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Court Enjoins Outpatient Primary Care Physician’s New Employment as a Hospitalist

A Pennsylvania appellate court recently granted an employer’s request for enforcement of a restrictive covenant against a hospitalist, finding that his departure from the primary care office setting did not affect the terms...more

North Carolina Business Court Holds Pleading Stage Too Early to Dismiss Broad Non-compete

On May 7, 2015, Judge Gregory McGuire of the North Carolina Business Court denied defendants’ motion to dismiss a claim that a physician’s assistant breached non-competition and non-solicitation provisions in her employment...more

The Efficient Market Theory—§ 10(b)’s Double-Edged Sword - The Eleventh Circuit in Sappssov Deploys Meyer in Affirming Dismissal...

On May 11, 2015, the Eleventh Circuit, relying on the “efficient market theory” as explained in Meyer v. Greene, 710 F.3d 1189, 1195 (11th Cir. 2013), affirmed the dismissal of a shareholder class action for failing to...more

Early Termination of Annuities Not Permitted

Since investing can be a risky business with investments dropping in value from time to time, investors seeking steady income with minimal risk are sometimes attracted to an annuity’s guaranteed-income feature. A recent case...more

4th Cir. Sides with Surgeon in Disability Policy Dispute

On May 5 the Fourth Circuit reversed a District Court decision upholding Lloyd’s of London’s rescission of a Maryland surgeon’s disability policies. Lloyd’s had rescinded the policies because the surgeon gave false answers...more

Iowa Supreme Court Affirms Ruling for Health Insurer in Antitrust Dispute

In late February, the Iowa Supreme Court affirmed a lower court ruling in Mueller v. Wellmark, ending a seven year battle over whether the health insurer’s agreement with employers operating “self-funded” insurance plans to...more

Insurance Antitrust Legal News: Volume 4, Number 3

Auto Insurers Again Seek Dismissal of In Re Auto Body Shop Antitrust Litigation - In early March, the auto insurer defendants in the In re Auto Body Shop Antitrust Litigation renewed their motions seeking the dismissal...more

All or Nothing: Federal Court Decides Exclusion from ‘Some’ Patients Insufficient for Refusal to Deal Claim

A federal district court in the Eighth Circuit dismissed claims brought against a physician-hospital organization and an insurer alleging that the defendants violated federal antitrust laws by refusing to deal with certain...more

Federal Arbitration Case Update | Bound and Determined

Owner Not Bound by Arbitration Clause in Engagement Agreement between Contractor and Law Firm - Auto Parts Manufacturing Mississippi v. King Construction - 2015 WL 1379980 - United States Court of Appeals, Fifth...more

Third Circuit Remands Class Certification Ruling in Blood Reagents Price-Fixing Case

On Wednesday, April 8, 2015, the Third Circuit Court of Appeals vacated a district court’s order certifying a class of direct purchasers of blood reagents in a price-fixing suit against Ortho-Clinical Diagnostics Inc. In re...more

Open Season on Provider-controlled Licensing Boards

In a closely followed decision with significant consequences for state licensing boards and their members, the Supreme Court in North Carolina State Board of Dental Examiners v. Federal Trade Commission, 135 S. Ct. 1101...more

Employer's "No Re-Hire" Provision May Violate California's Non-Compete Laws

Pretty much everyone knows that California courts do not favor covenants not to compete. We even have our own state laws that address this very issue (Business & Professions Code section 16600). But what about provisions in...more

“It’s Not Easy to Unscramble the Eggs” … Despite the FTC’s Win at the U.S. Supreme Court, the Phoebe Putney Hospital Merger...

Nearly four years after the Federal Trade Commission (“FTC”) first challenged the combination of the only two hospitals in Albany, Georgia, the FTC, Phoebe Putney Health Systems, Inc. (“Phoebe Putney”), Hospital Authority of...more

Beware medical records subpoenas: Connecticut Supreme Court issues opinion on negligence for noncompliance with HIPAA standards

Health care providers and their medical records custodians constantly find themselves under pressure to release medical records immediately upon receipt of a subpoena. However, regardless of the subpoena or the pesky...more

Software Company to Face Suit Over Contract Restructuring

The United States District Court for the Northern District of California sustained a securities fraud complaint alleging that the defendants, a software company and its executives, had defrauded investors by failing to...more

Fourth Circuit Sustains Securities Fraud Claim Against Drug Manufacturer

On March 6, the US Court of Appeals for the Fourth Circuit found that the United States District Court for the Western District of North Carolina had erred in dismissing a class action lawsuit filed under Section 10(b) of the...more

Hospital Wins First Round Against Largest Rival in Antitrust Suit Alleging Illegal Exclusive Dealing Agreements with Insurers

The waves of change affecting health care providers include reimbursement and funding developments, the impact of the Affordable Care Act, technological and medical advances, provider network design transformations imposed by...more

Federal Court Allows Hospital’s Antitrust Claims to Proceed on Narrow Market Definition

Winning an antitrust lawsuit hinges on defining the “relevant market,” and this case may prove the point. Methodist Health Services Corporation notched the first win in its battle against Saint Francis Medical Center as a...more

Supreme Court Rules No Presumption of Lifetime Vesting of Retiree Health Benefits

The Supreme Court overturned the Sixth Circuit’s long-standing Yard-Man presumption, ruling that courts should apply ordinary contract principles to determine whether benefits have vested....more

Omnicare: Section 11 Liability and Opinions

The Supreme Court defined the circumstances under which liability can be imposed for opinion statements under Securities Act Section 11. Specifically, the Court held that such liability could be imposed on two theories: One...more

Late Notice of Claim Costs Kentucky Hospital $10 Million

A federal court in Kentucky ruled on March 17 that Ashland Hospital had forfeited $10 million of insurance coverage because it was late in notifying its insurance company of the claim....more

Circuit Court Provides Clarification of Pleading Standards in FCA Cases - The Court's Holding Details Requirements for Alleging...

A recent U.S. Court of Appeals case from the Seventh Circuit has brought further insight into the heightened pleading standard required under the False Claims Act (FCA). The case, Thulin v. Shopko Stores Operating Co., LLC,...more

What Employers under Collective Bargaining Agreements Should Know about the Decision in M&G Polymers v. Tackett

Recently, the United States Supreme Court undertook a significant course-correction in the vesting of retiree health benefits under collective bargaining agreements (“CBAs”). ...more

Insurer’s Agreements with Providers Are Not Per Se Antitrust Violations

The Iowa Supreme Court refused to categorize a health insurer’s agreements with providers in Iowa and its participation in the national Blue Cross and Blue Shield (BCBS) network as per se violations of the antitrust laws. ...more

Cancellation and Delay Waive Right to Later Rescind Ab Initio

In DuBeck v. Cal. Physicians' Service (No. B250129, filed 3/5/15), a California appeals court held that Blue Shield’s initial decision to cancel a healthcare policy for application misrepresentations constituted a waiver of...more

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