say Daniel Garrie at Law & Forensics, Ryan Abbott at JAMS and Karen Silverman at Cantellus Group.

  • ESG Around The World: South Korea

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    Numerous ESG trends have materialized in South Korea in the past three years, with impacts ranging from greenwashing prevention and carbon neutrality measures to workplace harassment and board diversity initiatives, say Chang Wook Min and Hyun Chan Jung at Jipyong.

  • General Counsel Need Data Literacy To Keep Up With AI

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    With the rise of accessible and powerful generative artificial intelligence solutions, it is imperative for general counsel to understand the use and application of data for myriad important activities, from evaluating the e-discovery process to monitoring compliance analytics and more, says Colin Levy at Malbek.

  • A Look At Healthcare Timelines Set By Biden's AI Order

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    President Joe Biden's artificial intelligence executive order establishes standards for using AI in the healthcare industry, including a number of staggered deadlines that should help coordinate a more unified federal approach to AI governance, say attorneys at Holland & Knight.

  • A Look At Successful Bid Protests In FY 2023

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    Attorneys at Sheppard Mullin look beyond the statistics in the U.S. Government Accountability Office’s recent annual report on bid protests, sharing their insights about nine categories of sustained protests, gained from reading every fiscal year 2023 decision in which the protester had a positive result.

  • Navigating Discovery Of Generative AI Information

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    As generative artificial intelligence tools become increasingly ubiquitous, companies must make sure to preserve generative AI data when there is reasonable expectation of litigation, and to include transcripts in litigation hold notices, as they may be relevant to discovery requests, say Nick Peterson and Corey Hauser at Wiley.

  • FDA's Lab-Developed Test Rule May Bring Historic Challenges

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    If finalized, the U.S. Food and Drug Administration's proposed rule for regulating laboratory-developed tests will provoke some of the most interesting legal challenges that the agency has faced in decades, with outcomes that will likely reverberate across the agency's product centers, says Stacy Amin at MoFo.

  • Finding Focus: Strategies For Attorneys With ADHD

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    Given the prevalence of ADHD among attorneys, it is imperative that the legal community gain a better understanding of how ADHD affects well-being, and that resources and strategies exist for attorneys with this disability to manage their symptoms and achieve success, say Casey Dixon at Dixon Life Coaching and Krista Larson at Stinson.

  • AI Use May Trigger False Claims Act's Public Disclosure Bar

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    The likely use of publicly available artificial intelligence tools to detect government fraud by combing through large data sets will raise complex questions about a False Claims Act provision that prohibits the filing of claims based on previously disclosed information, say Nick Peterson and Spencer Brooks at Wiley Rein.

  • Beware Privacy Risks In Training AI Models With Health Data

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    Because data used to train artificial intelligence models may be protected by the Health Insurance Portability and Accountability Act or other regulations, users of these models should conduct proper diligence to avoid costly compliance failures, say Neha Matta and Barbara Bennett at Frost Brown.

  • Unpacking GAO's FY 2023 Bid Protest Report

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    The U.S. Government Accountability Office's recent bid protest report reflects an increase in sustained protests, illustrating that disappointed offerors may see little reason to refrain from seeking corrective action — but there is more to the story, say Aron Beezley and Patrick Quigley at Bradley Arant.

  • White House AI Order Balances Innovation And Regulation

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    President Joe Biden’s recently issued executive order on artificial intelligence lays out a sprawling list of directives aimed at establishing standards for safety, security and privacy protection, and may help strike the balance between the freedom to innovate and the need to impose regulation in this rapidly evolving space, say Kristen Logan and Martin Zoltick at Rothwell Figg.

  • Reading Between The Lines Of HHS' National Lab Opinion

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    The U.S. Department of Health and Human Services' Office of Inspector General recently rejected a national laboratory's request to pay a referring lab to process specimens, but the request might have been an attempt to exploit the OIG's advisory opinion process for a competitive advantage, says Mary Kohler at Kohler Health Law.