News & Analysis as of

Appeals ALJ

Maine WC Board Appellate Division Rules on § 312 Medical Findings

by PretiFlaherty on

In Dunn-Morrell v. Viking Motors, Mr. WCB App. Div. 17-17 (April 19, 2017), the Employee was granted protection of the Act in 2007 for a May 8, 2003, low back and right shoulder injury. She was awarded ongoing total...more

HHS Final Rule on Medicare Coverage Determination Appeals Process Takes Effect

by King & Spalding on

HHS’s final rule revising procedures for ALJ and Medicare Appeals Council level appeals, announced on January 17, 2017, took effect on March 20, 2017....more

Supreme Court Increases School Standards For Students With Disabilities

by Fisher Phillips on

IEPs Must Meet “Markedly More Demanding” Standard From Now On This week, in a unanimous decision crafted by Chief Justice John Roberts, the Supreme Court decided that the Individuals with Disabilities Education Act...more

Advertising Law - March 2017

FTC Fights Back in LabMD Suit - The Federal Trade Commission demonstrated its intention to fight for the power to regulate data security by filing a 111-page brief with the U.S. Court of Appeals for the Eleventh Circuit...more

The National Labor Relations Board 2016 Year in Review – Whitepaper

Introduction - In comparison to recent history, 2016 was a tame year for the National Labor Relations Board (“NLRB” or “the Board”). While continuing to issue decisions that left employers scratching their heads, the...more

HHS Publishes Final Rule Overhauling the Medicare Appeals Process

by Baker Ober Health Law on

The Department of Health and Human Services (HHS) published its final rule revamping the Medicare appeals process at the Administrative Law Judge (ALJ) level on January 17, 2017. The final rule extensively revises federal...more

Medicare Appeal Proposal Falls Far Short of Court Mandate

by Faegre Baker Daniels on

For years the hospital industry has been in an uproar over the mountainous backlog of Medicare claim appeals. Current estimates are that a whopping 650,000 claims are at the Administrative Law Judge level awaiting...more

Antennas up, Employers: Are ALJs History?

by Burr & Forman on

The Supreme Court of the United States is, of course, known for landmark decisions affecting the lives of Americans. When we hear "SCOTUS" we think of famous civil rights cases such as Marbury v. Madison, (1803) which...more

Keeping Section 5 Alive: The FTC Brings Suit Against D-Link

The U.S. Federal Trade Commission (“FTC”) has filed suit against Taiwan-based D-Link Corporation and D-Link Systems, Inc. (collectively, “D-Link”), manufacturers and sellers of home networking devices including routers,...more

Birmingham Medical News: End in Sight for Medicare ALJ Backlog?

by Burr & Forman on

As providers who are currently undergoing a Medicare claims appeal know, there is a lengthy delay to having an appeal actually heard by an Administrative Law Judge (“ALJ”). Some estimates indicate that it will currently take...more

HHS Ordered To Eliminate Medicare Appeals Backlog By 2021

by BakerHostetler on

On January 4, 2017, the U.S. District Court for the District of Columbia rejected a request by the Secretary of HHS asking the court to reconsider its decision that requires HHS to eliminate the backlog of Medicare claims...more

Tenth Circuit Court of Appeals Finds SEC’s Process for Designating Administrative Law Judges to be Defective, Causing Split with...

by Dechert LLP on

The U.S. Court of Appeals for the Tenth Circuit on December 27, 2016, in Bandimere v. SEC, found the Administrative Law Judges (ALJs) used by the U.S. Securities and Exchange Commission (SEC) to hear its administrative...more

Appellate Division Rules That Paid Blogger Was Not An “Employee” Entitled To Unemployment Benefits, Signaling Trend Toward More...

One of the recurring themes in workplace law in 2016 was the continued crackdown on independent contractor misclassification. Both federal and state agencies, as well as the plaintiffs’ bar, invested significant resources to...more

U.S. District Court for District of Columbia Requires HHS to Eliminate Medicare Appeals Backlog by December 31, 2020

by Baker Ober Health Law on

On December 5, 2016, a U.S. District Court for the District of Columbia granted summary judgment in American Hospital Association, et al., v. Burwell, in favor of the American Hospital Association (AHA) in its quest to reduce...more

Court Orders HHS to Fix the Medicare Appeals Backlog by the End of 2020

by Reed Smith on

Medicare providers with pending cases at the administrative law judge (“ALJ”) level received positive news last week as a federal judge for the United States District Court for the District of Columbia (the “Court”) granted...more

The FTC Faces an Embarrassing Set-Back in its Data Security Enforcement Authority as the LabMD Saga Continues

by Moore & Van Allen PLLC on

On November 10th, the Eleventh Circuit Court of Appeals handed an embarrassing defeat to the Federal Trade Commission and an early Christmas present to LabMD, Inc. in the ongoing David and Goliath battle between the...more

LabMD Scores Early Win in FTC Appeal

The fight between the Federal Trade Commission and LabMD, the defunct medical testing lab, entered a new chapter late yesterday. In a 13-page ruling, the U.S. Court of Appeals for the Eleventh Circuit said that LabMD’s...more

D.C. Circuit: SEC’s In-House Court is Constitutional

by Carlton Fields on

Previously, we advised that the Securities and Exchange Commission’s increased preference for bringing enforcement actions in its in-house court had triggered jurisdictional and constitutional challenges to SEC administrative...more

Environmental Case Law Update

“Summer’s lease hath all too short a date.” Many important environmental and administrative law decisions were reported by the federal and state courts over the past six months. The courts are dealing with very...more

Recent Developments in Litigation Challenging the Medicare Appeals Delays: Is Victory Likely for Medicare Providers?

by Latham & Watkins LLP on

On September 19, 2016, the U.S. District Court for the District of Columbia (D.D.C.) refused to stay a highly anticipated case seeking to force the government to comply with statutory deadlines governing the Medicare appeals...more

Advertising Law - August 2016 #3

ANA, 4As Battle Over Transparency Guidance - Two industry groups are engaging in a public battle over transparency. The dispute began when a joint task force was formed between the American Association of...more

FTC Reverses Its ALJ and Finds LabMD Section 5 Violation

The Federal Trade Commission recently vacated the decision of its Chief Administrative Law Judge and on July 29, 2016 entered a final order against LabMD potentially expanding previous interpretations of what constitutes...more

OCSLA Coverage for Land Injuries Has Limits

James Baker, Jr. v. Director, OWCP; Gulf Island Marine Fabricators, LLC, U.S. Fifth Circuit No. 15-60634 (August 19, 2016). In this case the Court of Appeals affirmed the Administrative Law Judge’s (ALJ) determination that...more

A Favorable, New Climate for Challenging Medicare Appeals

by Latham & Watkins LLP on

Over the past decade, health care providers seeking to challenge Medicare claim denials have faced increasing delays in reaching what many consider the most important step in the Medicare appeals process - a hearing before an...more

Financial Services Weekly News - August 2016 #2

by Goodwin on

Editor's Note - OATS Reporting Violations and FINRA Enforcement. FINRA’s Order Audit Trail System (OATS), is an integrated audit trail of order, quote and trade information for all NMS stocks and OTC equity securities,...more

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