Health Civil Procedure

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Medicaid Decision Makes Strange Bedfellows

The Idaho Medicaid program scored a victory in the United States Supreme Court today, and did it by persuading normally liberal Justice Breyer to enter the conservative tent reliably inhabited by Justices Scalia, Thomas,...more

Manatt on Health Reform: Weekly Highlights - March 2015 #5

This week, Medicaid expansion gains traction in Montana, California submits its waiver application to renew DSRIP and to propose several new delivery system transformation and alignment initiatives, and the Supreme Court...more

Multiple class action lawsuits filed against Premera Blue Cross for data breach

Days following Premera Blue Cross’s public announcement that it had experienced a data breach affecting approximately 11 million, it has been sued five times (as of the time of this writing) in proposed class action lawsuits...more

Toward Class Actions for Health-Related Claims in France

Class actions – which are progressively becoming part of the legal landscape in France as “actions de groupe” – will probably soon be extended to personal injury claims against health products manufacturers, suppliers or...more

Hospital Wins First Round Against Largest Rival in Antitrust Suit Alleging Illegal Exclusive Dealing Agreements with Insurers

The waves of change affecting health care providers include reimbursement and funding developments, the impact of the Affordable Care Act, technological and medical advances, provider network design transformations imposed by...more

Volunteer Directors and Officers Liable to Facility Creditors

The Third Circuit Court of Appeals recently upheld a trial court’s jury verdict finding the individual board members and officers of a non-profit healthcare facility personally liable to the facility’s creditors. The board...more

Federal Court Allows Hospital’s Antitrust Claims to Proceed on Narrow Market Definition

Winning an antitrust lawsuit hinges on defining the “relevant market,” and this case may prove the point. Methodist Health Services Corporation notched the first win in its battle against Saint Francis Medical Center as a...more

N.D. Cal Interprets the Biological Price Competition Act

Amgen Inc., et al. v. Sandoz Inc., et al., No. 14-cv-04741RS - On March 19, the Northern District of California became the first court to interpret two key provisions of the Biological Price Competition Act: whether...more

Antitrust “State Action” Exemption: North Carolina State Board of Dental Examiners v. Federal Trade Commission

On February 25, 2015, the U.S. Supreme Court issued its decision in North Carolina State Board of Dental Examiners v. Federal Trade Commission, holding that a regulatory board made up of market participants is exempt from...more

The Pitfalls of Settling Qui Tam Lawsuits

In a recent federal court case, the federal government and the State of California successfully enforced an oral settlement agreement of a qui tam lawsuit against a health care provider. United States v. North East Medical...more

Maine to Pay Out $142,500 to Settle Whistleblower Suit

The state Department of Health and Human Services in Maine will pay $142,500 to a former employee as a part of a settlement for a federal whistleblower suit. That employee is Sharon Leahy-Lind, who was at one time a...more

Appellate Court Decision Changes Rules on Healthcare Worker Meal Period

Gerard v. Orange Coast Memorial Medical Center - Court of Appeal, Fourth Appellate District (February 10, 2015) - A statute requires two meal periods for shifts longer than 12 hours. But an order of the...more

NJ Appeals Court Upends Nursing Home Negligence Suit

In a decision with far-reaching ramifications for long-term care litigation, the Superior Court of New Jersey, Appellate Division held that § 30:13-4.2 of the Nursing Home Responsibilities and Residents’ Rights Act (NHA) does...more

New York State Supreme Court Finds 24-Hour Home Care Attendants Must be Paid for Sleep and Meal Periods

The New York State Department of Labor ("NY DOL") has consistently enforced the New York Labor Law ("NYLL") as permitting third-party employers of 24-hour home care attendants to pay their employees for 13 hours of a 24-hour...more

Should Health Care Providers Pay Attention to the Seventh Circuit’s New Definition of “Referral”? – Part One

The Seventh Circuit Court of Appeals, in the case of United States v. Patel, just expanded the definition of “referring” under the federal Anti-Kickback Statute (“Statute”). In light of this case, health care providers should...more

Supreme Court Rules No Presumption of Lifetime Vesting of Retiree Health Benefits

The Supreme Court overturned the Sixth Circuit’s long-standing Yard-Man presumption, ruling that courts should apply ordinary contract principles to determine whether benefits have vested....more

Omnicare: Section 11 Liability and Opinions

The Supreme Court defined the circumstances under which liability can be imposed for opinion statements under Securities Act Section 11. Specifically, the Court held that such liability could be imposed on two theories: One...more

Late Notice of Claim Costs Kentucky Hospital $10 Million

A federal court in Kentucky ruled on March 17 that Ashland Hospital had forfeited $10 million of insurance coverage because it was late in notifying its insurance company of the claim....more

Federal Appeals Court Finds that New RAC Contracts Violate Federal Regulations

On March 10, 2015, the U.S. Court of Appeals for the Federal Circuit found that the Federal Acquisition Regulation (FAR) applies to CMS’s revised payment terms for new Recovery Audit Contractor (RAC) contract solicitations,...more

Health Care Employees Should Not Have Been Permitted To Waive Their Second Meal Periods

In this putative class/Private Attorney General Act (“PAGA”) action, Jazmina Gerard (and others) challenged a hospital policy that allowed health care employees who worked shifts longer than 10 hours to voluntarily waive one...more

Fifth Circuit: Hospital Enjoys Standing to Seek ERISA Benefits

The Fifth Circuit ruled that an out-of-network medical provider that was assigned a patient’s rights to health insurance benefits has standing to sue a health plan that underpays its portion of the benefits due even if the...more

Circuit Court Provides Clarification of Pleading Standards in FCA Cases - The Court's Holding Details Requirements for Alleging...

A recent U.S. Court of Appeals case from the Seventh Circuit has brought further insight into the heightened pleading standard required under the False Claims Act (FCA). The case, Thulin v. Shopko Stores Operating Co., LLC,...more

Supreme Court Update: NC Board Of Dental Examiners V. FTX (13-534), Direct Marketing Ass'n V. Brohl (13-1032), And Alabama Dep't...

We're bringing you up to speed with summaries of the Court's decisions in NC Board of Dental Examiners v. FTX (13-534), regarding the scope of state action immunity from federal antitrust law; Direct Marketing Ass'n v. Brohl...more

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

Committee on Energy and Commerce Subcommittee on Health Hearing Regarding 340B Drug Pricing Program – On Thursday, March 5, 2015, the Subcommittee on Health, chaired by Rep. Joe Pitts (R-PA), is holding a hearing titled...more

CMS Publishes Final Rule Establishing Appeal Process for Applicable Plans in Medicare Secondary Payer Cases

On February 27, 2015, CMS published a final rule, effective April 28, 2015, to establish a formal, multilevel administrative appeals process for applicable plans against which Medicare Secondary Payer (MSP) recovery demands...more

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