Policy & Compliance
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May 10, 2024
What To Know About Biden's ACA Nondiscrimination Rule
Recently finalized regulations tackling what constitutes discrimination under the Affordable Care Act could have significant impacts on health plans that include greater liability for third-party plan administrators, attorneys say. Here are three things employers should know now that the final rule is on the books.
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May 09, 2024
Judge Clarifies Gilead Didn't Directly Infringe HIV Drug IP
A Delaware federal judge on Thursday rejected Gilead Sciences' request to amend her judgment finding that two medications in its HIV prevention regimen, Truvada and Descovy, directly infringed the government's invalidated patents, but clarified her judgment to say that non-party patients or physicians committed the infringement.
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May 09, 2024
Doc Can't Escape Second Prednisone Overprescribing Suit
A Pennsylvania federal judge won't strike claims for punitive damages and references to "outrageous" conduct from a complaint alleging that a doctor wrongly overprescribed medications including prednisone, saying the complaint plausibly alleged that he knowingly had a patient on a medication plan that harmed her.
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May 09, 2024
9th Circ. Says Judge Defied Order To Revive Opioid Case
The Ninth Circuit on Thursday again revived a nearly 7-year-old case against a California doctor for allegedly selling opioid prescriptions and ordered that the case be reassigned, saying the presiding judge had defied the plain language of a previous order to reinstate the indictment.
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May 09, 2024
DOJ Task Force To Target Healthcare Monopoly, Collusion
The U.S. Department of Justice's Antitrust Division sharpened its focus Thursday on healthcare platforms that combine doctors with insurers, data and more in what the administration's top competition official called the "alarming" accumulation of assets.
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May 09, 2024
La. Lawmakers OK Local Tax Break For Certain Eye Meds
Louisiana would expand a local sales tax exemption to include prescriptions used to treat eye-related conditions under a bill that was unanimously passed by the state Senate and next goes to the governor.
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May 09, 2024
Ex-Celtic 'Big Baby' Gets 40 Mos. In Health Fraud Case
Former Boston Celtics forward Glen "Big Baby" Davis was sentenced to 40 months in prison Thursday after being convicted for his role in a scheme to submit fraudulent invoices to an NBA healthcare plan.
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May 08, 2024
GW Hospital Bargained In Bad Faith, NLRB Dems Say In Redo
A split National Labor Relations Board panel said Wednesday that George Washington University Hospital sabotaged union negotiations with unworkable proposals, reasserting precedent that employers bargain in bad faith by insisting on contract provisions that effectively nullify unions.
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May 07, 2024
MultiPlan, Insurance Cos. Accused Of Algorithmic Collusion
A medical provider has lodged a proposed class action in Illinois federal court accusing MultiPlan and major insurance companies, including UnitedHealth, Aetna, Kaiser Permanente and Cigna, of using pricing tools to systematically underpay out-of-network providers.
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May 07, 2024
Why Midwives Are Fighting Practice Limits Across The US
Heather Swanson has long hoped to use her training to help pregnant people in Nebraska give birth safely in their homes but is blocked by state law. Today, she’s among a number of midwives battling laws they say unduly restrict skilled healthcare providers while maternity care "deserts” proliferate across the U.S.
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May 07, 2024
Rare Texas Discovery Rule Deployed In Abortion Travel Case
A Lone Star State lawyer pursuing documents and depositions about an out-of-state abortion is relying on a quirk of Texas civil procedure allowing for pre-litigation discovery. The Arnold & Porter attorney representing the targets calls the move "a shot across the bow" meant to discourage women from exercising their rights.
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May 07, 2024
Wary Of 'Pharmacy Deserts,' Oregon Agency Eyes Grocer Deal
A new Oregon board focused on healthcare consolidation has the power to shape a divisive mega-deal between the Kroger and Albertsons grocery chains some fear would create "pharmacy deserts." Some experts think it could further entangle an agreement between chains that together fill a third of all prescriptions in the state.
