Read Insurance Law updates, alerts, news, and legal analysis from leading lawyers and law firms:
Condo Adviser: What is 'FHA approved,' exactly?
Greenberger: Derivatives Legislation Would Seriously Weaken Dodd-Frank
Insurance Dispute Freezes Avandia Victims’ Fund
NFA Chairman Chris Hehmeyer Talks Bankruptcy Reform
Ritholtz: Insurance Regulators Should Oversee Derivatives
How to Respond to President Obama's Cybersecurity Executive Order
Legal Minute: “Who Pays for my Expenses If I’m Injured By A Driver Who Doesn’t Have Auto Insurance?”
Ritholtz: 'Dot Com Bonus Envy' Stymies Wall St. Reform
Corporate Law Report: Obamacare Deadlines, $13M for Exotic Dancer Misclassification, 2013 Medicare Taxes, More...
Insurance Lawyer: Very Limited Coverage for Hurricane Sandy
Weekly Brief: Hurricane Sandy, GC Donations, Tweeting Fake News
Crystal Ball Perspective: Will Healthcare Reform be Repealed if Romney Wins the Presidential Election?
Not Prepared for Healthcare Reform? Three things employers need to focus on now.
The Benefits of WRAP Insurance on Large Construction Projects - Ray Buddie
Highlights from Day Three of Health Care Arguments [audio]
Highlights from Day Two of Health Care Arguments [audio]
Highlights from Day One of Health Care Arguments [audio]
Health Care Cases in 90 Seconds
Health Care 5: Will This Be a Landmark Decision?
Health Care 4: Can Congress Force States to Expand Medicaid?
On May 8, 2013, the Office of Inspector General (OIG) published an updated bulletin that spells out the frequency with which employers should check the OIG’s List of Excluded Individuals and Entities and clarifies which...more
The United States Senate and House of Representatives recently introduced bipartisan legislation designed to reduce fraud, waste, and abuse in the Medicare and Medicaid programs. The legislation, entitled “Preventing and...more
Bill Mathias of Ober|Kaler's Health Law Group presented on compliance as a part of the 2013 Healthcare Fraud and Abuse Bootcamp Webinar Series sponsored by the American Health Lawyers Association.
Complaints filed Monday, June 3, 2013, with the Office for Civil Rights of the U.S. Department of Health and Human Services (OCR), allege that an employer that receives federal funding may not exclude pregnancy coverage in a...more
On May 17, 2013, the Office of Inspector General, U.S. Department of Health and Human Services (OIG), announced a final regulation that would permit, effective June 17, 2013, state Medicaid fraud control units (MFCU) to use...more
The Centers for Medicare & Medicaid Service’s release of the final Medicare medical loss ratio regulations allows Medicare Advantage Organizations and Part D Plan Sponsors to evaluate their operations in order to come into...more
What’s at stake for states that fail to bring their false claims laws in line with new federal standards by the August 31 deadline? A 10% share from settlements of Medicaid fraud lawsuits which, considering the $4.2 billion...more
Earlier this month, the Justice Department filed a lawsuit against Vitas Hospice Services, LLC, and related entities, alleging that Vitas fraudulently billed the Medicare program in violation of the False Claims Act (FCA)....more
Over the years, CMS and its contractors have wrestled with how days approved under a Medicaid demonstration project should be counted, if at all, for purposes of the Medicare disproportionate share hospital (DSH) calculation....more
On April 17, 2013, the Office of the Inspector General (OIG) of the United States Department of Health and Human Services released an updated Provider Self-Disclosure Protocol (SDP). As self-described, OIG updated the SDP to...more
In St. Paul Mercury Insurance v. Mountain West Farm Bureau, 210 Cal. App. 4th 645 (10/25/12), the California Court of Appeal addressed the duty of an insurance carrier to defend a general contractor named as an additional...more
California Courts handed down some interesting decisions re insurance coverage during the fourth quarter of 2012:
St. Paul Mercury Insurance v. Mountain West Farm Bureau (10/25/12)
In an equitable contribution action, an...more
On May 8, 2013, the Office of Inspector General of the Department of Health and Human Services (“OIG”) released an Updated Special Advisory Bulletin on the Effect of Exclusion from Participation in Federal Health Care...more
On May 8, 2013, the Office of Inspector General (OIG) issued an updated Special Advisory Bulletin on the effect of exclusion from federal health care programs. A federal health care program (e.g., Medicare and Medicaid) is...more
On May 8, 2013, the OIG issued an update that supersedes and replaces its 1999 Special Advisory Bulletin, The Effect of Exclusion from Participation in Federal Health Care Programs. The updated bulletin continues to stress...more
The Office of the Inspector General (OIG) released a Special Fraud Alert on March 26, 2013 warning that physician-owned distributorships (PODs) are "inherently suspect" under the Anti-Kickback Statute (AKS). Generally...more
Leslie Silverman, former EEOC Commissioner, now Co-Chair of Proskauer’s Government Regulatory and Contract Compliance Group, was part of a panel that testified before the EEOC today concerning the need for clearer guidance...more
When a health plan/HMO ("Plan") provides group health coverage to employers, including the federal government, the hospitals that treat federal employees under a contract with the Plan are government "subcontractors" subject...more
District Court Finds That Medical Group’s Failure to Further Investigate Audit Results May Violate Requirement to Return Overpayments -
Internal audits of third-party payment claims – frequently...more
On April 17, 2013, the Office of Inspector General (OIG) of the United States Department of Health and Human Services (HHS) revised its Provider Self-Disclosure Protocol (SDP), originally published in 1998, and updated in...more
A federal district court has confirmed the position of the Office of Federal Contract Compliance Programs (OFCCP) finding that three hospitals providing medical services to U.S. government employees, and receiving payments...more
In a case closely monitored by the healthcare industry, a recent decision from the United States District Court for the District of Columbia expanded the jurisdiction of the Office of Federal Contract Compliance Programs...more
On April 1, 2013, the U.S. Court of Appeals for the Sixth Circuit overturned an $11.1 million False Claims Act (FCA) judgment by the U.S. District Court for the Middle District of Tennessee against MedQuest Associates, Inc.,...more
On April 17, 2013, the U.S. Department of Health and Human Services Office of Inspector General (OIG) released an updated Provider Self-Disclosure Protocol (Protocol) that supersedes and replaces the protocol published in the...more
On Wednesday, April 17, 2013, the Department of Health and Human Services’ Office of Inspector General (OIG) released an updated Self-Disclosure Protocol (SDP) governing the process by which health care providers can...more
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