Health Civil Procedure

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Decision Alert: US Supreme Court Potentially Shifts the Balance in Healthcare Employee Benefits Litigation

Justice Clarence Thomas and a unanimous US Supreme Court decided to vacate a Sixth Circuit decision and hold that the federal courts cannot assume from silence in a union’s collective bargain agreement that retiree group...more

U.S. Supreme Court Rebukes Reliance on Yard-Man In Retiree Health Benefit Dispute

The U.S. Supreme Court ruled that the Sixth Circuit’s reliance on retiree-friendly inferences set forth in UAW v. Yard-Man are incompatible with ordinary principles of contract interpretation and should not be used when...more

Supreme Court Decides M & G Polymers USA, LLC v. Tackett

On January 26, 2015, the U.S. Supreme Court decided M & G Polymers USA, LLC v. Tackett, No. 13-1010, holding that ordinary principles of contract law govern the interpretation of pension and insurance provisions of...more

Traditional Contract Rules Determine Whether Retirees Are Entitled to Lifetime Healthcare Benefits

Yesterday, in a unanimous decision, the U.S. Supreme Court held that courts must apply ordinary rules of contract interpretation when determining whether retiree healthcare benefits vest for life pursuant to the terms of a...more

Illinois Supreme Court Debates Self-Critical Analysis Privilege

Last week, the Illinois Supreme Court heard argument in a case being closely watched by the civil defense bar: Harris v. One Hope United, Inc. Harris poses a simple question: does Illinois recognize the self-critical...more

CMS Guidance on Provider Timeframes for Responding to Additional Documentation Requests

CMS has updated the Medicare Program Integrity Manual to clarify that providers and suppliers have 45 days to produce documents in response to a pre-payment review Additional Documentation Request (ADR) issued by a Medicare...more

Can Digital Healthcare Innovation Be Patented? Eligibility of Digital Healthcare Technologies Under the New USPTO Eligibility...

Digital healthcare, the confluence of digital technology with medical and other biological fields, has become an ever-increasing presence in our daily lives. Ideas that seemed nearly impossible just a few years ago (such as...more

The Supreme Court Hears Case Regarding Private Enforcement of the Medicaid Act Against States

On Tuesday, January 20, 2015, the U.S. Supreme Court will hear oral argument in a significant Medicaid-preemption case from the Ninth Circuit, Exceptional Child Center, Inc. v. Armstrong. In that case, Medicaid-participating...more

Low Medicaid Reimbursement Rates Violate the Supremacy Clause?! …The Supreme Court to Weigh In!

Today is a big day. Not only will most of us return to work after a long weekend, but the Supreme Court will hear oral arguments on a very important issue....more

Court Vacates DOL’s New “Companionship Services” Definition

On January 14, 2015, the court in Home Care Association of America v. Weil vacated the U.S. Department of Labor’s (DOL) regulation narrowing the definition of “companionship services” under the Fair Labor Standards Act...more

Who Decides When Medicaid Payment Rates Are Not Enough?

In 2005, the Florida Pediatric Society, the Florida Association of Pediatric Dentists, and a number of parents and guardians on behalf of their individual children in the Medicaid program brought suit against the state of...more

Minnesota Supreme Court Holds that Medical Staff Bylaws Are an Enforceable Contract

In an opinion released on December 31, 2014, the Supreme Court of Minnesota held that medical staff bylaws can be an enforceable contract and that a hospital’s medical staff (as an unincorporated association) can have the...more

Pennsylvania Nursing Home That Failed To Sign Arbitration Agreement Cannot Seek to Enforce the Agreement

On January 15, 2015, the Pennsylvania Superior Court in Bair v. Manor Care of Elizabethtown, PA, LLC 2015 Pa. Super. 9 (2015) ruled that a nursing home arbitration agreement was not enforceable when the facility did not sign...more

False Claims Act: 2014 Year In Review

In what is becoming an annual refrain, 2014 marked another year of robust False Claims Act (FCA) enforcement by the U.S. Department of Justice (DOJ) and mushrooming qui tam lawsuits by whistleblowers. Indeed, fiscal year 2014...more

Department of Labor regulations narrowing companionship care definition vacated

In a second decision in the case challenging federal Department of Labor regulations relating to the Fair Labor Standards Act’s (FLSA) companionship care exemption, the US District Court for the District of Columbia vacated...more

Home Health Care Remains Affordable: New Companionship Exemption Rules Overturned

A federal court has invalidated the U.S. Department of Labor's ("DOL") amended rule that would have extended minimum wage and overtime protections to nearly two million home health care workers and affected the cost and...more

Judge Vacates Parts of USDOL Home-Care Regulation

A federal judge has scuttled key aspects of the U.S. Department of Labor's rule that would have extended the federal Fair Labor Standards Act's minimum-wage and overtime requirements to many home care workers starting January...more

Pharmacy Qui Tam Based On U&C Price Billing Survives Motion to Dismiss

Once again, a pharmacy employee has filed a qui tam involving a drug discount program, alleging that the failure of the pharmacy to use the discounted pricing as the “usual and customary” price in Medicaid and Medicare Part D...more

When Is a Pharmacist Not a Pharmacist?

On January 14 the Texas Supreme Court will hear argument in an appeal that asks the question, When is a pharmacist not a pharmacist? The appeal is from a Texas Court of Appeals decision that answered the question this way: ...more

2014 Review: The New York False Claims Act

There was significant activity in 2014 in matters involving the New York False Claims Act (NY FCA). This review summarizes the legislative activity, case law developments and noteworthy settlements in 2014....more

Food Fights Make Bad Law

The axiom "hard facts make bad law" never held so true than in the case of the Minnesota Supreme Court's decision in Medical Staff of Avera Marshall Regional Medical Center vs. Avera Marshall, issued on December 31, 2014. ...more

Florida Federal Court Retains Jurisdiction Over Knee Implant Case

Debra Kilmer filed suit against Stryker Corporation, Stryker Sales Corporation and Howmedica Osteonics Corporation (“Defendants”), asserting that she had been injured by a defective knee implanted in her in Florida state...more

Seventh Circuit Uses Rule 9(b) to Dismiss False Claims Act Case

The Seventh Circuit has been on quite a tear recently with cases involving the False Claims Act; we wrote about three of them, involving the federal assignment law, the worthless-services doctrine, and the public-disclosure...more

Pain Clinic Sues CMS Over $25 Million Repayment Demand

Alabama Pain Center thought it knew all about pain, but nothing had prepared it for the bill it received when CMS decided to retroactively “reprice” certain compounded drugs: $25 million....more

Minn. Sup. Court: Med Staff Bylaws Are a Contract & Staff May Sue

On the last day of 2014 the Minnesota Supreme Court gave a hospital medical staff a double victory, ruling that (1) medical staff bylaws constitute a contract between the hospital and medical staff members and (2) the medical...more

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