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Washington Court of Appeals Expands "Jeopardy" Element of Claim for Wrongful Discharge in Violation of Public Policy

This month the Washington State Court of Appeals, Division III issued a ruling in Becker v. Community Health Systems, Inc. that expands protections in a wrongful termination action based on violation of a public policy....more

Third Circuit Affirms Dismissal of FLSA Overtime Claims in Hospital Meal Break Cases

On August 26, the United States Court of Appeals for the Third Circuit affirmed the District Court’s dismissal of the Fair Labor Standards Act (FLSA) overtime claims brought against a myriad of health care systems and their...more

Seventh Circuit Limits “Worthless Services” Theory under False Claims Act

On August 20, 2014, the Seventh Circuit struck another blow against relators’ and the federal government’s increasingly aggressive False Claims Act theories of liability. Rejecting the relators’ use of the “worthless...more

Another Court Weighs in on Rule 9(b)’s Requirements Under the False Claims Act

A federal district court recently dismissed a qui tam relator’s complaint in a declined case against the Hospital for Special Surgery (“Hospital”), its former CEO, and an outside billing company alleging that they violated...more

Health Alert (Australia) - Week of August 25, 2014

In This Issue: Judgments; Legislation; and Reports. Excerpt from Reports: Australia. Department of Health & Ageing Media releases - 20 August 2014 - New Centre to Deliver More Health...more

Summer Fraud and Abuse Roundup

The federal government was busy over the summer when it came to decisions and settlements under the Stark Law, anti-kickback law and federal False Claims Act. This article revisits recent developments with respect to...more

Oral COBRA Notice OK?

In a recent District Court opinion, a judge dismissed a COBRA claim against an employer based on the oral notice the employer gave a former employee of her right to continue coverage under COBRA. The court said that the...more

One Step Closer to the Supreme Court: The Fate of Obamacare Premium Tax Credits in the Face of the Circuit Split

Last month, two federal courts of appeals issued opposing decisions on whether the Patient Protection and Affordable Care Act (the “ACA”) permitted subsidies, in the form of premium tax credits, to health coverage bought...more

The Hobby Lobby Decision and Religious-Based Exemptions

On June 30, 2014, the United States Supreme Court issued a ruling which held that a closely held, for-profit entity can object to certain aspects of the birth control mandate imposed by the Patient Protection and Affordable...more

Summer 2014 SCOTUS Roundup: Burwell v. Hobby Lobby

To close out our review of the Supreme Court’s summer decisions impacting labor and employment issues, we’ll examine the ramifications of the much-publicized and hotly discussed Burwell v. Hobby Lobby....more

Affordable Care Act Update: Courts Divided on who is Eligible for Subsidies on the Exchange

On July 22, 2014, within 2 hours of each other, two U.S. Courts of Appeal issued conflicting rulings on whether subsidies may be offered in states that use the federal insurance exchange. Background. The...more

No delay of game – Affordable Care Act (ACA) compliance efforts should continue, despite court rulings

Perhaps you have put your compliance efforts on the back burner, hoping the ACA will just go away. We have heard many reasons for this procrastination, including the constitutional challenge to the individual mandate, the...more

ERISA (8th Circuit): Over-The-Counter Vitamin Supplements Trigger Pre-Existing Condition Exclusion

What sort of “medical treatment” triggers the pre-existing condition exclusion in an ERISA-governed disability policy?...more

For-Profit Companies Find Religion – What’s a Transactional Lawyer to Do?

Last month, the United States Supreme Court ruled in the Hobby Lobby case that closely held for-profit corporations can have “free exercise rights” as “persons” under The Religious Freedom Restoration Act of 1993 (“RFRA”),...more

HEAL Advisory: How Big Is Halbig? The Potential Effects of This Major Ruling Are Numerous and Significant

On July 22, 2014, the U.S. Court of Appeals for the D.C. Circuit and the U.S. Court of Appeals for the Fourth Circuit issued conflicting opinions on a key aspect of the Affordable Care Act ("ACA"). The cases are Halbig v....more

Capital Thinking: Health Care

LEGISLATIVE ACTIVITY - On Monday, July 28, the House Committee on Energy and Commerce, Subcommittee on Health will hold a markup to consider two bills: H.R. ____, a bill to require the Secretary of Health and Human...more

Circuit Courts Split on ACA Subsidies

On July 22, 2014, United States Circuit Courts of Appeals from two different circuits issued opposing rulings on the legality of the Federal government providing subsidies to eligible buyers of health insurance products from...more

The Affordable Care Act—Countdown to Compliance for Employers, Week 22: Charting the Future of the Premium Subsidies (and Employer...

On July 22, 2014, two federal appellate courts issued conflicting decisions, within hours of each other, regarding the IRS final rule published on May 23, 2012 (the “IRS Rule”), intended to implement the exchange-related tax...more

Conflicting Rulings on Health Insurance Subsidies Raise Concerns Among Insurers and Providers

On Tuesday, July 23rd 2014, separate federal circuit court panels issued conflicting rulings regarding whether the government could subsidize health insurance premiums for Americans enrolled in federally-run health exchanges....more

Joint Employment Finding Leads to Unexpected $3 Million Liability in Hospital Malpractice Case

When Washington Hospital obtained an insurance policy in 2003 to cover medical claims arising from acts by its employees, its insurer probably did not consider whether hospital employees included workers supplied by a...more

Of Mice and Elephants: Halbig and King and The Struggle of Two Federal Appeals Courts to Find Meaning in Words That May or May Not...

At issue in Halbig v. Burwell and King v. Burwell is whether or not subsidies to buy insurance on an exchange are available in both state and federal exchanges. On its face the Affordable Care Act (“ACA”) provides for...more

Circuit Court Split Casts Doubt on PPACA Subsidies for Individuals and Employer Penalties in 36 States

Two federal appeals courts issued conflicting rulings on July 22 on whether individual premium subsidies under the Patient Protection and Affordable Care Act (PPACA) are available in 36 states that have federally run...more

Federal Courts Make Conflicting Rulings on Premium Assistance for Federal Exchange Plan Participants

Does the Affordable Care Act (ACA) authorize the payment of premium and copayment subsidies, or “premium assistance subsidies,” to individuals enrolled in a federally established Exchange? On July 22, 2014, two federal courts...more

Clash of the Circuits: Federal Exchange Subsidies at Risk?

These four words “established by the state,” at first blush do not appear obtuse or particularly vague. But these four words form the basis for the latest challenges to the Affordable Care Act (ACA) and have resulted in two...more

U.S. Appeals Courts Issue Conflicting Decisions on Whether ACA Permits Tax Subsidies of Health Care Coverage Purchased Through...

On July 22, 2014, three-judge panels of the U.S. Courts of Appeals for the District of Columbia and Fourth Circuits issued conflicting decisions regarding whether the Affordable Care Act (ACA) permits federal tax credits for...more

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