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Religious Institutions Update: January 2016

Timely Topics - The Internal Revenue Service (IRS) issued on Dec. 17, 2015, a memorandum instructing its examiners not to conduct employment tax audits of churches without getting in touch with a high-ranking Treasury...more

Bad News for ERISA Plan Reimbursements: Chase The Money Before Settlement Funds Dissipate, Supreme Court Rules

This just in…. A big debate was resolved today by the United States Supreme Court: Can an ERISA plan sue to recover medical expenses paid on the participant’s behalf after the settlement funds have dissipated?...more

Supreme Court Decides Montanile v. Board of Trustees of the National Elevator Industry Health Benefit Plan

On January 20, 2016, the U.S. Supreme Court decided Montanile v. Board of Trustees of the National Elevator Industry Health Benefit Plan, No. 14-723, holding that where an ERISA-plan participant has dissipated a third-party...more

Florida 5th DCA Says Referral Relationships Not Protectable

A recent case out of Florida’s Fifth District Court of Appeals raises important raises important issues related to physician non-compete agreements. Let’s take a look: Before addressing the specifics of this case, some...more

Fourth Circuit Upholds $1.75 Million Punitive Damages Award In Transvaginal Mesh Case

About a month ago, we reported on a Delaware trial court decision reducing a $75 million punitive award to $7.5 million in a transvaginal mesh case. Last week, in what we believe to be the first appellate decision in one of...more

Medical Malpractice and Healthcare Quarterly - Winter 2015-2016

DELAWARE MOVES TO MAKE TELEMEDICINE MORE ACCESSIBLE - On July 7, 2015, Governor Jack Markell signed into law House Bill No. 69 (DE LEGIS 80 (2015), 2015 Delaware Laws Ch. 80 (H.B. 69)), which amends various provisions of...more

Annual Report on EEOC Developments – Fiscal Year 2015

This Annual Report on EEOC Developments—Fiscal Year 2015 (hereafter “Report”), our fifth annual Report, is designed as a comprehensive guide to significant EEOC developments over the past fiscal year. The Report does not...more

FTC and Pennsylvania Challenge Penn State Hershey’s Planned Merger with PinnacleHealth System

BNA has reported the planned merger of Penn State Hershey Medical Center with PinnacleHealth System will be challenged in federal court by federal and state officials. The Federal Trade Commission and Pennsylvania’s...more

Measuring Medical Expense Damages and the Role of the Collateral Source Rule

Two recent rulings illustrate the widely varying responses courts have taken in confronting an emerging national issue: how to measure damages for past medical expenses when the hospital’s treatment charges, before discounts...more

Equitable in Name Only?: Tracing a Long and Tortured Path

Knowingly spending money that isn’t yours sounds like a no-no, but depending on how the Supreme Court rules in Montanile v. Board of Trustees of the National Elevator Industry Health Benefit Plan (No. 14-723), certain ERISA...more

FDA Legal and Regulatory – 2015 Year In Review

Looking back on 2015, it’s apparent that this was another very busy year for the Food and Drug Administration (FDA or Agency), whose oversight responsibilities are estimated to touch 25% of American consumers’ spending on...more

Delaware Superior Court Cuts Punitive Damages In Transvaginal Mesh Case

Last week, we posted about a $10 million award of punitive damages in a product liability action against a manufacturer of hip implants.  We explained our view that the award was excessive, in part because hundreds of similar...more

California marijuana dispensary scores victory against DOJ … but how long will it last?

The Marin Alliance for Medical Marijuana (MAMM), one of California’s oldest lawful marijuana dispensaries, won a major victory against the U.S. Department of Justice (DOJ) in October. In U.S. v. Marin Alliance for Medical...more

Court Rules that Medicare and Medicaid Payments to Nursing Home Must Continue Pending Jurisdictional Dispute

On October 27, 2015, United States District Judge James S. Moody, Jr. extended a stay of proceedings thereby permitting Bayou Shores SNF, LLC (“Bayou Shores”) to remain viable and continue receiving Medicare and Medicaid...more

Seventh Circuit Reverses Injunctive Relief for Chiropractic Association

On October 1, 2015, the United States Court of Appeals for the Seventh Circuit reversed what was previously regarded as a victory for the Pennsylvania Chiropractic Association. The case, Pennsylvania Chiropractic Association...more

Health Alert (Australia) - October 5, 2015

In This Issue: - Judgments; Legislation; and Reports. - Excerpt from Judgments: Victoria. Epichealth Pty Ltd v Yang [2015] VSC 516 The Supreme Court has granted an interlocutory...more

The United States’ First-Ever Biosimilar Reaches the Market

Today, Sandoz (a Novartis subsidiary) launched the first biosimilar approved under the BPCIA: the cancer drug Zarxio (filgrastim-sndz), which is a biosimilar version of Amgen’s Neupogen. The launch follows the Federal...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

The Difficulty Of Challenging FCA Fine As Excessive

Last month, in U.S. ex rel. Drakeford v. Tuomey, No. 13-2219, (4th Cir. July 2, 2015), the Fourth Circuit affirmed a False Claims Act verdict against a nonprofit hospital in Sumter, South Carolina. In an area of the law where...more

Hospital Chain Pays Heavy Price for Being Too Clever

Finding that Community Hospital Systems had been “too clever by half” in negotiating a global settlement agreement for seven whistleblower suits, a federal judge ordered the chain to pay the attorneys’ fees of all the...more

Be Careful What You Say: Allegations Of Worker Misconduct Might Be Defamation

Healthcare institutions have a moral and legal obligation to promote patient safety as an essential component of patient care. Supervisors and managers must be supportive of their staffs while remaining vigilant about the...more

Court Adopts Tough Interpretation of 60-Day Repayment Rule

New York’s Mt. Sinai Hospitals can’t seem to catch a break in its long-running battle with whistleblower Bob Kane. First, the government joined the case and wanted not just the $1,000,000 in Medicaid overpayments, but an...more

Health Care Providers Lacked Standing to Sue as ERISA Beneficiaries: Rojas v. Cigna Health and Life Insurance Company

The U. S. Court of Appeals for the Second Circuit has affirmed a dismissal of claims by two physicians and their medical practice asserting standing under ERISA to enjoin an insurer from removing them from its coverage...more

Circuit Court Affirms $237.5 Million Judgment Against Tuomey

On July 2, 2015, the Fourth Circuit affirmed a $237,454,195 judgment against Tuomey Health Care System (Tuomey) for violations of the Federal False Claims Act (FCA), which liability arose from violations of the Stark law....more

Beware of Nurses Bearing Gifts

Alisia and David blew the whistle on their former employer, Nurses’ Registry & Home Health, for sending gift baskets and ticket events to doctors who referred patients to the home health operation. Their qui tam suit alleged...more

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