Civil Procedure, Health Law

Insurance Recovery Law -- May 16, 2013

by Manatt, Phelps & Phillips, LLP on 5/17/2013

In This Issue: Prepare For A Storm of Lawsuits; To Ensure Coverage, Read Policy Carefully; and Ticketmaster Wins Reversal, Possible Coverage For Class Action Over Ticket Fees ...more

The High Cost of Paying Physicians for Referrals: Tuomey Healthcare System Faces Penalties of up to $357 Million

by Ari H. Gerstin, Elizabeth F. Hodge | Akerman Senterfitt on 5/17/2013

On May 8, 2013, a jury sitting in the U.S. District Court for South Carolina found that Tuomey Healthcare System, Inc. violated the Stark Law and the False Claims Act (FCA) by illegally paying referring physicians. The jury...more

SuperVision Today - 2nd Quarter 2013

by Erin Jones Adams, R. Scott Adams, Alyesha Asghar Dotson, Carrie Harris, Eric W. Iskra, Eric E. Kinder, Richard Wallace | Spilman Thomas & Battle, PLLC on 5/16/2013

In This Issue: - Notes from the Chair & Executive Editor - The Board Plays On: The NLRB Clarifies Its Position on At-Will Disclaimers - Interns This Summer? Evaluating Your Unpaid Internship Programs...more

Sixth Circuit Applies Strict Precondition of Payment Requirement to Reverse $11.1 Million FCA Judgment

by Nicholas Linder, Kirsten Mayer, Arefa Shakeel | Ropes & Gray LLP on 5/15/2013

The U.S. Court of Appeals for the Sixth Circuit, in United States ex rel. Hobbs v. MedQuest Associates, Inc., 711 F.3d 707 (6th Cir. April 1, 2013), recently reversed an $11.1 million False Claims Act (“FCA”) judgment,...more

Absent a Contract With the Provider, HMOs Are Not Liable for Unpaid Services

by Michael Klein | Sedgwick LLP on 5/10/2013

On April 19, 2013, the Texas Supreme Court handed down its opinion in Christus Health Gulf Coast, et al. v. Aetna, Inc. et al. The court’s ruling put an end to the so-called “double pay” theory of liability by downstream...more

Rubin v. General Hospital Corp. (Fed. Cir. 2013)

by Donald Zuhn | McDonnell Boehnen Hulbert & Berghoff LLP on 5/8/2013

On March 28, the Federal Circuit in Rubin v. General Hospital Corp. affirmed judgment by the District Court for the District of Massachusetts dismissing the suit brought by Drs. Berish Rubin and Sylvia Anderson against The...more

First Department Upholds Commercial Division Decision Striking Parties' Answer And Entering Default Judgment As A Sanction For...

by Valentina Shenderovich | Sheppard Mullin Richter & Hampton LLP on 5/7/2013

In Suffolk P.E.T. Mgt., LLC v. Anand, 2013 NY Slip Op 02335 (First Dep’t April 4, 2013), the Appellate Division, First Department affirmed an Order by the Supreme Court, New York County Commercial Division (Bernard J. Fried,...more

Wisconsin Court Confirms Computer-Controlled Medical Devices Are Exempt From Property Tax

by Theresa Andre, Eric Hatchell, Maureen McGinnity | Foley & Lardner LLP on 5/6/2013

In 2008, the Wisconsin Tax Appeals Commission ruled that the following categories of computerized medical equipment are exempt from property tax: - Ultrasound equipment - Magnetic resonance imaging (MRI)...more

Court of Appeal Applies Howell Rule to Future Medical Expenses and Noneconomic Damages

by Samuel Sorich | Barger & Wolen on 5/6/2013

In Howell v. Hamilton Meats & Provisions, Inc., the California Supreme Court ruled that where a plaintiff’s medical care provider, pursuant to a prior agreement with the plaintiff’s health care provider, accepted less than...more

Novel “Bad Faith Admission” EMTALA Theory Survives Motion to Dismiss

by Darby C. Allen, Melissa Brown, Robert Wolin | BakerHostetler on 5/3/2013

The U.S. District Court for the Northern District of California recently denied Contra Costa Regional Medical Center’s (CCRMC) motion to dismiss regarding an alleged violation of the Emergency Medical Treatment and Labor Act...more