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May 07, 2024
20 Years Ago, One Case Opened Up Billions In FCA Liability
On the 20-year anniversary of a landmark whistleblower case, attorneys look back on how Franklin v. Parke-Davis shaped the healthcare landscape, put Boston on the map as a hotbed of False Claims Act litigation and changed the drug industry's off-label marketing practices.
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May 07, 2024
DOJ Inks FCA, Opioid-Branding Enforcement Settlements
The U.S. Department of Justice has been busy over the past week settling a variety of False Claims Act claims as well as a case against a pharmaceutical company for allegedly violating the Food, Drug and Cosmetic Act with deceptive opioid marketing.
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May 07, 2024
9th Circ. Asks Idaho To Define 'Recruit' In Abortion Travel Ban
A Ninth Circuit panel grappled Tuesday with an Idaho law that makes it a criminal offense to help minors travel out of state to receive abortions without parental permission, with one judge struggling to understand what it means to "recruit" a pregnant teen to get an abortion under the law.
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May 07, 2024
Gov't Seeks Early Win In Ga. Medicaid Expansion Suit
The Biden administration is urging a federal judge to take its side in a lawsuit in which Georgia is attempting to keep its Medicaid program for low-income residents running until 2028, arguing that the state never properly asked for a program extension and that the court lacks jurisdiction to extend its end date.
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May 06, 2024
Judge Trims ESOP Valuation Suit Against Healthcare Co.
A California federal judge has trimmed a lawsuit against KPC Healthcare Inc., its employee stock ownership plan committee and its investment manager Alerus Financial alleging that a sale of company stock was mismanaged.
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May 06, 2024
UChicago Can't Ditch Data Sharing Privacy Claim
A University of Chicago Medical Center patient accusing the hospital of illegally sharing her and other patients' identifying information with Meta can pursue her claims that the info sharing constitutes a federal wiretap violation, an Illinois federal judge said.
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May 06, 2024
Hooper Lundy Adds Government Relations Director
An attorney who worked in-house for healthcare industry trade and advocacy associations has joined healthcare boutique Hooper Lundy & Bookman PC as director of government relations and public policy.
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May 03, 2024
Ala. High Court Won't Rethink Decision On Frozen Embryos
The Alabama Supreme Court on Friday refused to revisit its February decision finding that frozen embryos count as children, a first-of-its-kind decision that has been received as potentially ruinous for in vitro fertilization services in the Yellowhammer State.
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May 03, 2024
Aetna To Pay $2M To End LGBTQ Fertility Coverage Suit
A group of Aetna policyholders said Friday that the insurance giant has agreed to pay $2 million and revise certain health insurance guidelines to settle a proposed class action alleging its definition of infertility made it difficult and expensive for LGBTQ couples to obtain coverage for fertility treatments.
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May 03, 2024
Ohio Statehouse Catch-Up: Trans, Abortion Laws Face Battles
Ohio lawmakers have shepherded controversial bills impacting healthcare, social media and other matters into law in recent months, prompting lawsuits and even a veto from Gov. Mike DeWine.
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May 03, 2024
6 States Strike $270M Opioid Deal With Amneal
The New York state attorney general on Friday said that a $270 million multistate deal had been reached with opioid manufacturer Amneal Pharmaceuticals for its role in the addiction epidemic over allegations that the company failed to report suspicious orders of the narcotics.
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May 02, 2024
7th Circ. Mostly Backs Ill. Home Health Kickbacks Judgment
The Seventh Circuit on Thursday largely left intact an Illinois federal judge's $6 million ruling that a home health care company broke federal kickback laws, refusing to reverse the lower court's liability finding but directing it to ensure its damages award was calculated correctly.
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May 02, 2024
Endo Judge Hopes Criminal Sentence Warns Opioid Makers
A Michigan federal judge said Thursday she hoped Endo's criminal sentence for falsely advertising a pain medication as "abuse deterrent" would itself be a deterrent for other opioid makers, as she accepted the company's recent $200 million settlement deal with federal prosecutors.
