News & Analysis as of

Appeals Physicians

Cozen O'Connor

Notice of Appeal - A quarterly newsletter reviewing Third Circuit opinions impacting white collar defense lawyers - Fall 2023

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BACKGROUND- A sugar distributor sought to acquire a sugar producer. The district court determined that the relevant product market included distributors as sources of refined sugar, in addition to sugar producers. The...more

Hendershot Cowart P.C.

CMS, Qlarant Scrutinizing Medicare Claims for Skin Substitute Treatments

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Our firm is seeing an uptick in Medicare demand letters for the recovery of overpayment for skin substitutes, such as WoundFixTM, Biobrane, Dermagraft®, AmnioBand®, or AlloPatch®, used in the treatment of wounds. CMS auditors...more

Husch Blackwell LLP

Texas Jury Renders $10 Million Verdict in Novel Corporate Practice of Medicine Case

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Following two weeks of trial testimony, a Travis County jury recently rendered a $10 million verdict in a novel corporate practice of medicine (CPOM) case. The jury found in favor of a physician hospitalist group that claimed...more

McDermott Will & Emery

Federal Jury Returns $43 Million Verdict for Kickback Scheme in Violation of the False Claims Act

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After a rare False Claims Act (FCA) trial—especially one premised on violations of the Anti-Kickback Statute (AKS)—a federal jury in Minnesota returned a $43 million verdict against Precision Lens, a distributor of medical...more

Bass, Berry & Sims PLC

Second Circuit Holds False Claims Act Complaint Is Barred by SEC Filings

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In July 2021, the U.S. District Court for the Eastern District of New York dismissed a False Claims Act complaint filed by CKD Project, LLC, an entity created for the purpose of filing the lawsuit, which alleged that...more

Weber Gallagher Simpson Stapleton Fires &...

NJ Appellate Court Rules that a Settling Defendant Cannot Pursue Contribution from Third-Party Defendant Without a Judgment...

Upon settlement between the estate of a plaintiff, who suffered injuries which resulted in amputation, and a defendant physician, the trial court denied a third-party defendant’s motion to dismiss the joinder complaint...more

Bradley Arant Boult Cummings LLP

30(b)(6) vs. 702 – Is Your Witness a Party or an Expert?

Earnest v. Sanofi U.S. Services et al, U.S. Circuit Court of Appeals for the Fifth Circuit, No. 20-30184 (Feb. 10, 2022) - The plaintiff sued Sanofi U.S. Services, Inc. and Sanofi-Aventis U.S., LLC in the Eastern District...more

Dorsey & Whitney LLP

CMS’ COVID-19 Vaccine Mandate: What Health Care Providers Need to Know

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Last week, the Centers for Medicare and Medicaid Services (CMS) and the Occupational Safety and Health Administration (OSHA) published their much-anticipated rules mandating COVID-19 vaccinations. ...more

Polsinelli

Preclusion Doctrines and Peer Review: Arizona Hospital Peer Review Process Given Same Preclusive Effect as Court Judgment

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You only get one bite at the apple. Lawyers use this expression to describe the legal concept that a cause of action may not be relitigated after it has already been judged on the merits. The twin components of this concept...more

Zuckerman Spaeder LLP

[Webinar] A Step-by-Step Strategy for Maximizing Insurance Coverage Under ERISA - July 22nd, 2:00 pm - 3:00 pm ET

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Building on our recent overview presentation “Six Lessons Patients and Providers Need to Know," we invite you to join us as we examine a single medical provider/patient encounter, in order to identify the concrete steps a...more

Mitchell, Williams, Selig, Gates & Woodyard,...

