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Fifth Circuit: Hospital Enjoys Standing to Seek ERISA Benefits

The Fifth Circuit ruled that an out-of-network medical provider that was assigned a patient’s rights to health insurance benefits has standing to sue a health plan that underpays its portion of the benefits due even if the...more

Biosimilars in the US: still at the starting line?

Congress enacted the Biologics Price Competition and Innovation Act (BPCIA) in 2009 to create a framework for the introduction of biosimilar and interchangeable drugs into the US market. Like the predecessor Hatch-Waxman Act,...more

My Day at the U.S. Supreme Court: King v. Burwell

Describing her recent Supreme Court experience as “my Super Bowl,” Susan Feigin Harris offers her personal account and analysis of the oral arguments in King v. Burwell. I was ready to go: hat, gloves, boots and parka. A...more

High Court Sides with DOL, Holding that Agencies May Flip-Flop on Regulatory Interpretations Without Engaging in...

In June, we wrote that the U.S. Supreme Court agreed to address whether a federal agency (in this case, the Department of Labor) must engage in formal notice-and-comment rulemaking in order to significantly alter its...more

Oral Argument in King v. Burwell Concludes; Debates Ensue

At approximately 10:00am EST this morning, the Justices of the U.S. Supreme Court heard oral argument in King v. Burwell – the highly publicized case whose final decision may “end Obamacare as we know it!” (as one excitable...more

King v. Burwell: What to Expect From the Supreme Court Argument

On Wednesday, March 4, 2015, the Supreme Court of the United States will hear argument in King v. Burwell, a case involving premium tax credits under the Affordable Care Act (ACA). Among its many provisions, the ACA includes...more

Medical Staff By-laws are Contracts? Minnesota Supreme Court Says “Yes”

That sound you just heard was the simultaneous gasp of hospital boards of directors throughout the state of Minnesota. In Medical Staff of Avera Marshall Regional Medical Center v. Avera Marshall, Minnesota’s highest court...more

Federal Court Decision Demonstrates Ongoing Challenges Faced by Plaintiffs in Data Breach Litigation

On February 11, 2015, the U.S. District Court for the Southern District of Texas dismissed a class action complaint against the St. Joseph Health System arising out of a data security breach that occurred after hackers...more

Same-Sex Spouse Has No Standing to Assert COBRA Notice Claim

A New Jersey federal district court held (in an unpublished opinion) that a former plan participant’s same-sex spouse who never enrolled in the benefit plan did not have standing to assert a claim alleging that his spouse’s...more

No Harm, No Standing: Texas Federal Court Dismisses Data Breach Class Action

Dismissing a class action based on a data breach, the Southern District of Texas added to the growing number of decisions that find an alleged risk of future identity theft due to a data breach is not an injury that creates...more

Illinois Supreme Court Affirms Constitutionality of Nursing Home Bed Tax

In the closing days of its January term, a unanimous Illinois Supreme Court upheld the constitutionality of a “bed tax” on Illinois nursing homes, reversing the Circuit Court’s judgment that the tax violates the state...more

"2014-15 Supreme Court Highlights"

Approaching the midpoint of its 2014-15 term, the Supreme Court has added to its docket several cases with potentially wide-reaching implications for a range of important policy and business issues. The Court accepted for...more

Williams Mullen and Local Counsel, Bryan Davis, Win Declaratory Action Against HSD in New Mexico!!

For those of you who follow my blog, you know that the single state agency in New Mexico, Human Services Department (HSD), accused 15 behavioral health care providers, which made up 87% of the mental health care in NM, of...more

Low Medicaid Reimbursement Rates Violate the Supremacy Clause?! …The Supreme Court to Weigh In!

Today is a big day. Not only will most of us return to work after a long weekend, but the Supreme Court will hear oral arguments on a very important issue....more

Food Fights Make Bad Law

The axiom "hard facts make bad law" never held so true than in the case of the Minnesota Supreme Court's decision in Medical Staff of Avera Marshall Regional Medical Center vs. Avera Marshall, issued on December 31, 2014. ...more

AZ Supreme Court Holds AZ Legislators Have Standing to Challenge AZ Law, But Media Mischaracterizing the Lawsuit

It seems that the media have become so accustomed to polarizing the topic of Medicaid expansion that reporters seem incapable of truly assessing the issues objectively and reporting accordingly. This has happened recently...more

Supreme Court Update: Dart Cherokee Basin Operating Co. V. Owens (13-719) And Heien V. North Carolina (13-604)

Greetings, Court fans Long before he became Chief, John Roberts quipped that "[o]nly Supreme Court justices and schoolchildren are expected to and do take the entire summer off." Right now, the Justices are in the midst...more

Texas Appeals Court Invalidates Certain Medicaid Payment Hold Rules

Last week, a Texas appeals court invalidated three rules that permitted the Texas Health and Human Services Commission (HHSC) and the Texas OIG to impose a pre-notice payment hold against a Medicaid provider in certain...more

New Jersey Court Supports Peer Review Immunity for Hospital

On November 24, 2014, the New Jersey Appellate Division affirmed a lower court’s decision to dismiss a physician’s lawsuit against a hospital based on federal and state statutory immunity provisions that shield hospitals and...more

Fourth Circuit Applies Sovereign Immunity to Shield State Hospital Supervisors from Suit

Some employers are immune from liability by virtue of their status as a state-run operation. Employees have become more creative in attempting to obtain recovery from their employers in such situations by naming individual...more

D.C. Circuit Upholds Contraceptive Coverage Mandate

Last week, a unanimous three-judge panel of the D.C. Circuit upheld the religious accommodation to the Affordable Care Act’s (“ACA”) contraceptive coverage mandate (Priests for Life v. HHS, D.C. Cir. No. 13-5368, Nov. 14,...more

DC Circuit Dismisses Appeal By Three Hospitals Challenging Subcontractor Status

On November 14, 2014, the United States Court of Appeals for the District of Columbia dismissed as moot an appeal by three hospitals affiliated with the University of Pittsburgh Medical Center. The hospitals had challenged...more

Illinois Supreme Court Rejects Constitutional Challenge to Medical Licensing Amendments

Last month, a unanimous Illinois Supreme Court rejected assorted constitutional challenges to 2011 amendments to the Department of Professional Regulation Law governing medical licensing. In an opinion by Justice Burke, the...more

The Only Surprise Is That It Took This Long...The First Ebola Class Action Has Been Filed

I am always amused by the manner in which class action lawyers attempt to capitalize on current events and public fears in bringing a “cutting edge” lawsuit that will garner a great amount of media attention. Although the...more

Class Action Claims: Gluing Together Systemwide Judicial Relief

The award of class action certification is often the gateway for obtaining lifesaving systemwide judicial relief in broken correctional health care systems. It also can be the beginning of a decades-long, burdensome and...more

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