Insurance Antitrust Legal News - May 2013 • Volume 2, Number 3

by James M. Burns | Dickinson Wright on 5/2/2013

In This Issue: - STATE EFFORTS TO RESTRICT HEALTH INSURER USE OF “MOST FAVORED NATION” CLAUSES IN PROVIDER CONTRACTS CONTINUE TO MULTIPLY: Over the last several years, several states have considered legislation...more

20 Million Reasons Why Class Action Defendants Need to Read Their Insurance Policies Closely

by Judy Selby | BakerHostetler on 4/29/2013

As previously noted in a recent blog post, defendants should immediately evaluate their insurance coverage upon receipt of a class action complaint. But as one defendant recently discovered the hard way, that evaluation must...more

Washington Supreme Court Limits Public Access to Hospital Privileging, Peer Review Documents

by Angela Galloway, Eric Stahl | Davis Wright Tremaine LLP on 4/26/2013

Public hospital districts may not disclose certain records created during closed-door meetings about hospital privileging decisions, the Washington Supreme Court recently held in Cornu-Labat v. Hospital Dist. No. 2 Grant...more

Sixth Circuit in MedQuest: No FCA Liability for Violation of Medicare Conditions of Participation Without Violation of Conditions...

by Calvin Marshall | Chambliss, Bahner & Stophel, P.C. on 4/26/2013

On April 1, 2013, the U.S. Court of Appeals for the Sixth Circuit overturned an $11.1 million False Claims Act (FCA) judgment by the U.S. District Court for the Middle District of Tennessee against MedQuest Associates, Inc.,...more

Sixth Circuit Holds Physician Supervision and Enrollment Issues Are Not Conditions of Payment for Purposes of FCA Liability

by Darby C. Allen, B. Scott McBride | BakerHostetler on 4/23/2013

The Sixth Circuit Court of Appeals recently issued a decision overturning an $11.1 million False Claims Act (FCA) verdict against MedQuest Associates, Inc. (MedQuest) for submitting claims to Medicare in violation of the...more

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Civil Procedure › Health Law

Insurance Recovery Law -- May 16, 2013

The High Cost of Paying Physicians for Referrals: Tuomey Healthcare System Faces Penalties of up to $357 Million

SuperVision Today - 2nd Quarter 2013

Sixth Circuit Applies Strict Precondition of Payment Requirement to Reverse $11.1 Million FCA Judgment

Absent a Contract With the Provider, HMOs Are Not Liable for Unpaid Services

Rubin v. General Hospital Corp. (Fed. Cir. 2013)

First Department Upholds Commercial Division Decision Striking Parties' Answer And Entering Default Judgment As A Sanction For...

Wisconsin Court Confirms Computer-Controlled Medical Devices Are Exempt From Property Tax

Court of Appeal Applies Howell Rule to Future Medical Expenses and Noneconomic Damages

Novel “Bad Faith Admission” EMTALA Theory Survives Motion to Dismiss

Insurance Antitrust Legal News - May 2013 • Volume 2, Number 3

20 Million Reasons Why Class Action Defendants Need to Read Their Insurance Policies Closely

Washington Supreme Court Limits Public Access to Hospital Privileging, Peer Review Documents

Sixth Circuit in MedQuest: No FCA Liability for Violation of Medicare Conditions of Participation Without Violation of Conditions...

Sixth Circuit Holds Physician Supervision and Enrollment Issues Are Not Conditions of Payment for Purposes of FCA Liability

ERISA Legal News - 1st Quarter, 2013 • Volume 4, Number 1

Courts of Appeals Continue to Limit the Government’s Aggressive False Claims Act Theories

Whistleblower Guidance from NJ Appellate Court May Help Employers Keep More CEPA Claims from Reaching a Jury

Court Rules That Supervision and Enrollment Issues Don't Give Rise to False Claims Act Liability

Court Grants Unexpected Victory to Providers on Medicare DSH Adjustment

Compounding Animal Drugs from Bulk Ingredients

Recent Changes Impact Appeal of Medicare Denials and Reimbursement Strategies

HIPAA Preemption Case – Opis Management Resources, LLC v. Florida Agency for Health Care Administration

False Claims Act Focus - April 2013

Howell Rule Applies When Medical Services Were Paid by Medicare, Court of Appeal Concludes

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