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Second Circuit Reminds Healthcare Providers to Seek Relief from Insurance Companies Under Their Own Contracts, Not the Insureds’...

In Rojas v. Cigna Health and Life Ins. Co., 793 F.3d 253, 258 (2d Cir. 2015), the Second Circuit joined several other circuits in holding that “healthcare providers are not ‘beneficiaries’ of an ERISA welfare plan by virtue...more

PSQIA held to preempt florida constitutional right to access adverse medical incident reports

On October 28, 2015, the District Court of Appeal in the First District of Florida held in Southern Baptist Hospital, Inc. v. Jean Charles, Jr. et al. that the federal Patient Safety and Quality Improvement Act of 2005...more

Complicit in Sin: the Burden of the Opt-Out Form

Does filling out a form burden religious beliefs? We’re about to find out. On November 6, the Supreme Court agreed to review a group of seven cases (led by No. 14-1418, Zubik v. Burwell) brought by religious non-profit...more

Supreme Court Update: Mullenix V. Luna (14-1143) And Order List

Was it Jean-Baptiste Alphonse Karr or Jon Bon Jovi who remarked, "The more things change, the more they stay the same"? (They both did!) Over the last few terms, we've encountered a few steady themes in the Supreme Court's...more

Litigation Alert: Federal Circuit’s Ariosa Decision, Good Chance for Rehearing En Banc

In June of this year, the Federal Circuit panel in Ariosa Diagnostics, Inc. v. Sequenom, Inc. invalidated a patent on the grounds of patent-ineligible subject matter. 788 F.3d 1371 (Fed. Cir. 2015). While the case is one of...more

FTC Provides Guidance Regarding Antitrust Compliance for State Regulatory Boards

In North Carolina State Board of Dental Examiners v. FTC, 135 S. Ct. 1101 (2015), the Supreme Court held that the North Carolina Board of Dental Examiners (“Board”), a state agency, was not exempt from federal antitrust laws...more

Second Circuit Finds Member Associations Have Standing to Bring Claims on Behalf of Members

Last month the Second Circuit Court of Appeals reversed the U.S. District Court’s decision to deny the New York State Psychiatric Association (NYSPA) standing in its claim against UnitedHealth Group and related entities...more

Also In The News - Health Headlines - September 2015 #2

Final ACO Fraud Waiver Under OMB Review – The White House Office of Management and Budget (OMB) reported on September 9, 2015, that it began its review of the final rule (CMS-1439-F; RIN 0938-AR30), titled “Medicare Shared...more

First, Arizona Legislature v. AIRC, Now the ACA Subsidies: Standing for Political Institutions

Citing what some might call a quirk of the U.S. Supreme Court’s (SCOTUS) recent opinion in Arizona Legislature v. Arizona Independent Redistricting Commission (AIRC), U.S. District Court Judge for the District of Columbia...more

Court Rejects Claim that a Doctor’s Loss of Privileges is an Antitrust Injury

A federal appeals court held that a doctor who lost his privileges at a local hospital failed to establish an antitrust injury sufficient to confer standing under the Sherman Act. The United States Court of Appeals for the...more

The Difficulty Of Challenging FCA Fine As Excessive

Last month, in U.S. ex rel. Drakeford v. Tuomey, No. 13-2219, (4th Cir. July 2, 2015), the Fourth Circuit affirmed a False Claims Act verdict against a nonprofit hospital in Sumter, South Carolina. In an area of the law where...more

Two Federal Circuit Courts Weigh In Ahead of Gomez

Just two months before the U.S. Supreme Court hears argument in Campbell-Ewald Co. v. Gomez, two federal circuit court panels have ruled on jurisdictional issues presented in the case. Both the Seventh Circuit in Chapman v....more

Circuit Court Affirms $237.5 Million Judgment Against Tuomey

On July 2, 2015, the Fourth Circuit affirmed a $237,454,195 judgment against Tuomey Health Care System (Tuomey) for violations of the Federal False Claims Act (FCA), which liability arose from violations of the Stark law....more

Chasing Payments: District Court Holds that Providers Lack Standing to Sue ERISA Plans for Benefits if the Patients Remain Liable...

A district court in Tennessee recently rejected ERISA claims by healthcare providers against a plan insurer, holding that the providers lacked standing to sue under ERISA as their patients’ assignees. Brown v. Blue Cross...more

SCOTUS Upholds Obamacare Federal Subsidies: A First Glance Analysis

A First Glance analysis of the United States Supreme Court's decision upholding Obamacare subsidies by Robert Projansky, partner at law firm Proskauer in New York, and head of the firm’s Health Care Reform Task Force....more

King v. Burwell – Will the Supreme Court Tip the ACA Dominos? Part 2

In our previous blog post, we evaluated the legal issues at stake in King v. Burwell. We will now examine some of the ramifications of a Supreme Court decision that goes against the Obama Administration, assuming such were to...more

Lack of Typicality and Adequacy of Representation Prevents Class Certification in Health Care Data Breach

The opinion from the Philadelphia Court of Common Pleas reinforces lack of standing as a defense for companies facing data breach–related class actions. On March 25, the Philadelphia Court of Common Pleas provided...more

When a Custodian of Records Has a Fifth Amendment Privilege

In a recent decision, the U.S. Court of Appeals for the Third Circuit held that a physician acting as custodian of records may not withhold records subpoenaed from his professional association on Fifth Amendment...more

Developments in Long-Term Care – Q1 2015

The following summary highlights key federal court cases and administrative decisions involving skilled nursing facility survey issues during the first quarter of 2015. Federal Court Cases - Fifth Circuit Upholds...more

Supreme Court Ruling Could Alter Class Action Landscape

The U.S. Supreme Court has agreed to decide a case that could alter the landscape of federal class action litigation. Granting the defendant’s petition for certiorari in Campbell-Ewald Company v. Gomez, the Court will review...more

Religious Freedom and the Affordable Care Act

The fascinating interplay that weaves between the First and Fifth Amendments to the U.S. Constitution, the Religious Freedom Restoration Act (RFRA) and the Patient Protection and Affordable Care Act (ACA) continues to march...more

"Defamation Claims Brought by Texas Health Care Providers Will Be Subject to Anti-SLAPP Act Requirements"

Health care providers should keep in mind that virtually any suit alleging defamation or other harm from a “communication” relating to the provision of services by a health care professional will be subject to the demanding...more

Supreme Court Update: Rodriguez v. United States (13-9972); United States v. Wong (13-1074 And 13-7075); Oneok, Inc. v. Learjet,...

When is a sniff not up to snuff (as far as the Fourth Amendment is concerned)? Ten years ago, in Illinois v. Caballes (2005), the Court held that a dog sniff conducted during a lawful traffic stop does not violate the Fourth...more

Federal Courts in the Third Circuit are Following the National Trend and Dismissing Data Breach Cases for Lack of Standing

Data breaches are becoming increasingly common. These incidents have spawned considerable litigation, including class action lawsuits brought by individuals whose personal information has been compromised. But many of these...more

Fifth Circuit Finds Out-Of-Network Medical Provider Has Standing To Sue Health Plan

The Fifth Circuit recently addressed an out-of-network provider’s right to sue and whether coverage may be conditioned on collections of patient’s out of pocket costs. North Cypress Medical Ctr. Operating Co., et al. v. Cigna...more

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