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Trove of SNF Claims Data Released By CMS – Ready for Mining By Auditors and Whistleblowers

Over recent years, the Federal government has trained its sights on potential billing abuses in the Medicare Part A program for Skilled Nursing Facilities (“SNFs”) in the provision of rehabilitation therapy services. The...more

So You’ve Filed Your 1095-C…Now What?

As companies complete their Section 6055 and 6056 reporting under the Affordable Care Act (ACA), now it’s time to be on the lookout for notices regarding ACA penalties....more

Labor & Employment E-Note - April 2016

In an article published by the Birmingham Business Journal ("BBJ") in the March 25 print edition, Bryance Metheny provides insights into a series of questions related to labor and employment law, including what are some legal...more

Supreme Court Seeks Meaning in Falsity and Fraud in the False Claims Act

Oral arguments were heard Tuesday, April 19th by the U.S. Supreme Court in one of the most significant False Claims Act (FCA) cases the Court has dealt with in decades on an issue with very real impact on whistleblower suits...more

Nursing Manager, Removed from Patient Case, Seeks Supreme Court Review in Discrimination Case

Petitioner to the Supreme Court claims that the Sixth Circuit engaged in a “separate but equal” rationale when it rejected her claim that her employer discriminated against her based on race after the employer allegedly...more

A Wellness Win for Employers, But Will it Last?

As explained in our April 21, 2015 and May 9, 2015 blog posts, wellness programs that are part of a group health plan are subject to the HIPAA nondiscrimination rules, and other state and federal laws including, but not...more

Florida’s Agency for Healthcare Administration Announces Crackdown on Employee Background Checks

Florida’s Chapter of the Assisted Living Federation of America just advised that Florida’s Agency for Healthcare Administration released an e-blast today warning that it will begin to carefully scrutinize employee rosters at...more

Employee Benefits & Executive Compensation Advisory: The ACA: New Concerns for Employer Plan Sponsors Under the Fair Labor...

The Affordable Care Act (ACA) anti-retaliation provisions have been in effect for several years, but have so far largely gone unnoticed. Now that employees can get financial assistance through the Health Insurance...more

EEOC v. Flambeau, Voluntary Plans, the Insurance Safe Harbor, and the Future of Wellness Programs

The benefits world was set abuzz late last year with Equal Employment Opportunity Commission v. Flambeau, Inc., in which the Federal District Court for the Western District of Wisconsin upheld the validity of Wisconsin-based...more

Retaliation Claim Survives Though False Claim Act Claim Is False

Roxanne Perkins was employed as a clinical supervisor of prior authorizations therapy at Wellcare Health Plans. When she returned from a leave of absence, she learned that Wellcare had instituted a new practice of approving...more

Five Challenges Facing Employers in the Health Care Industry

Employers in the health care industry are facing a number of looming threats. Workplace violence is one of the most serious occupational hazards facing health care workers, while cyber-attacks pose a significant threat to the...more

Massachusetts SJC Lightens Plaintiffs’ Summary Judgment Burden in Employment Discrimination Cases

Last week, the Massachusetts Supreme Judicial Court issued a seminal ruling in Bulwer v. Mt. Auburn, which clarified the type of evidence an employment discrimination plaintiff needs to defeat a summary judgment motion. In...more

Hospice Care Eligible Patient Certification is a “Condition of Payment” Under False Claims Act

In order to state a cognizable claim under the False Claims Act (“FCA”) on a false certification theory, a plaintiff must allege that a defendant failed to comply with a federal statute or regulation that was a “condition of...more

What is The Status of OFCCP Jurisdiction Over Healthcare Providers?

In recent years, the U.S Department of Labor’s (DOL) Office of Federal Contract Compliance Programs (OFCCP) has aggressively argued that healthcare providers that participate in one of three federal healthcare...more

Employment Law - March 2016

Failure to WARN Alleged in Complaint Against Yahoo - Why it matters - In a novel lawsuit, a former employee of Yahoo claims that the company manipulated its performance-review rating system in order to dodge both...more

EEOC Loses Another Wellness Case, Part 2 – Beware the ACA Penalties

In my last blog post, I discussed a recent loss by the EEOC in its efforts to limit the ability of employers to require employees to complete health risk assessments (HRAs) or biometric screenings in order to enroll in the...more

Illinois Medical Marijuana Law: What Employers Should Know

Currently, 23 states have enacted laws to legalize medical marijuana. Medical marijuana laws are challenging for all employers, but particularly multistate employers, as employers must reconcile federal and varying state...more

EEOC Loses Another Wellness Case, Part 1

The EEOC has been bringing lawsuits against employers challenging wellness programs. A recent case involved a company that had previously provided a credit to employees enrolled in the health plan who participated in a health...more

Most States Delayed in Implementing Long-Term Care Background Check Program, OIG Finds

The Office of Inspector General’s (OIG’s) recent report found significant delays in states’ implementation of a background check program for long-term care employees. Because the interplay between Ban the Box laws and...more

SJC Rules in Employment Discrimination Cases a Plaintiff Need Only Show the Reason for Discharge was Untrue to Survive Summary...

On February 29, 2016, the Massachusetts Supreme Judicial Court (“SJC”), in Bulwer v. Mount Auburn Hospital, articulated the type of evidence required for a plaintiff to survive summary judgment and have his claims heard by a...more

New Developments in Medical Marijuana and the Workplace

According to the National Conference of State Legislatures, twenty-three states now have medical marijuana laws on the books. The conventional wisdom is that these laws bring with them greater protections for employees who...more

Cutting Hours to Avoid Obamacare Challenged Under ERISA

Since the passage of the Affordable Care Act in 2010, opponents have said that the law will actually hurt employees in two ways. First, companies on the cusp of hiring a 50th full-time employee may hold off in fear of...more

Another Win for Wellness: The Erosion of Voluntary Participation

Consider the following wellness program scenario: A company implements a program that incentivizes employees to take a health risk assessment and undergo biometric screening. The assessment asks questions about the...more

Religious Accommodation in the Healthcare Industry: What to Do When an Employee’s Beliefs Clash With Job Duties

Title VII of the Civil Rights Act of 1964 prohibits employers from discriminating against applicants and employees based on their religion, and requires employers to provide a reasonable accommodation of employees’ sincerely...more

Employment Law This Week: EEOC Enforcement Data, Definition of “Religion,” ACA Class Action, Justice Scalia’s Death [Video]

We invite you to view Employment Law This Week - a weekly rundown of the latest news in the field, brought to you by Epstein Becker Green. We look at the latest trends, important court decisions, and new developments that...more

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