John LeBlanc

John LeBlanc

Manatt, Phelps & Phillips, LLP

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Third-Party Payment of Premiums: Controversy and HHS Guidance

Since the passage of the Affordable Care Act (ACA), the payment of healthcare premiums by third parties has been the subject of controversy. As Congress develops its plan to repeal and replace the ACA, it is uncertain how...more

3/25/2017 - Affordable Care Act CMS Health Care Providers Health Insurance Healthcare Reform HHS

Escobar's Impact: Recent Application of "Materiality" in Ninth Circuit

Last year, a unanimous U.S. Supreme Court decided Universal Health Services, Inc. v. United States ex rel. Escobar (Escobar), 136 S.Ct. 1989 (2016), creating important implications for Federal False Claims Act (FCA) cases...more

3/25/2017 - Conditions of Payment Failure To Disclose False Claims Act (FCA) False Implied Certification Theory Federal Contractors Health Care Providers Implied Certification Material Misrepresentation Materiality Medicaid Qui Tam SCOTUS Universal Health Services Inc v United States ex rel Escobar Unlicensed Medical Providers

Health Update - March 2017

The Future of Essential Health Benefits - Editor's Note: The Essential Health Benefits (EHB) rule may be among the many parts of the Affordable Care Act (ACA) that are on the chopping block as the Trump Administration and...more

3/24/2017 - Affordable Care Act Antitrust Immunity CMS Essential Health Benefits False Claims Act (FCA) Health Insurance Healthcare Reform HHS Insurer Liability Medicaid Premiums Repeal Trump Administration

Healthcare Litigation - October 2016

Recently, California Governor Jerry Brown signed into law “surprise medical bill legislation,” seeking to curb out-of-network medical bills. This law, designated AB 72, amends California’s Health and Safety Code to limit the...more

10/21/2016 - Billing Dispute Resolution Health Insurance Jerry Brown Medical Reimbursement Out of Network Provider Physicians Surprise Medical Bills

Health Update - October 2016

Defining and Resolving the Provider Data Dilemma - Editor’s Note: Provider data drives the most fundamental processes in the healthcare system. Inaccurate provider data puts patient care and billions of dollars at risk....more

10/21/2016 - Affordable Care Act Bipartisan Budget Consumer Privacy Bill of Rights Data-Sharing Dispute Resolution DSRIP FTC Healthcare HIPAA Hospital Mergers Mexico Personal Data Private Sector Public Policy Public Service Commissions Social Media Value-Based Payments

California's New End of Life Option Act Impacts Insurers

California's "End of Life Option Act" (the Act) went into effect June 9, 2016—making California the fifth state (behind Oregon, Washington, Vermont and Montana) to allow terminally ill adults with fewer than six months to...more

10/10/2016 - End-of-Life-Care Health Care Providers Insurance Industry Life Insurance Pharmaceutical Industry Physicians Prescription Drugs

Health Update - August 2016

Section 1332 Waivers: Will We See More State Innovation? - Editor's Note: In a new essay for the National Institute of Health Care Management (NIHCM), summarized below, Manatt Health examines Section 1332 waivers and the...more

8/25/2016 - 1332 Waiver Assisted Suicide Customer-Loyalty Programs Discounts Dispute Resolution False Claims Act (FCA) FTC HHS Long Term Care Facilities Medicaid Off-Label Promotion Patient Privacy Rights PHRMA Prescription Drug Coverage Section 340B Unfair or Deceptive Trade Practices

California Supreme Court Clarifies Constitutional Limits on Punitive Damages

In Brandt v. Superior Court, the California Supreme Court held that when a plaintiff proves that an insurance company withheld policy benefits in bad faith, attorneys' fees reasonably incurred to compel payment of the...more

7/28/2016 - Appeals Attorney's Fees Bad Faith Brandt Fees CA Supreme Court Calculation of Damages Compensatory Damages Denial of Benefits Due Process Fourteenth Amendment Insurance Companies Punitive Damages

Health Update - June 2016

Real-Time Data Analytics in Government Investigations and Reducing Exposure - It is not every day that the words “innovative” and “nimble” are used when referring to an agency of the federal government bureaucracy. Yet,...more

6/24/2016 - ACOs Affordable Care Act CMS DOJ FTC Government Investigations Healthcare Fraud HEAT HHS Hospital Mergers IRS MCOs Medi-Cal Medicaid Medicare Advantage OIG Section 340B

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