General Business Health

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Breaking: Third Circuit Dismisses Antitrust Suit Concerning Marketing of Lovenox

Earlier today, the Third Circuit Court of Appeals upheld the decision of the District of New Jersey trial court dismissing the antitrust claims lobbed against Sanofi-Aventis by its rival pharmaceutical company Eisai. The...more

Phase 2 of the OCR HIPAA Audit Program Already Underway

On March 21, 2016, the Department of Health and Human Services, Office for Civil Rights (OCR) announced the launch of the long-awaited Phase 2 HIPAA Audit Program (Phase 2), and OCR activities related to Phase 2 are already...more

Your daily dose of financial news The Brief – 5.4.16

MetLife, accused by regulators of misleading tens of thousands of customers about variable annuities—“a product that retirees seek out for safety,” will pay a $25 million dollar fine for its actions. It’s the second-largest...more

California Insurance Commissioner Approves Centene/Health Net Merger

Since the summer of 2015, a great deal of attention has focused on whether the proposed Anthem/Cigna and Aetna/Humana mergers will be approved by federal and state antitrust regulators. These transactions have been the...more

Hello Insurers – Court says CGL may Cover Privacy Breaches Occurring Prior to 2014

In April 2013, Glens Falls Hospital admitted that the medical records for more than 2,300 of its patients were stored for several months on an unprotected computer server. The hospital’s outside records contractor, Portal...more

Your daily dose of financial news The Brief – 4.29.16

Dealbook looks back at a crazy Thursday of healthcare company deals [with Abbott/St. Jude taking the prize for biggest] and concludes that the industry appears to be “convinced, regardless of tax benefits [or common financial...more

FTC Settles Monopolization Charges Stemming from Contract Exclusivity Terms Used by First-to-Market Medical Polymer Maker

The mere possession of monopoly power does not violate federal antitrust laws. The laws only address the anticompetitive acquisition, maintenance, or abuse of that power. The Federal Trade Commission (“FTC”) entered into a...more

New HIPAA Phase 2 Audits: Targets Notified by Email Only

The U.S. Department of Health and Human Services Office for Civil Rights (OCR) recently announced the long-awaited launch of Phase 2 of its HIPAA Audit Program (Phase 2 Audits). The Phase 2 Audits will review the policies...more

Section 1557 of the ACA: The Legal Side of Health Equity

This week marks the end of National Minority Health Month and its 2016 theme of “Accelerating Health Equity for the Nation.” This month, the HHS Office of Minority Health’s goal was to “raise awareness of the health...more

Fourth Circuit Upholds Coverage Under CGL Policy for Data Breach Claims

The United States Court of Appeals for the Fourth Circuit (“Fourth Circuit”) recently concluded that an insurer had a duty to defend a health care company that was sued by individuals whose personal health information was...more

Spring Showers Bring HIPAA Breaches

OCR has announced several recent settlement agreements to resolve violations of the Health Insurance Portability and Accountability Act (“HIPAA”). These settlement amounts range from $25,000 to $3.9 million dollars and...more

OCR Releases Updated HIPAA Audit Protocol and Business Associate Listing Template

The Office of Civil Rights (OCR) recently updated the audit protocol that it will be using to assess Covered Entities’ and Business Associate’s compliance with the Health Insurance Portability and Accountability Act (HIPAA)...more

Supreme Court Hears Oral Arguments in Significant False Claims Act Case

Our colleagues Jackie Baratian and Jason Popp summarize...the oral argument for Universal Health Services v. United Sates ex rel. Escobar heard by the U.S. Supreme Court on Tuesday, April 19th, laying out the various...more

Changes to IRS Partnership and LLC Audit Rules

Recent history has seen a proliferation of health care organizations—including tax-exempt organizations, for-profit companies, and physician practice groups—that have joined together to take advantage of different synergies...more

Medical Non-Competes in Rhode Island: No Clean Bill of Health

The Rhode Island Superior Court recently refused to enforce a non-compete agreement against a local physician because it was against the public interest. Medicine and Long Term Care Associates, LLC v. Khurshid, PC 2015-0458,...more

Department of Health and Human Services Cracks Down on Vendor Oversight in Recent Hospital Settlements

From the rise in ransomware attacks to inadvertent disclosure of information by subcontractors, the health services industry is reminded that a potential consequence of a data breach is the threat of a regulatory enforcement...more

Rhode Island Trial Court Decision Could Spell Trouble for Employers Seeking to Enforce Restrictive Covenants Against Healthcare...

One of an employer’s first steps in a suit against a former employee to enforce a restrictive covenant is to seek a preliminary injunction to prevent the employee from continuing to violate his or her contractual obligations....more

What You Say in Your SPD About Claims Processing Makes a Difference

Employers who self fund their medical plans often have contracts with their third party administrators about claims processing. Some of those contracts provide that the claims processor has discretion to decide claims; others...more

Keeping Coverage Online: Fourth Circuit Confirms Internet Data Breach Claim Triggers Commercial General Liability Policies

In a clear rejection of insurers’ attempts to artificially narrow the broad coverage provided by commercial general liability (“CGL”) policies, the United States Court of Appeals for the Fourth Circuit recently held that an...more

News Flash: An Agreement Between Competitors to Limit Advertising/Marketing Violates the Antitrust Laws

For the second time in less than a year, the U.S. Department of Justice (DOJ) has filed an antitrust complaint against hospital systems that agreed to not advertise on billboards or in print in each other’s home county. Last...more

Bound to Arbitrate Nursing Home Litigation?

When is a personal representative bound to arbitrate claims against a nursing home? The answer depends on the nature of the claim, as illustrated in a recent case. Here’s what happened in Monschke v Timber Ridge Assisted...more

Insurer Must Defend Data Breach Claim Under Traditional Commercial General Liability Policies

On April 11, 2016, the U.S. Court of Appeals for the Fourth Circuit affirmed a ruling by Judge Gerald Bruce Lee of the U.S. District Court for the Eastern District of Virginia that Travelers Indemnity Company of America...more

AGG Food and Drug Newsletter - April 2016

Arnall Golden Gregory LLP's (AGG) Food and Drug Newsletter is a monthly update of legal and regulatory issues that affect the FDA-regulated community, including regular updates on legislative initiatives from AGG’s...more

Insurer Actions Cut the Heart Out of Out-of-Network Providers

Aetna Life Insurance Company recently won a $37 million verdict against a group of Northern California surgical centers, Bay Area Surgical Management, LLC and its affiliates (collectively, Bay Area), for an alleged...more

OCR issues audit protocol and targets over 800 entities—business associates too

The Office for Civil Rights (OCR) has issued its revamped audit protocol for its second phase of auditing covered entities and business associates’ compliance with the HIPAA Privacy, Security and Breach Notification Rules....more

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