News from the Health Law Gurus™

News from the Health Law Gurus™ is a weekly summary of notable health law news from around the country with helpful links to related content.

Circuit Split on ACA Subsidies—On Tuesday, the Court of Appeals for the D.C. Circuit (“D.C. Circuit”) and the Court of Appeals for the Fourth Circuit (“Fourth Circuit”) came to different conclusions as to the legality of Affordable Care Act (“ACA”) subsidies in Halbig v. Burwell and King v. Burwell, respectively. In both cases, the challengers argued that Section 36B of the ACA, which creates subsidies for purchasing health insurance, only applies to health insurance plans purchased through a state-established health insurance exchange, and not a federally-created health insurance exchange.  The D.C. Circuit sided with the challengers and found that the subsidies did not apply to federal exchanges, while the Fourth Circuit felt that the Internal Revenue Service’s interpretation of Section 36B, that subsidies are available for plans purchased through both state and federal exchanges, was valid. Read our full blog post here.

Women & Infants Hospital Settles Data Breach Allegations for $150,000—On Wednesday, Attorney General of Massachusetts Martha Coakley announced that Women & Infants Hospital of Rhode Island (“WIH”) has agreed to pay $150,000 in connection with the loss of 18 unencrypted back-up tapes containing patient protected health information discovered in 2012. The tapes went missing from two WIH sites, one in Rhode Island and one in Massachusetts, and contained the protected health information (“PHI”) of over 12,000 patients, including names, dates of birth, social security numbers, and ultrasound images. In addition to the settlement, WIH will take steps to secure PHI in the future, including reviewing and auditing security measures. It is not clear whether the Department of Health and Human Services (“HHS”) Office of Civil Rights will conduct an investigation. To read the Massachusetts’s Attorney General press release, click here

Former Walmart Exec to Help Manage HHS—Leslie Dach, former Executive Vice President of Corporate Affairs for Walmart, will assume the role of Senior Counsel of the HHS, according to a press release on Wednesday.  As Senior Counsel, a newly created position, Dach will work on HHS’s strategic initiatives and will play an important part in facilitating the second round of open enrollment under the ACA, slated to take place from November 15, 2014 to February 15, 2015. HHS Secretary Sylvia Mathews Burwell, to whom Dach will report, stated that Dach’s experience “will further enhance [HHS’s] ability to deliver impact for the American people.” Read the HHS press release here.

Wall Street Journal Spotlights Serial FCA Whistleblower—An article by the Wall Street Journal on Thursday highlights how lucrative blowing the whistle on health care fraud can be under the False Claims Act (“FCA”). The article, called “Invoking Antifraud Law, Louisiana Doctor Gets Rich”, focuses on Dr. William LaCorte, who has received $38 million as a plaintiff in 12 FCA whistleblower suits over two decades. Under the FCA, successful plaintiffs receive a share of the government’s recovery in the action to incentivize individuals to monitor fraud on behalf of the government. The article summarizes the ongoing debate between critics of FCA incentives in spurring whistleblower suits, which have doubled since incentives were increased in 2009, and the government, which argues that the incentives are necessary part of ensuring people are not defrauding the government. For this interesting read from Peter Loftus, click here.

DISCLAIMER: Because of the generality of this update, the information provided herein may not be applicable in all situations and should not be acted upon without specific legal advice based on particular situations.

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