The CMS Interoperability and Prior Authorization Rules
Antitrust Considerations in Long-Term Care — Assisted Living and the Law Podcast
Taking the Pulse, A Health Care and Life Sciences Video Podcast | Episode 206: Supporting Patient Care with Darra Coleman of Prisma Health
Workplace Violence in Health Care: Dissecting the Legal Landscape and Implications for Employers – Diagnosing Health Care
Hospice Insights Podcast: What’s the Latest on UPICs? Highlights from Recent Audit Activity, Part I
Taking the Pulse, A Health Care and Life Sciences Video Podcast | Episode 205: Novant Health’s Carolinas Expansion with Senior Vice President Jason Bernd
Navigating the Labyrinth of Private Equity Investments in Health Care – Diagnosing Health Care
False Claims Act Insights - Are All Healthcare “Kickbacks” Subject to FCA Liability?
HHS Office for Civil Rights Director Melanie Fontes Rainer on Progress and News at OCR
Hospice Insights Podcast - Stories of Successful Hospice Leadership: The CEO and Chief Medical Officer Relationship
Understanding Trends and Challenges in the Behavioral Health Sector
AI in the Operating Room: Liability Issues for Device Makers — The Good Bot Podcast
Taking the Pulse, A Health Care and Life Sciences Video Podcast | Episode 202: Life Sciences Startups and Industry Developments with Gil Price, Life Sciences Leader
AGG Talks: Healthcare Insights Podcast - Episode 6: Charting the Future of Nursing Home Staffing
Taking the Pulse, A Health Care and Life Sciences Video Podcast | Episode 201: SHL Medical’s Investment in the Carolinas with Kimberlee Steele of SHL Medical
Healthcare Document Retention
The DEA Is Knocking at Your Door . . . Are You Prepared? – Diagnosing Health Care
Hospice Insights Podcast - A Rise in Medicare Deactivations: Tips for Avoiding This Financial Pain
Taking the Pulse, A Health Care and Life Sciences Video Podcast | Episode 199: Bringing Awareness to Organ and Tissue Donation with Dave DeStefano of We Are Sharing Hope
Hosted by American Conference Institute, the 28th Annual Conference on Drug & Medical Device Litigation returns for another exciting year with curated programming and networking opportunities with 400+ industry...more
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
The decision provides organizational plaintiffs, including nonprofits and trade associations, with a basis to establish standing to bring UCL claims. In July 2023 the California Supreme Court expanded the ability of...more
AGG Healthcare attorneys Matthew M. Lavin and Aaron R. Modiano recently secured a revival of an $8.6 million reimbursement suit against Cigna Health and Life Insurance. In Bristol SL Holding, Inc. v. Cigna Health and Life...more
Second Circuit Denies Settlement of Data Breach Case Due to Lack of Standing - As we previously reported, in April 2021, the Second Circuit became the latest federal circuit to hold that an individual may establish Article...more
It’s hard to keep up with all the recent changes to labor and employment law. While the law always seems to evolve at a rapid pace, there have been an unprecedented number of changes for the past few years—and this past month...more
Supreme Court Upholds Affordable Care Act: On June 17, 2021, the Supreme Court ruled 7 to 2 to dismiss for lack of standing a challenge to the Affordable Care Act (ACA) brought by Texas and other states. The states had...more
The year 2019 was another active year in False Claims Act (FCA) investigations and litigation. Although the year lacked a singular blockbuster case, there were decisions of particular note. The Supreme Court clarified the...more
SDNY Rejects Standing under “Increased Risk” Theory Where Data Not Targeted or Stolen - The Southern District of New York rejected a settlement that would have resolved a class action based on the unauthorized (and...more
The Third Circuit recently held that anti-assignment clauses in ERISA-governed healthcare plans are enforceable as long as they are unambiguous. The Court concluded that the anti-assignment clause clearly stated that...more
On April 19, 2019, the Eleventh Circuit threw out a putative class action seeking declaratory relief against GEICO, citing the lead plaintiff’s lack of standing. The Eleventh Circuit’s decision was based on the long-settled...more
Perhaps the single most appropriate word to describe the current state of the civil and criminal healthcare fraud enforcement environment is uncertainty. From changes in personnel and policy at the highest levels of...more
A federal judge recently held that mere allegations that a healthcare provider’s patient information portal failed to utilize sufficient security measures, without allegations of an actual breach, were insufficient to confer...more
Regulation - CMS Contemplating Telemedicine Changes - The Centers for Medicare & Medicaid Services (CMS) recently published what it described as a "major proposed rule" that covers a number of topics that could have...more
Recently, the U.S. Court of Appeals for the Third Circuit handed the insurance industry a small victory by holding that, in American Orthopedic & Sports Med. v. Indep. Blue Cross Blue Shield, unambiguous anti-assignment...more
U.S. Courts of Appeals in all but four Circuits have now held that anti-assignment provisions in health insurance plans governed by ERISA are enforceable. In American Orthopaedic & Sports Medicine v. Independence Blue Cross...more
On May 16, 2018, the US Court of Appeals for the Third Circuit held in a precedential opinion that “anti-assignment clauses in ERISA-governed health insurance plans as a general matter are enforceable.” In so holding, the...more
Two recent cases illustrate the continuing challenges providers, and in particular hospital providers, face when seeking to collect their charges when dealing with “out-of-network” patients....more
A federal judge in New York has reinstated claims brought against a healthcare provider by customers whose personal information was exposed in the 2015 data breach of Excellus BlueCross Blue Shield. The breach affected the...more
In 1879, Connecticut passed a law barring the use of “any drug, medicinal article or instrument for the purpose of preventing conception”; the penalty was“not less than fifty dollars” or between 60 days and one year in...more
The existence and scope of assignments of benefits from patients to health care providers continues to be critically important to a provider’s ability to challenge an insurer’s reimbursement decision under the Employee...more
The Eleventh Circuit, in Silva v. Baptist Health South Florida, Inc., recently addressed a healthcare provider’s obligation to provide effective communication, through appropriate auxiliary aids and services, to persons with...more
The Ninth Circuit affirmed two district court decisions that concluded medical providers were not “beneficiaries” under Section 502(a) of ERISA and therefore lacked standing to bring an ERISA claim...more
A federal appeals court recently brushed aside the claims of several health care providers, in large part because of the language in the assignment forms signed by their patients. The opinion from the U.S. Court of Appeals...more
The antitrust injury and antitrust standing defenses/doctrines are alive and well in healthcare. A recent case, SCPH Legacy Corp. et al. v. Palmetto Health et al., shows that a competitor is not always the most legally...more