Civil Procedure, Health Law, Commercial Law & Contracts

Retired County Employees Can Amend Their Complaint In An Attempt To Prove Existence Of A Contract for Health Benefits

by Laura Izon Powell, Bruce A. Scheidt, Kristianne Seargeant, David W. Tyra | Kronick, Moskovitz, Tiedemann & Girard on 5/22/2013

In 2008, the Sonoma County Board of Supervisors (“County”) acted to cap the county’s contributions for health care benefits for retired employees at $500 per month. The Sonoma County Association of Retired Employees...more

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

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

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

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

Federal Court Orders FDA to Approve OTC Sales of “Morning-After Pill,” Finds Current Age and Point-of-Sale Restrictions to be...

by Fuerst Ittleman David & Joseph, PL on 4/11/2013

On April 5, 2013, Judge Edward R. Korman of the United States District Court for the Eastern District of New York found that the Secretary of Health and Human Service’s (“HHS”) decision to limit over-the-counter (“OTC”)...more

What's In A Word? N.C. Court of Appeals Invalidates Nursing Home Arbitration Clause Based on Language of the Agreement

by Kenneth L. Burgess | Poyner Spruill LLP on 4/9/2013

Many nursing homes and assisted living communities commonly include arbitration agreements as part of their admission agreement and documents. Typically, these agreements require residents or their legal surrogates to...more

D.C. District Court Again Rules That Bad Debt at a Collection Agency is Allowable

by Leslie Demaree Goldsmith | Ober|Kaler on 4/4/2013

The United States District Court for the District of Columbia recently ruled, again, that a Medicare contractor is not permitted to disallow Medicare bad debts solely on the ground that the bad debt is still at an outside...more

Washington Supreme Court: Insurers May Not Reserve the Right to Seek Reimbursement of Non-covered Defense Costs

by Meredith Dishaw, William Knowles | Cozen O'Connor on 3/18/2013

The Washington Supreme Court joined a minority of jurisdictions that hold that insurers may not unilaterally reserve the right to seek reimbursement for defense costs paid in defending non-covered claims through a reservation...more

Pro Te Solutio - Vol. 5 No. 4 November 2012

by Butler, Snow, O'Mara, Stevens and Cannada,... on 3/4/2013

In This Issue: - Forecast for the Physician Payments Sunshine Act: Partly Cloudy - Document Preservation Notices and the Lists of Who Receive Them: Are They Discoverable? - FDA Warning Letters Through...more

Misrepresentation Law and Insurance Coverage In South Carolina

by Stephen Groves | Nexsen Pruet, PLLC on 2/13/2013

1. The Claim - An insurer may use the alleged misrepresentations and/or omissions of an insured in the life, health and disability insurance application process in two ways: (i) affirmatively, by seeking rescission of...more

Tennessee Insurance Legal News - February 2013 • Volume 2, Number 1

by John Anderson, Sr., James M. Burns, Autumn Gentry, Kelly Telfeyan | Dickinson Wright on 2/7/2013

In This Issue: - AUTO REPAIR TRADE ASSOCIATION REQUESTS THAT DOJ INVESTIGATE THE USE OF MOST FAVORED NATION CLAUSES BY AUTO INSURERS: Over the last several years, the use of most favored nation clauses by health...more

How Requiring Uninsured Patients to Pay Chargemaster Rates Impacts Personal Injury Cases

by Pavlack Law, LLC on 12/21/2012

This week we discuss the Indiana Supreme Court decision in Allen v. Clarian Health Partners, Inc., which held that uninsured patients were required to pay the chargemaster rates and not a reasonable rate. Our analysis focuses...more

BLG Monthly Update for December 2012

by Neil Guthrie on 12/19/2012

UGG boots, thieving drug addicts, misappropriated sheep and the usual neat contracts cases: all this and more in the BLG Monthly Update for December....more

Court Denies Whistleblowers Motion for Summary Judgment Finding Agreements Specific Enough to Meet Anti-Kickback Statute Safe...

by King & Spalding on 11/26/2012

On October 29, 2012, the federal District Dourt for the Middle District of Florida denied a whistleblower’s summary judgment motion alleging that certain agreements failed to meet the safe harbors established under the...more

City’s Promise To Pay Portion Of Future Retirees’ Medical Insurance Premiums Is Enforceable

by Jeffrey L. Massey, Laura Izon Powell, Bruce A. Scheidt | Kronick, Moskovitz, Tiedemann & Girard on 11/14/2012

A court of appeal recently concluded that a trial court erred when it dismissed a lawsuit by city employees who alleged in their petition that the memorandum of understanding (“MOU”) ratified by the city council promised...more

Pro Te Solutio - Vol. 5 No. 3 August 2012

by Butler, Snow, O'Mara, Stevens and Cannada,... on 11/12/2012

In This Issue: - Diversity In Clinical Trials: The Need For Diversity To Ensure Safety And Efficacy - Federal Removal Statutes: A Review Of The Federal Courts Jurisdiction And Venue Clarification Act Of 2011 -...more

Insurance Antitrust Legal News - November 2012 • Volume 1, Number 4

by Dickinson Wright on 11/1/2012

In This Issue: - DOJ and FTC Hold Public Workshop to Consider the Antitrust Issues Raised by “Most Favored Nation Clauses” in Health Insurance Contracts by James M. Burns: On September 10, the Federal Trade...more

Sanders v. Ahmed, 364 S.W.3d 195 (Mo. banc 2012): Future Payments and Appeals for Medical Malpractice

by Williams Venker & Sanders on 7/5/2012

In a recent opinion, the Missouri Supreme Court rejected constitutional challenges to several provisions pertaining, among others, to wrongful death medical malpractice actions, explained the discretion afforded a trial judge...more

Insurance Legal News - June 2012 • Volume 5, Number 1

by Dickinson Wright on 6/13/2012

In This Issue: - AUTISM COVERAGE MANDATED IN MICHIGAN by Cynthia A. Moore, Member The State of Michigan has approved new laws requiring health insurance companies to cover the diagnosis and treatment of autism...more

Insured’s Failure to Pay Contract Benefits Due and Related Attorneys’ Fees Are Not Covered Under Errors and Omissions Policy

by Sedgwick LLP on 5/24/2012

In Health Net, Inc. v. RLI Insurance Company, et al., Cal. Ct. App. Case N. B224884 c/w B240833, the California Court of Appeal clarified that contract benefits owed by an insured are not covered by a liability insurer...more

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Civil Procedure › Health Law › Commercial Law & Contracts