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Abbott v. Banner Health Network - Hospitals Cannot Place Liens on AHCCCS Patients’ Third Party Recoveries

The Arizona Court of Appeals recently handed down this decision holding that hospitals that accept payment from the Arizona Health Care Cost Containment System (“AHCCCS”) for services to AHCCCS patients cannot later impose or...more

Physician Medicare Data: Has the Drought Ended?

After 34 years, a federal district court in Florida has overturned a 1979 injunction which prevented the Centers for Medicare and Medicaid Services (CMS) from releasing to the public Medicare data related to physician billing...more

Supreme Court Clarifies Subrogation Rights, Emphasizes Need for Precise Plan Language

Plan sponsors, particularly those that sponsor self-funded health plans, should review plan document provisions in light of the recent decision of the Supreme Court of the United States in US Airways, Inc. v. McCutchen. In...more

Seventh Circuit Rules that Medical Necessity Trumps State-Imposed Cap on “Optional” Medicaid Coverage

In a class action lawsuit, the U.S. Court of Appeals for the 7th Circuit recently affirmed a lower court decision granting a preliminary injunction that prevented the state of Indiana from enforcing a $1,000 annual cap on...more

Revolution in Disputes Between Hospitals and Their Physicians?

Originally published in the Daily Journal on August 24, 2012. A new decision of the state Court of Appeal last week may change the way disputes between hospitals and their privileged physicians will play out. In Fahlen...more

Affordable Care Act Runs Into Religious Freedom Issues in Court

Although the Supreme Court, in a landmark decision earlier this summer, affirmed the constitutionality of the Patient Protection and Affordable Care Act (ACA), the challenges to and controversies surrounding that Act are far...more

False Claims Act Quarterly, Fall 2011

In This Issue: U.S. SUPREME COURT DECLINES TO SETTLE CIRCUIT SPLIT ON IMPACT OF FAILURE TO FOLLOW FCA'S FILING-UNDER-SEAL PROCEDURES The Supreme Court of the United States on June 27, 2011, denied certiorari in U.S....more

California Supreme Court: State Laws on Disclosure of Protected Health Information Are Not Preempted

California has long been considered a bastion of consumer protection and individual privacy rights. By its recently issued decision in Brown v. Mortensen, (2011) 51 Cal. 4th 1052 the California Supreme Court buttressed that...more

Exhaustion of Administrative Remedies Under ERISA Not Required If Exhaustion Would Have Been Futile

Terrance Burnett was eligible for short-term disability (“STD”) benefits and long-term disability (“LTD”) benefits through employee welfare benefit plans funded by his employer, The Raytheon Company, and administered by...more

What to do when your Patient wants to sue?

This article covers: Your Liabilty risks, What to Document, Spotting patients prone to sue as well as how to make sure you chart properly and what should be charted and what should be left out....more

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