Peer Review Immunity is a Bar to Doctor's Allegations of Defamation

When a doctor is subject to a formal peer review proceeding, those involved must pay close attention to the medical staff bylaw and any hospital policies, procedures, and rules governing the process. These protections require...more

Laughlin, Falbo, Levy & Moresi LLP

Applied Materials v. WCAB – Physician Misconduct Compensable and Fitzpatrick Affirmed

The Sixth District Court of Appeal recently issued its decision in the matter of Applied Materials v. WCAB. The decision was initially issued as unpublished and the California Workers’ Compensation Institute obtained an...more

Bricker Graydon LLP

Court upholds Ohio law criminalizing physician participation in abortions based on Down syndrome

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A federal appeals court issued a decision on April 13, 2021, upholding an Ohio law that prohibits providers from performing abortions based on a fetal diagnosis of Down syndrome, or on the possibility of a diagnosis. ...more

Dorsey & Whitney LLP

A New Circuit Split: FCA Protects Former Employees from Post-Employment Retaliation in the Sixth

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Over a vigorous dissent last week, a panel of the U.S. Court of Appeals for the Sixth Circuit vacated a ruling from the U.S. District Court for the Eastern District of Michigan and held the False Claims Act’s anti-retaliation...more

Health Care Compliance Association (HCCA)

Provider Wins $2M Appeal at ALJ Over Modifier 25, Random Sample

Report on Medicare Compliance 30, no. 11 (March 22, 2021) - A cancer center has won its appeal of $2 million in Medicare claim denials in a case about modifier 25 and the extrapolation of an overpayment. Problems with the...more

McGuireWoods LLP

Fifth Circuit Vacates Fraud Conviction after Denying Codefendants’ Appeal

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The U.S. Fifth Circuit recently reversed a former home health agency employee’s conviction and vacated his sentence related to three counts of healthcare fraud and abuse. Jonathan Nora was convicted by the trial court of...more

Bradley Arant Boult Cummings LLP

Justices Should Weigh In On FCA Objective Falsity Standard

In its conference on Feb. 19, the U.S. Supreme Court is scheduled to consider two pending petitions for certiorari that could resolve a critical but deeply disputed issue that impacts both the False Claims Act and health care...more

Hinshaw & Culbertson - Health Care

Expert Demonstrations Must Meet Substantially Similar Standard: Hinshaw's Annual Guide to Key Illinois Medical Malpractice...

Must an expert's demonstration be made under substantially similar conditions and circumstances as those which surrounded the occurrence? Can an expert opine regarding the permanency of injuries without recent medical data? ...more

Fisher Phillips

Independent Contractor vs. Employee: Federal Appeals Court Instructs How to Structure Physician Agreements To Avoid...

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While the use of independent contractors in the healthcare industry has been a longstanding practice, it is now front and center as the gig economy continues to expand across several industries and the preference for...more

Hinshaw & Culbertson - The LHD/ERISA Advisor

The LHD/ERISA Advisor - October 2020: District Court Holds Breach of Contract Claims are Time-Barred

Plaintiff Gene Myers (“Plaintiff”), a physician, made a claim for individual disability insurance (IDI) benefits under an individual disability policy arising from low back injury caused by wearing a heavy leaded gown worn...more

Hinshaw & Culbertson - Employment Law...

Medical Staff Member Deemed Independent Contractor, Not Eligible for Title VII Protection

When assessing potential exposure for their employer-clients under federal labor and employment statutes, employment and health care attorneys often must start with the basics. That determination of employment status becomes...more

Morrison & Foerster LLP - Left Coast Appeals

This Week at The Ninth: Employees, Independent Contractors, and ERISA

This week, this Ninth Circuit once again issued a number of opinions arising from the employment relationship. Here, we focus on two of particular interest. In the first, the Court sought to unravel whether an emergency room...more

K&L Gates LLP

K&L Gates Triage: Michael P. V. BCBS Of Texas

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In this week’s episode, Gary Qualls discusses a recent case decided in the Western District of Louisiana, which highlights how the application of the arbitrary and capricious standard as applied to payor coverage...more

Nilan Johnson Lewis PA

New Liability for Minnesota Hospitals: Independent Contractors and Apparent Authority

On July 29, 2020, the Minnesota Supreme Court issued an opinion* that reverses the long-held common-law understanding in Minnesota that hospitals are not liable for the actions of their physician independent contractors. ...more

Bass, Berry & Sims PLC

Eighth Circuit Affirms Dismissal of Kickback Case

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On June 25, the U.S. Court of Appeals for the Eighth Circuit affirmed the dismissal with prejudice of a qui tam False Claims Act (FCA) suit alleging certain physician compensation arrangements at Trinity Health violated the...more

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