Norman Tabler, Jr.

Norman Tabler, Jr.

Faegre Baker Daniels

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Iowa Drug Pricing Disclosure Law Bites the Dust

In 2014 Iowa enacted a statute requiring pharmacy benefit managers (PBMs) to disclose pricing methodologies to their network pharmacies and to the State Insurance Commissioner. Is the statute “a patchwork of costly mandates...more

1/19/2017 - Drug Pricing ERISA Pharmaceutical Industry Preemption

Qualifications for Artificial Limb Suppliers, After Only 16 Years

Bill Clinton was President when Congress enacted a law requiring CMS to come up with qualifications for those who make or supply artificial limbs to Medicare patients. It was January 11, 2017, when CMS finally unveiled the...more

1/19/2017 - CMS DMEPOS Durable Medical Equipment Medicare

Physician Liability for Death of Nonviable Fetus

If an obstetrician’s negligence causes the miscarriage of a nonviable fetus—i.e., one that couldn’t live outside the womb–does the patient have a cause of action for wrongful death? In Alabama the answer is yes, according to...more

1/17/2017 - Health Care Providers Negligence Physicians Wrongful Death

2016 Nerve-of-a-Burglar Award

Competition for the 2016 Nerve-of-a-Burglar Award was fierce, with health care providers constantly coming up with new and different ways to scam Medicare and Medicaid. Nevertheless, we have a clear winner: the Michigan...more

1/11/2017 - Criminal Prosecution Fraud Health Care Providers Healthcare Fraud Medicaid Medicare

Apology Laws Are Not Self-Executing

A recent study of state apology laws by three Vanderbilt University researchers concludes, among other things, that “from the perspective of physicians, apology laws are almost certainly detrimental,” increasing the frequency...more

12/16/2016 - Health Care Providers Medical Malpractice Physicians

EMTALA Anti-Retaliation Rule Narrower Than You Might Think

Regional Care Hospital fired Marie Gillispie because she was outspoken in telling hospital management that it was required to report an incident of patient dumping and had violated EMTALA by failing to do so. At least that’s...more

11/17/2016 - Anti-Retaliation Provisions EMTALA Health Care Providers Hiring & Firing Retaliation Summary Judgment

8th Cir. Resists Opportunities to Nix Nursing Home Arbitration

The plaintiff offered the Eighth Circuit several reasons to rule that he needn’t arbitrate claims against his father’s nursing home. But, figuratively swimming against the juridical current, the Eighth Circuit rejected all...more

11/17/2016 - Arbitration Arbitration Agreements Health Care Providers Nursing Homes

Broadening of Indiana Collateral Source Statute

The issue comes up a lot in personal injury cases: may the defendant introduce the discounted amount the provider actually accepted for medical services as evidence to be weighed against the undiscounted bill the plaintiff...more

11/9/2016 - Evidence Insurance Industry Insurance Litigation

The Difference between Expecting Referrals & Inducing Them

A new Fifth Circuit opinion explains the difference between offering a benefit in order to induce a Medicare referral and offering it in the expectation of a referral. The difference is important because the former is a...more

11/7/2016 - Anti-Kickback Statute Health Care Providers Medicare Omnicare Qui Tam Whistleblowers

La. Decision Clears Path for Circumventing Med Mal Cap

Brandi’s parents allege that they rushed her to the Opelousas General Hospital ER and asked Dr. Z to administer stroke medication, but Dr. Z declined, administering anti-seizure medication instead. Frustrated, they...more

10/31/2016 - Health Care Providers Medical Malpractice Summary Judgment

Whistleblower Can’t Use Discovery Info to Satisfy Rule 9(b)

Rule 9(b) requires a whistleblower alleging fraud to “state with particularity the circumstances constituting fraud.” Tom Bingham provided the particularity, but his case was nevertheless dismissed because of the way he came...more

10/21/2016 - Discovery False Claims Act (FCA) Rule 9(b) Whistleblowers

Continuing Assaults on Surprise Out-of-Network Bills

California struck the most recent blow against surprise out-of-network medical bills. Surprise bills are different from the bills you get when you knowingly choose an out-of-network provider. Those are painful, but they...more

10/14/2016 - Health Insurance HHS Out of Network Provider

Another Judicial Assault on Nursing Home Arbitration

They seem to come on an almost weekly basis: judicial rejections of arbitration provisions in nursing home contracts. The Sept. 22 attack by the Florida Supreme Court is the latest, and one of the harshest. When Juan...more

