General Business Civil Remedies Health

Read need-to-know updates, commentary, and analysis on General Business issues written by leading professionals.
News & Analysis as of

Managing Institutional Risk: Fraud-Proofing Your Organization

In this presentation: - Top 5 Fraud and Abuse Risks Facing Health Systems - Results of Enforcement Action - Top 5 Steps Health Systems Can Take To Minimize Fraud & Abuse Risk - Non-Compliant...more

FTC Obtains $26.8 Million in Disgorgement to Settle Monopolization Claims

On April 17, 2015, the Federal Trade Commission (FTC) entered into a settlement with Cardinal Health, Inc. (Cardinal) to resolve allegations that Cardinal, the largest and in certain areas the sole operator of...more

Non-Compete Nonsense: Louisiana Enforces Non-Competes Against Cardiologists (but not Car Dealers)

A recent case out of the Louisiana Court of Appeal reminds us that some states will enforce physician non-compete agreements, even in the absence of a clear protectable interest and even where such enforcement threatens harm...more

FDA Approves First US Biosimilar but Court Action Could Delay Market Entry

On March 6, 2015, the U.S. FDA announced that it had approved Zarxio, making Sandoz the first company ever to obtain approval of a biosimilar product in the U.S. The FDA deemed Zarxio to be biosimilar to Amgen’s Neupogen...more

Anatomy of a Provider-Merger Antitrust Challenge (Part 3)

This is the third in a six-part series discussing the Federal Trade Commission's challenges to provider mergers. Following the initial Introduction and Background (Part 1), the series discusses The Need for Early Legal Advice...more

Standard Of Reasonableness In Contract With Public Body: Wednesbury Not Applied

In David Krebs v NHS Commissioning Board (As successor body to Salford Primary Care Trust) [2014] EWCA Civ 1540 The Court of Appeal ruled that the NHS Commissioning Board (NHSCB) had not acted unreasonably in terminating a...more

California Physician Pleads Guilty to Failing to File FBAR for Bank Leumi Account

On February 2, 2015, Baruch Fogel, a California doctor, pleaded guilty in the U.S. District Court for the Central District of California to one count of willful failure to report the existence of a foreign bank account on a...more

CFO’s Thirst for Wine Club Invitation Costs Hospital Millions

You can’t make this stuff up. Last Monday a federal court in Rhode Island ordered two insurance companies to pay a $30 million claim by hospital management company Lifespan Corp. Lifespan filed the claim after being ordered...more

Catch Me If You Can: Fake Doctor’s Application Voids Coverage for Himself But Not for Innocent Co-Insureds

Written like a blockbuster Hollywood film, the U.S. District Court in South Carolina, in Evanston Insurance Company v. Agape Senior Primary Care, et al., 2014 WL 5365679, issued a ruling October 21, 2014, in which it held...more

Provider of Physical, Speech, and Occupational Therapy Services Agrees to $38,000,000 False Claims Act Settlement

As announced in an recent press release, Extended Care Health Services, Inc. (“Extendicare”), an operator of skilled nursing facilities, and its subsidiary Progressive Step Corporation (“Pro Step”), a provider of physical,...more

Torts – Effect of The Howell Decision on Liens Brought Under The Hospital Lien Act

Dameron Hospital Association v. AAA Northern California, Nevada, and Utah Insurance Exchange et al. - California Court Of Appeal, Third Appellate District (September 4, 2014) - In Howell v. Hamilton Meats (...more

Insurers, Be Ready To Pay Twice In Texas

Often, an insurance carrier will issue a check to two joint payees — the named insured and either a public adjuster or a mortgagee. What happens when the one payee cashes the check without first obtaining a signature from the...more

New Jersey Superior Court Appellate Division rules that physicians’ damages for breach of contract with hospital are limited to...

The New Jersey Superior Court Appellate Division recently ruled that the damages a physician-independent contractor can recover are limited to those sustained during a notice period in the physician’s contract. The decision...more

Government Issues New Rules for Religious Employers, But Health Plans, TPAs, and PBMs are still on the Hook to Provide...

