General Business Health

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

No Resuscitation of Hospital’s Exclusive Dealing Antitrust Suit against Competing Hospitals and Physicians

The Third Circuit reminds, “[i]n antitrust suits, definitions matter.” Last week, in applying that maxim, the court affirmed a lower court’s dismissal of a suit filed by a hospital against a competing hospital and physician...more

Changes in Cuba May Impact the Insurance Industry

While much remains to be determined, the recent easing of U.S. restrictions on travel to and trade with Cuba may bring opportunities for U.S. and global insurance companies. However, many questions and obstacles remain. This...more

Two New England States Pass Legislation Restricting Physician Non-Competes

We’ve written a lot this summer about the Massachusetts legislature’s latest failed attempt at non-compete reform. Two other states in New England, however, are able to claim accomplishments in that regard. Specifically,...more

SEC Takes Aim at Anti-Whistleblower Employment Agreements

On August 15, 2016, the U.S. Securities and Exchange Commission (SEC) issued its second fine in six days to a health insurer for allegedly creating severance agreements that illegally restrict former employees from collecting...more

A Plague O’ Both Your Clauses: Insurance Probably Won’t Cover Businesses Stung By Zika

During the past several months, Zika virus has rapidly spread across Latin America and into the United States. While Congressional action has stalled, the Centers for Disease Control and Prevention (CDC) has issued a number...more

Drug Companies and Charitable Patient Foundations

Charitable organizations can easily become enmeshed in Justice Department enforcement issues. We have seen charities used in FCPA cases as a means to funnel bribes to government officials, spouses or family members....more

Texas Diagnostic Imaging Service Settles FCA Allegations for $3.5 Million; Whistle-Blower to Receive $596,700

A recent settlement illustrates the substantial recovery available to whistle-blowers under the FCA’s qui tam provisions. Those provisions allow a qui tam plaintiff to receive typically between 15 percent and 25 percent of...more

The Dennis Decision: A Shot Across the Bow for Hospitals

A recent Virginia court decision questions the reasonable value of health care services and creates a challenge to debt collection efforts by hospitals. In March, the Circuit Court for Henry County, Patrick County, and the...more

HIPAA News: HHS Getting Tough On ePHI Data Breaches

On August 4, 2016, the U.S. Department of Health and Human Services, Office of Civil Rights (OCR) announced a record-setting settlement with Advocate Health Care Network (Advocate) for multiple potential violations of HIPAA...more

Headlines from Mid-Year FCPA Enforcement Review

Just to add my voice to the cottage industry surrounding FCPA enforcement and compliance, I wanted to take a deep breath and offer some observations on FCPA enforcement in 2016. There are a few significant headlines...more

Anti-Discrimination, Language Access Rules Compliance Deadline Fast Approaching for Health Insurers

Health insurers and HMOs have a limited time to review the new federal meaningful access rules and amend plan documents accordingly. However, many payors still have not revised their plans to include the required language,...more

Terminal Prognosis For Physician Non-Competes in Rhode Island?

Non-competition provisions signed by Rhode Island physicians on or after July 12, 2016 are now unenforceable pursuant to recent legislation. As summarized in a prior post, the Rhode Island Superior Court in the case Medicine...more

California Health Care District Financing Techniques

Across the nation, the delivery of health care services is undergoing a period of transformation. Much of this change is being driven by The Affordable Care Act signed into law in 2010. Many hospital facilities in...more

Basic Contract Issues for New Physician Contracts

When physicians have finally completed the medical education journey, many are confronted with a “physician employment contract,” usually from a hospital or medical practice, which could define the essential terms of their...more

Insurers Challenge Retroactive Application of New Florida Law that Requires Comparison of Names of Accounts to Death Master File

Amendments to the Florida Disposition of Unclaimed Property Act in 2016 made significant changes to unclaimed property presumptions and insurance company obligations. See § 717.107, Fla. Stat. (2016) (the Act). Among other...more

HHS OCR Guidance on Ransomware Attacks: They Constitute a “Security Incident” and Are Likely a Data Breach

On July 11, 2016, the HHS Office of Civil Rights (OCR) released guidance on HIPAA covered entities’ responsibilities in a ransomware attack, a type of cyber-attack that has targeted the health care sector extensively in...more

No Health Insurers Need Apply: Health Plan Can’t Recover Medical Costs From NY No-Fault Insurer

Under no-fault laws, automobile policies typically must cover the cost of certain medical services provided to policyholders who have been injured in covered accidents. New York’s insurance laws also permit those costs to be...more

OCR Announces First HIPAA Enforcement Action against a Business Associate

The U.S. Department of Health and Human Services Office for Civil Rights (OCR) announced an agreement with Catholic Health Services of the Archdiocese of Philadelphia (CHCS), settling allegations that CHCS violated the Health...more

It’s Time to Update Physician Noncompete Agreements in Connecticut

There have been a number of recent legislative developments that will impact physician noncompete agreements entered into in Connecticut. First, any physician noncompete agreement entered into on or after July 1, 2016, must...more

Check Up on Healthcare Fraud Prosecutions

Chief compliance officers face an overwhelming level of risk in the healthcare sector. I do not mean to belittle the risks of corruption, AML, sanctions and other risks typically associated with global companies. Healthcare...more

DOJ Challenges Health Insurance Merger

On July 21, 2016, the Department of Justice, Antitrust Division (the “DOJ”) announced that it, along with several state attorneys general, would sue to block two multi-billion dollar health insurance mergers between Aetna and...more

Hospital/Physician Leases Compliance Checklist

LEGAL REQUIREMENTS: A "no" answer to any of the following questions may mean your lease is out of compliance with applicable laws. Is the lease in writing? Is the lease signed by both parties? Does it...more

Is There Coverage for The Pill Mill Lawsuits?

In an effort to deal with the terrible epidemic of drug abuse and the human and economic costs of this dilemma, the state of West Virginia has brought lawsuits in several jurisdictions against pharmaceutical companies and...more

Breach of ePHI Results in $2.7 Million Fine

Oregon Health & Science University (“OHSU”) has paid $2.7 million to the U.S. Department of Health and Human Services, Office for Civil Rights (“OCR”) to settle allegations that it violated the Health Insurance Portability...more

No More Surprises: Florida Ends Certain Medical Balance Billing

"Surprise medical billing" occurs when a patient receives care at a facility and receives treatment from a provider, such as an anesthesiologist or radiologist, who is not contracted with the patient’s health insurance plan....more

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