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Five Key Lessons for Business Litigators from National Abortion Federation v. Center for Medical Progress

On February 5, 2016, Morrison & Foerster secured a preliminary injunction on behalf of its client, National Abortion Federation (“NAF”), in National Abortion Federation v. Center for Medical Progress. The firm’s work on this...more

Do Your Assignment of Benefits Clauses Need a Check-up? Recent Southern District of Florida Decision Highlights the Importance of...

A frequently litigated issue in reimbursement cases brought by in- and out-of-network healthcare providers against insurers under the Employee Retirement Income Security Act of 1974 (“ERISA”) is provider standing. Because...more

Health Care Enforcement in 2016: A Look Back on 2015 and Forecasting the Year Ahead

2015 was a year of transition for the U.S. Department of Justice (“DOJ”), with the installation of a new Attorney General, Deputy Attorney General, and several other high-level officials. In January 2015, Andrew Weissmann...more

FDA Regulatory and Compliance Monthly Recap — December 2015

Pacira secures expanded marketing for painkiller medication as FDA agrees to settle lawsuit, revoke warning letter - The pharmaceutical industry won in its latest bid for more leeway to promote drugs for unapproved uses,...more

Massive Fraud Alleged by Camarillo Pharmacist

Russell Reitz, a Camarillo pharmacist, with a modest prescription-filling service, R&O Pharmacy, sold his business to Philidor Rx Services, a mail-order pharmacy, for $350,000. Reitz stayed on as manager, only to see an...more

Danger Ahead? The Yates Memo and Some Strategic Considerations for Corporations and Individuals

If you are a corporate executive or employee, the U. S. Department of Justice has a message for you: Investigating you for potential misconduct is clearly a top priority. Recently, the DOJ issued a policy memorandum...more

The Insidious Myth of Tort Reform | Medical Malpractice

We all have the right to safety, to know that if we are harmed, those responsible will be held accountable, regardless of their occupation. For years, insurance companies and lobbyists have tried to sway state legislators and...more

Whistleblower Filed Too Early & Too Late for Share of $322M SCAN Scam Recovery

During his days as a data encounter manager at SCAN, Jim suspected the company had been double-billing Medicare and Medicaid for years. He expressed his concerns within SCAN. When he refused a job reassignment, he was fired....more

Texas Hospital Strikes Back at Aetna

On February 23, 2015, Aetna filed suit in Texas federal court against Robert A. Behar, M.D. and North Cypress Medical Center (North Cypress), alleging that Dr. Behar, the CEO of North Cypress, offered impermissible ownership...more

Fourth Circuit Affirms $237 Million Jury Verdict for Stark and FCA Violations; Rejects Advice-of-Counsel Defense

On July 2, the U.S. Court of Appeals for the Fourth Circuit affirmed a jury verdict of more than $237 million against Tuomey Healthcare System, a nonprofit hospital in South Carolina, based on Stark Law and False Claims Act...more

Dialysis Provider Settles Whistleblower Lawsuit for $450 Million

The Department of Justice and dialysis provider DaVita Healthcare Partners recently finalized a $450 million agreement settling claims that the company intentionally inflated Medicare billings. The parties had filed a joint...more

Recent DOJ and OIG Actions Show Growing Federal Scrutiny of Physician Financial Arrangements

Over the last month the Office of Inspector General (OIG) of the Department of Health and Human Services and the Department of Justice (DOJ) have each taken actions that suggest an increasing appetite to examine the financial...more

Illinois Supreme Court Debates Whether Attorneys’ Fees Are Charged to Health Care Liens

In the final days of its March term, the Illinois Supreme Court heard oral arguments in McVey v. M.L.K. Enterprises, LLC. McVey poses a question of considerable importance for tort litigation: must attorneys’ fees and costs...more

Supreme Court Update: Rodriguez v. United States (13-9972); United States v. Wong (13-1074 And 13-7075); Oneok, Inc. v. Learjet,...

When is a sniff not up to snuff (as far as the Fourth Amendment is concerned)? Ten years ago, in Illinois v. Caballes (2005), the Court held that a dog sniff conducted during a lawful traffic stop does not violate the Fourth...more

CMS Fines Insurer for Misleading Medicare Part D Beneficiaries

The federal agency that oversees Medicare’s prescription drug program has alleged that a major U.S. insurance company misled beneficiaries about the pharmacies included in the company’s drug plan, and imposed a $1 million...more

Successful Rule 9(b) Defense of False Claims Act Whistleblower Litigation

The lure of significant monetary awards continues to stimulate high-risk whistleblower actions under the False Claims Act (FCA), and these claims are increasingly common in the pharmaceutical and medical device industry. The...more

Volunteer Directors and Officers Liable to Facility Creditors

The Third Circuit Court of Appeals recently upheld a trial court’s jury verdict finding the individual board members and officers of a non-profit healthcare facility personally liable to the facility’s creditors. The board...more

California Court Rejects Insurer’s Right to Rescind Policy

In DuBeck v. California Physicians’ Service, 2015 Cal. App. LEXIS 203 (March 5, 2015, opinion filed), the California Court of Appeal examined whether a health insurer’s conduct constituted a waiver of the right to rescind its...more

Federal Appellate Court Ruling Sounds the Liability Alarm for Officers and Directors of Struggling Health Care Providers – Both...

Last month, the United States Court of Appeals for the Third Circuit issued an important, 28-page opinion that confirmed a jury verdict, holding former officers and directors of a not-for-profit health care provider in...more

Florida Hospitals Face Glenn Close-Like Threat

Remember the evil Glenn Close character in Fatal Attraction? We were sure Michael Douglas had drowned her in the bathtub, but she popped up again, still alive and scary as all get-out. Class actions by uninsured...more

California Lawyer 2015 Roundtable Series: White-Collar Defense

The latest developments in white-collar criminal law include a gamechanging decision on insider trading, new sentencing guidelines for fraud convictions, more options for filing charges under the bank fraud statutes, and a...more

No Private Right to Recoup Funds Based on Corporate Practice of Medicine Violation

The United States District Court for the Western District of Washington ruled recently that the state’s corporate practice of medicine doctrine does not provide a private right of action, either express or implied, and...more

The ERISA Litigation Newsletter

Editor's Overview - As it is well known, in Cigna Corp. v. Amara, 131 S. Ct. 1866 (2011), the U.S. Supreme Court identified several forms of appropriate equitable relief that may be available under Section 502(a)(3) of...more

Catch Me If You Can: Fake Doctor’s Application Voids Coverage for Himself But Not for Innocent Co-Insureds

Written like a blockbuster Hollywood film, the U.S. District Court in South Carolina, in Evanston Insurance Company v. Agape Senior Primary Care, et al., 2014 WL 5365679, issued a ruling October 21, 2014, in which it held...more

Ninth Circuit Holds That Provider Cannot Sue Nonsignatory Insurer for Breach of Contract

On October 10, 2014, the Ninth Circuit affirmed a grant of summary judgment in favor of Manatt client The MEGA Life and Health Insurance Company. In an unpublished memorandum opinion, the Ninth Circuit held that a health care...more

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