10/6/2016 - Arbitration Arbitration Agreements Health Care Providers Nursing Homes

DOJ & FTC Join Telemedicine Attack on Texas Medical Board

The U.S. Department of Justice and Federal Trade Commission have sided with Teledoc, Inc., one of the country’s biggest telemedicine companies, in its legal battle with the Texas Medical Board. The two agencies filed a joint...more

9/29/2016 - DOJ FTC Motion to Dismiss Sherman Act Telemedicine

False Claims that Don’t Violate the False Claims Act

A recent Fourth Circuit decision answers this riddle, “How can a contractor knowingly submit a false claim to the government without violating the False Claims Act (FCA)?” Give up? The answer is blindingly obvious—once...more

9/27/2016 - Corporate Counsel Failure To State A Claim False Claims Act (FCA) Federal Rule 12(b)(6) Hiring & Firing Retaliation Whistleblowers

Do CMS Ratings Punish Hospitals for Serving the Poor?

Does the CMS star rating system reward hospitals for serving the affluent and punish those that serve the poor? The answer is a resounding yes, according to a recently published analysis by Bloomberg BNA. The analysis...more

9/26/2016 - CMS Health Care Providers Hospitals

7th Cir. Demands Objective Standards in Whistleblower Complaint

On September 1 the Seventh Circuit affirmed dismissal of three of a whistleblower’s four fraud allegations against a mental health clinic, ruling that the allegations were based on the whistleblower’s subjective judgment...more

9/23/2016 - Corporate Counsel False Claims Act (FCA) Fraud Rule 9(b) Whistleblowers

Strangest Regulatory Interpretation of the Month

The Massachusetts federal district court is hands-down winner of the August award for strangest regulatory interpretation of the month. The interpretation came in the context of denial of Omnicare’s summary judgment...more

9/22/2016 - Anti-Kickback Statute False Claims Act (FCA) Medicaid Whistleblowers

California Physician Loses at Dating Game

A California appellate court has declared physician Visha Dev the loser in his dating contest with Blue Shield Life and Blue Shield California. The contest arose when the Blues moved for summary judgment in Dev’s action...more

9/14/2016 - Blue Shield Health Insurance Physicians Quantum Meirut Reimbursements

Ambulance Service Liable for Sexting Monkey?

An ambulance service may be liable for damages arising from sexting by a monkey it employed, the Second Circuit ruled on August 29. Actually, the monkey was a man, but the court sided with a female employee who sued the...more

9/9/2016 - Adverse Employment Action Cat's Paw Hiring & Firing Internal Investigations Retaliation Sexual Harassment

Whistleblower’s Claim Survives Dismissal and Death

The Energizer Bunny has nothing on the whistleblower claim of Robert Cunningham. Here’s what’s happened since Robert files his qui tam action against Millennium Labs back in 2009: the government declined to intervene; seven...more

8/26/2016 - False Claims Act (FCA) Federal Rule 12(b)(1) Federal Rule 12(b)(6) Motion to Dismiss Whistleblowers

Another Blow to Medicare “Self-Disallowance” Rule

You can tell by its name that you won’t like the Medicare “self-disallowance” rule. The federal district court for D.C. didn’t like it, either, and gave a group of Banner Health hospitals summary judgment that the rule was...more

8/26/2016 - HHS Hospitals Medicare Provider Payments PRRB

The Law Doesn’t Forbid Submitting False Claims

An Eighth Circuit decision provides a reminder that the False Claims Act doesn’t forbid submitting false claims: it forbids knowingly submitting false claims. That made all the difference in an appeal of summary judgment in...more

8/25/2016 - CMS False Claims Act (FCA) Health Care Providers Medicare Summary Judgment

Anti-Kickback Regs Near Approval, After Only 19 Years

The White House is reviewing proposed regulations to ease restrictions on certain financial arrangements between hospitals and physicians and on certain transactions between providers and patients. The proposed regulations,...more

8/25/2016 - Affordable Care Act Anti-Kickback Statute Bi-Partison Balanced Budget Act (BBA) Civil Monetary Penalty Hospitals OMB Physicians Safe Harbors

HHS Proposes 340B Dispute Resolution Process

From its inception the 340B program has been the subject of disputes between drug manufacturers and their safety-net hospital customers. On August 12 HHS proposed an administrative process for resolving those...more

8/25/2016 - Affordable Care Act Drug Pricing HHS HRSA Pharmaceutical Industry Section 340B

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