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What Has Fahlen Wrought?

The California Supreme Court's decision in Fahlen v. Sutter Central Valley Hospitals has confirmed (not created) a sea change in the relations between hospitals and their medical staffs on the one hand, and physicians on such...more

OFCCP Withdraws Claim Regarding TRICARE Jurisdiction

Last week, the Office of Federal Contract Compliance Programs (OFCCP) dismissed OFCCP’s 2008 complaint against Florida Hospital of Orlando. In its Order of Dismissal, the Administrative Law Judge (ALJ) reported that OFCCP...more

Affordable Care Act Update April 7, 2014: High Courts Vet Key Provisions Of The Affordable Care Act Government Extends Enrollment...

March 2014 has produced quite a bit of activity regarding the Patient Protection and Affordable Care Act ("ACA"). On March 24, 2014, oral argument was held in the latest challenges to the ACA in Sebelius v. Hobby Lobby...more

TRICARE Complaint Dismissed Against Florida Hospital

On March 28, 2014, the OFCCP withdrew its jurisdictional Complaint against Florida Hospital of Orlando after several years of litigation. OFCCP alleged it had jurisdiction to conduct an audit because the Hospital...more

Religious Freedom, Contraceptive Services, and The ACA: The Dilemma of the Self-Certification Provision

On February 21, 2014, the Seventh Circuit Court of Appeals, in a 2-to-1 decision, denied a preliminary injunction enjoining the federal government from enforcing the self-certification provisions of the Affordable Care Act...more

Employee Benefits Developments - March 2014

On January 9, 2014, the Departments of Labor (DOL), Health and Human Services (HHS), and the Treasury (collectively, the “Departments”) issued additional health care reform guidance in the form of Frequently Asked Questions...more

Whistleblowers, Do Tell?

Whizzle Blour, a professor of surgery at University Medical School, complained to his supervisor that trauma residents at University Hospital were treating and operating on patients without an attending physician’s...more

California Supreme Court Allows Whistleblowing Doctor To Sue Before Exhausting Judicial Remedies

Fahlen v. Sutter Central Valley Hospitals, S205568 (February 20, 2014): The California Supreme Court recently held that a physician, who claimed that a hospital terminated his staff privileges in retaliation for raising...more

Take 5 Newsletter: 5 Employment Law Considerations in "The Cloud"

What is "the cloud," and what on Earth (pun intended) does cloud computing have to do with employment law? While many definitions abound, cloud computing at its core is a form of remote electronic data storage,...more

California Supreme Court Expands Protections To Whistle-Blowers And Weakens Hospital Peer Review Systems

The recent decision by the California Supreme Court in Fahlen v. Sutter Central Valley Hospitals, No. S205568 , 2014 WL 655995 (Cal. 2014) may significantly weaken the efficacy of hospital peer review proceedings in...more

Do Your Plans Include a Time Limit on a Participant’s Right to Sue?

Some, but far from all, employee benefit plans set a limit on the amount of time a participant has to file a lawsuit claiming benefits under the plan. Until recently, however, not all courts would recognize these plan...more

High Court Employee Benefits Cases: A Review and Look Ahead

Having settled into the new year, we reflect on decisions from the U.S. Supreme Court in 2013 that are likely to have a significant impact in the world of pension and welfare employee benefits and, in some cases, already have...more

Omnicare Decision Limits the Reach of False Claims Act

A recent decision by the Court of Appeals for the Fourth Circuit limiting the reach of the False Claims Act demonstrates how relators who pursue cases in which the government declines to intervene can end up making law that...more

Shaking Down the Thunder from the Sky: Notre Dame’s Challenge to the Contraception Mandate

The Supreme Court will inevitably decide to what extent the Religious Freedom Restoration Act protects religiously affiliated employers from providing insurance coverage for contraceptive services, as is generally required...more

"Cursory Services" May Be "Worthless Services" Under False Claims Act

A recent federal court decision allowed the federal government to proceed with a False Claims Act (FCA) case involving an allegation that a health care provider’s “services were so cursory that they were worthless.” U.S. v....more

Feds’ Argument in Favor of Premium Tax Credit Gains Momentum, Still Under Attack in Federal Courts

A second federal district court judge has ruled in favor of the government on one of the most serious challenges to the Patient Protection and Affordable Care Act of 2010 (ACA). The court dismissed a challenge to the...more

The Fahlen Floodgates: Straight Talk about Two-Track Peer Review

The California Supreme Court unanimously ruled on February 20, 2014, that a physician claiming that her/his privileges were terminated in retaliation for whistleblowing to safeguard patient care and safety does not have to...more

The ERISA Litigation Newsletter - February 2014

The employee benefits issues to be considered by the U.S. Supreme Court continue to be of great significance to plan sponsors and fiduciaries. This month we review the Court's employee benefit decisions from 2013 and also...more

Ninth Circuit Sides with Orange County in Retiree Health Benefits Case

A Practice or Policy without Clear Legislative Intent Does Not Create Implied Contractual Right to Retiree Health Benefits - A federal appellate court has affirmed a U.S. District Court’s decision to grant Orange...more

Common Employers in Class Actions

In mid-December, Justice Paul Perell released an interesting decision involving wage claims made by post-doctoral fellows at Sunnybrook Hospital (Pasian v Academic Clinicians’ Management Services, 2013 ONSC 7787)....more

Court of Appeal Holds that State Courts Have Concurrent Jurisdiction over FCA Retaliation Claims

On January 30, 2014, the California Court of Appeal for the Fifth Appellate District ruled that California State courts have concurrent jurisdiction over retaliation claims under the federal False Claims Act (FCA) in Driscoll...more

Cal. Appellate Court: Cal. State Courts Have Concurrent Jurisdiction Over FCA Retaliation Claims

On January 30, 2014, the California Court of Appeal for the Fifth Appellate District ruled that California State courts have concurrent jurisdiction over retaliation claims under the federal False Claims Act (FCA) in Driscoll...more

Benefits Litigation Update - January 2014

In this issue: - Will Section 510 of ERISA Restrict Workforce Structuring under the Affordable Care Act? - A New Threat to Sponsors and Fiduciaries: Equitable Remedies After Amara - First ERISA Decision...more

The ERISA Litigation Newsletter - January 2014

This month we look at part three of our three part series on Class Actions. In part three, Robert Rachal and M. Todd Mobley address the role of experts in class certification post Wal-Mart and Comcast and how to use and...more

District Court Relies on Recent Supreme Court Decision to Uphold Plan Limitations Provision

A federal district court in New Jersey granted summary judgment in favor of New Jersey Bac Health Fund, finding the limitations provision set forth in the Fund’s SPD to be reasonable. Barriero v. NJ Bac Health Fund, 2013 U.S....more

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