The Affordable Care Act (“ACA”) requires that non-grandfathered health plans make preventive care and screenings available to their members at no cost (i.e. no deductibles, coinsurance, or co-payments). The Department of...more

Hospital Recovers Income Guarantee Payments from Suspended Physician

It should come as no surprise there are cases in which hospitals seek to and actually do recover income guarantee payments made to physicians whom, either through termination of employment or loss of hospital privileges, fail...more

First Circuit Rejects Talley and Allows a Business Expense Deduction for Settlement Payments Made Under the False Claims Act

On August 13, 2014, the United States Circuit Court for the First Circuit rejected the United States’ request to deny Fresenius Medical Care Holdings Inc. from deducting a portion of a settlement payment to settle civil...more

Points & Authorities - Spring 2014

In this Issue: - AB 1000 and Corporate Practice in California: More than Meets the Eye—or Less? - Loose Lips Sink Ships and Careless E-mails Torpedo a Transaction - New Faces - Points from the...more

Physician Obtains Injunction Preserving Clinical Privileges Despite Attempted Exclusive Contract

Despite the many cases acknowledging the right of hospitals to enter into exclusive contracts, there is always the issue of what happens with the existing clinical privileges and medical staff memberships of the physicians...more

Appeals Court Sides With Hospitals, Rejects Health Plan’s Demand for Refund

The United States Court of Appeals for the Seventh Circuit recently affirmed a Wisconsin district court’s grant of summary judgment in favor of two Wisconsin hospitals, ruling the hospitals were not obligated to repay $1.7...more

Mississippi Governor Rescinds Executive Order Requiring Blue Cross of Mississippi to Grant “In Network” Status to Excluded...

In early November, Mississippi Governor Phil Bryant rescinded an Executive Order (Executive Order 1327), issued only weeks earlier, that would have compelled Blue Cross of Mississippi to continue to offer “in-network” status...more

Judge Finds Illinois Insurance Department's Policy Prohibiting Offshoring To Be Improper Rulemaking

On November 27, 2013, the Circuit Court of Cook County, Illinois issued an Order in a lawsuit filed by the American Council of Life Insurers, Inc. ("ACLI") v Andrew Boron, Director of the Illinois Department of Insurance and...more

Court Orders Tuomey to Pay $237 Million for Violations of Stark and False Claims Act

On October 2, 2013, the United States District Court for the District of South Carolina issued an Amended Order and Opinion directing the entry of a civil judgment against Tuomey Health Care System (Tuomey) in the amount of...more

Defendants Must Keep Insurance Coverage Considerations in Mind When Settling Class Action Lawsuits

On July 18, 2013, a Pennsylvania appellate court held that class action defendant Cigna Corporation (Cigna) was not entitled to insurance coverage for any part of a settlement it paid to plaintiffs because Cigna did not...more

The High Cost of Paying Physicians for Referrals: Tuomey Healthcare System Faces Penalties of up to $357 Million

On May 8, 2013, a jury sitting in the U.S. District Court for South Carolina found that Tuomey Healthcare System, Inc. violated the Stark Law and the False Claims Act (FCA) by illegally paying referring physicians. The jury...more

Washington Supreme Court: Insurers May Not Reserve the Right to Seek Reimbursement of Non-covered Defense Costs

The Washington Supreme Court joined a minority of jurisdictions that hold that insurers may not unilaterally reserve the right to seek reimbursement for defense costs paid in defending non-covered claims through a reservation...more

63 Results
|
View per page
Page: of 3

Follow General Business Updates on:

"My best business intelligence, in one easy email…"

Your first step to building a free, personalized, morning email brief covering pertinent authors and topics on JD Supra:

Sign up to create your digest using LinkedIn*

*With LinkedIn, you don't need to create a separate login to manage your free JD Supra account, and we can make suggestions based on your needs and interests. We will not post anything on LinkedIn in your name. Or, sign up using your email address.
×