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Mintz Levin Health Care Qui Tam Update - Recent Developments & Unsealed Cases: November 2014

Trends & Analysis - In the period covered by this issue, we have identified 68 whistleblower cases related to health care that were unsealed. In this Qui Tam Update, we analyze the trends and take an in-depth look at...more

Seventh Circuit Holds Pharmacy Billing Medicaid For Drug Prices Above Private Rates Is Not Fraudulent

On November 12, 2014, the Seventh Circuit upheld the dismissal of a False Claims Act action challenging a retail pharmacy chain’s practice of billing Medicaid for the price differential between the higher Medicaid-negotiated...more

Employment Law - November 2014

State Voters Pass Paid Sick Leave, Wage Increases - Why it matters: The polls have closed and the votes are in: The midterm elections will have a significant impact on employers across the country as voters in multiple...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

The Seventh Circuit Rejects Medicaid False Claims Act Suit

The United States Court of Appeals for the Seventh Circuit affirmed the dismissal of a False Claims Act (“FCA”) case against Shopko Operating Stores, LLC, in which a former Shopko pharmacist asserted Medicaid billing...more

Responding Effectively to Third-Party Subpoenas

It is your lucky day!! A subpoena comes in the mail and makes its way to your desk. The subpoena comes from a creditor involved in a lawsuit with one of your employees and demands that you produce copies of your employee’s...more

Supreme Court will hear King v. Burwell

On November 7, the Supreme Court announced it would hear its second significant legal challenge to the Affordable Care Act (ACA). King v. Burwell, expected to be heard this spring and ruled on by the end of June, is a direct...more

Minnesota Judge Issues Blow to EEOC’s Challenge to Corporate Wellness Program (For Now, Anyway…)

Can an employer require employees to undergo biometric testing or suffer penalties under their health benefit plan as part of a corporate wellness program? On November 3, U.S. District Judge Ann Montgomery refused to grant...more

Seventh Circuit: No Fraud in Billing Medicaid More than Private Insurers for Drugs

Last Wednesday the Seventh Circuit affirmed the dismissal of a whistleblower suit brought by a pharmacist against his former employer, the Shopko pharmacy chain, for what he alleged was fraudulent billing of Medicaid by...more

Uncertain Privilege: Implied Waiver of the Attorney-Client Privilege in False Claims Act Litigation

In a pending False Claims Act (“FCA”) case stemming from alleged violations of the physician self-referral law (the “Stark Law”), 42 U.S.C. § 1395nn, and the federal Anti-Kickback Statute (“AKS”), 42 U.S.C. §1320a-7b, the...more

Supreme Court Grants Review in ACA Tax Subsidies Case

The Supreme Court announced on Friday that it would hear King v. Burwell, a case challenging whether tax subsidies are available to individuals purchasing health insurance through the Federal exchange rather than State...more

November Generality-in-Pleading Award

We’re only one-third of the way through the month of November, but we already have a winner of November’s Generality-in-Pleading Award. The hands-down winner is Dr. Warren Troxler, whose False Claims Act whistleblower suit...more

U.S. Supreme Court Agrees to Hear Arguments Involving Federal Health Insurance Exchange Subsidies

On Friday, the U.S. Supreme Court announced that it would review the U.S. Court of Appeals for the Fourth Circuit’s decision in King v. Burwell. In that case, the Fourth Circuit held that tax credits for health insurance...more

Supreme Court to Decide Who Is Entitled to the Federal Health Care Subsidy

Are the federal government’s subsidies to purchasers of health insurance available only to those who purchase insurance from state-run exchanges or to those who purchase from federal health care exchanges as well? Was the...more

Whistleblowers Must Have Independent Knowledge to Actually Blow the Whistle

To bring a valid qui tam action and overcome the so-called “public disclosure bar” under the False Claims Act (“FCA”), a whistleblower must have direct knowledge of the alleged fraudulent activity, independent of already...more

SCOTUS to Review Subsidy Issue

On November 7, the U.S. Supreme Court announced it was going to review King v. Burwell. At issue in the case is whether Fourth Circuit correctly determined that the IRS did not exceed its authority when it released a rule in...more

Don't Fall Into The Gap: Wage/Hour Lawsuit Highlights Risks For Employers

In August, the U.S. Circuit Court of Appeals for the 3rd Circuit affirmed dismissal of five purported class or collective actions brought against a number of healthcare systems and their affiliates. Although favorable for the...more

Federal Judge Denies EEOC’s Petition for Temporary Restraining Order; Allows Employer to Penalize Employees Who Decline to...

Last week, we blogged about the EEOC’s recent litigations involving employee wellness programs, including the Honeywell case where the EEOC sought to prohibit Honeywell from penalizing employees who decline to participate in...more

Government demonstrates willingness to enforce Affordable Care Act provision that could cost providers millions of dollars

Under a little-known provision of the Patient Protection and Affordable Care Act (“ACA”), healthcare providers could face millions of dollars in liability for failing to reimburse the government for overpayments in a timely...more

The Contraception Coverage Controversy Continues…

As we have been discussing, the Affordable Care Act (“ACA”) requires all health plans to cover preventive health services for women, including all Food and Drug Administration (“FDA”)-approved contraceptives, at no cost (i.e....more

Employment Law - Oct 2014 #3

DOL Grants Could Signal More Misclassification Actions - Why it matters: Employers have faced a tidal wave of litigation over the alleged misclassification of employees as independent contractors, with workers ranging...more

Recent Employee Benefit Developments - October 2014

IRS Expands Cafeteria Plan Status Change Events - On September 18, 2014, the Internal Revenue Service issued Notice 2014-55, which establishes two new change in status events for cafeteria plans. The new change in...more

Doctors and Lawyers and Such

When doctors and lawyers get sideways with their business partners, they might dispute whether one or more of them are really “employees.” In a recent case, an anesthesiologist alleged disability and sex discrimination. To...more

With Prejudice: Judge Dismisses FCA Claim and Orders Sanctions Against Attorney

On October 16, 2014, United States Magistrate Judge Jeremiah McCarthy of the Western District of New York issued a Report and Recommendation to District Judge William Skretny in which he recommended dismissal with prejudice...more

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