Expert Analysis
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Why Hemp-Synthesized Intoxicants Need Uniform Regs
State laws regulating hemp-synthesized intoxicants are a patchwork with little consistency between any given state, and without the adoption of a uniform regulatory framework, producers and consumers alike will need to be very cautious, say Dylan Anderson and Seth Goldberg at Duane Morris.
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Attorneys, Law Schools Must Adapt To New Era Of Evidence
Technological advancements mean more direct evidence is being created than ever before, and attorneys as well as law schools must modify their methods to account for new challenges in how this evidence is collected and used to try cases, says Reuben Guttman at Guttman Buschner.
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The Self-Funded Plan's Guide To Gender-Affirming Coverage
Self-funded group health plans face complicated legal risks when determining whether to cover gender-affirming health benefits for their transgender participants, so plan sponsors should carefully weigh how federal nondiscrimination laws and state penalties for providing care for trans minors could affect their decision to offer coverage, say Tim Kennedy and Anne Tyler Hall at Hall Benefits Law.
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ESG Around The World: The UK
Following Brexit, the U.K. has adopted a different approach to regulating environmental, social and governance factors from the European Union — an approach that focuses on climate disclosures by U.K.-regulated entities, while steering clear of the more ambitious objectives pursued by the EU, say attorneys at Dechert.
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3 Tips For Defending Against Data Breach Litigation
As cyberattacks become more prevalent, companies responding to data breaches must consider several strategies to better position themselves in the event of litigation even during their preliminary investigations and breach notifications, say attorneys at Davis Wright.
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Tips For Litigating Against Pro Se Parties In Complex Disputes
Litigating against self-represented parties in complex cases can pose unique challenges for attorneys, but for the most part, it requires the same skills that are useful in other cases — from documenting everything to understanding one’s ethical duties, says Bryan Ketroser at Alto Litigation.
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Air Ambulance Ch. 11s Show Dispute Program Must Resume
Air Methods’ recent bankruptcy filing highlights the urgent need to reopen the No Surprises Act’s independent dispute resolution program for air ambulances, whose shutdown benefits insurance companies and hurts providers, says Adam Schramek at Norton Rose.
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Pro Bono Work Is Powerful Self-Help For Attorneys
Oct. 22-28 is Pro Bono Week, serving as a useful reminder that offering free legal help to the public can help attorneys expand their legal toolbox, forge community relationships and create human connections, despite the challenges of this kind of work, says Orlando Lopez at Culhane Meadows.
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Playing In A Rock Cover Band Makes Me A Better Lawyer
Performing in a classic rock cover band has driven me to hone several skills — including focus, organization and networking — that have benefited my professional development, demonstrating that taking time to follow your muse outside of work can be a boon to your career, says Michael Gambro at Cadwalader.
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The Pop Culture Docket: Judge Espinosa On 'Lincoln Lawyer'
The murder trials in Netflix’s “The Lincoln Lawyer” illustrate the stark contrast between the ethical high ground that fosters and maintains the criminal justice system's integrity, and the ethical abyss that can undermine it, with an important reminder for all legal practitioners, say Judge Adam Espinosa and Andrew Howard at the Colorado 2nd Judicial District Court.
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Calif. GHG Disclosure Law Will Affect Companies Worldwide
California's Climate Corporate Data Accountability Act, which will require comprehensive greenhouse gas emissions disclosures from large companies operating in the state, will mean compliance challenges for a wide range of industries, nationally and globally, as the law's requirements will ultimately trickle out and down, say attorneys at Brownstein Hyatt.
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How To Navigate The FTC's New Private Equity Frontier
The Federal Trade Commission's recent district court complaint against an anesthesia firm and its private equity partner tests key bounds of the agency's stand-alone authority, and defense strategies can include challenges to both the geographic and the service market fronts, say attorneys at Baker McKenzie.
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Newman Suspension Shows Need For Judicial Reform
The recent suspension of U.S. Circuit Judge Pauline Newman following her alleged refusal to participate in a disability inquiry reveals the need for judicial misconduct reforms to ensure that judges step down when they can no longer serve effectively, says Aliza Shatzman at The Legal Accountability Project.