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Mintz - Health Care Viewpoints

Mintz IRA Update — IRA Litigation Update: Courts Begin to Address Legal Challenges to the Medicare Drug Price Negotiation Program

The IRA’s Medicare Drug Price Negotiation Program (the “Negotiation Program” or “Program”), which enables the federal government to negotiate prices for some of the costliest Medicare Part D drugs, has been subject to several...more

McDermott Will & Emery

This Week in 340B: March 19 – 25, 2024

Find this week’s updates on 340B litigation to help you stay in the know on how 340B cases are developing across the country. Each week we comb through the dockets of more than 50 340B cases to provide you with a quick...more

Goodwin

Court Dismisses PhRMA Lawsuit Challenging IRA

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Today, the district court for the Western District of Texas granted the government’s motion to dismiss the lawsuit brought by PhRMA and other organizations challenging the Drug Price Negotiation Program of the Inflation...more

Bass, Berry & Sims PLC

Recent False Claims Act Decisions to Know

In this post, we summarize noteworthy False Claims Act (FCA) decisions so far from 2023. Each of the three circuit court opinions discussed here ruled in favor of the defendants on different aspects of the FCA: the Sixth...more

Foley & Lardner LLP

False Claims Act: Prediction on Supreme Court Ruling on Government Dismissal Authority

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On December 6, 2022, the Supreme Court heard argument in United States ex rel. Polansky v. Executive Health Resources, Inc., a case with potential implications on the cost and longevity of certain False Claims Act (FCA)...more

King & Spalding

D.C. District Court Upholds HHS’s 2013 Policy of Including Part C Days in the Medicare Fraction of the DSH Calculation

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On July 7, 2021, the U.S. District Court for the District of Columbia ruled in favor of HHS and upheld HHS’s 2013 rule readopting its policy of including Part C days in the Medicare fraction of the disproportionate share...more

King & Spalding

Fifth Circuit Affirms Government’s Unilateral Dismissal of FCA Claims Despite Initially Declining to Intervene

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On July 7, 2021, a Fifth Circuit panel upheld a decision by the U.S. District Court for the Eastern District of Texas to grant the government’s dismissal of two qui tam actions under the False Claims Act (FCA) in Texas,...more

Dorsey & Whitney LLP

Eight Years Later: “Speculative” and “Straightforward” FCA Allegations Against Walmart Dismissed

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Walmart successfully ended eight years of protracted litigation under the False Claims Act (“FCA”) on June 4, 2021, when the Sixth Circuit affirmed dismissal of Medicare and Medicaid fraud allegations against the major...more

King & Spalding

Seventh Circuit Upholds Dismissal of Medicare Overpayment Lawsuit Brought by Home Health Agency for Failing to Complete...

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On June 3, 2021, the Seventh Circuit upheld a decision by the U.S. District Court of the Northern District of Illinois to dismiss a home health agency’s lawsuit against a Medicare integrity contractor for temporarily...more

Holland & Knight LLP

Healthcare Law Update: February 2021

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To date, there has been little consistency in how Health Insurance Portability and Accountability Act (HIPAA) requirements are enforced by the U.S. Department of Health and Human Services (HHS), or the amount of settlements...more

Dorsey & Whitney LLP

In the First FCA Appellate Case of 2021, the Fourth Circuit Affirms the Dismissal of Relators’ Claims for Lack of Scienter and...

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On January 8, 2021, in the first appellate decision of the year addressing a False Claims Act case, the Fourth Circuit affirmed the summary judgment dismissal of relators’ claims that a manufacturer of allergenic extracts...more

King & Spalding

United States Supreme Court Passes on Review of FCA Dismissal from Fifth Circuit Involving Alleged Medicare Overbilling

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On December 7, 2020, the United States Supreme Court declined review of the U.S. Court of Appeals for the Fifth Circuit’s affirmation to dismiss a $61.8 million False Claims Act case alleging Medicare overbilling against a...more

Benesch

Dialysis & Nephrology Digest - December 2020 #2

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Proposed class action alleges DaVita subsidiaries withheld wage premium during declared COVID health emergency - According to a proposed class action filed in Washington state, an employee at Total Renal Care contends the...more

Baker Donelson

Recent Litigation Underscores Continued Difficulties with the 'Logjam' of the 'Colossal' Medicare Claim Appeals Backlog

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Although newly released data from the Office of Medicare Hearings and Appeals (OMHA) suggests that the Medicare claim appeals backlog might be decreasing, OMHA's case processing time and recent litigation challenging the...more

Bass, Berry & Sims PLC

Recent Developments in False Claims Act Pleading Standards

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The Department of Justice (DOJ) recently released its report detailing the settlements and judgments obtained in 2019 from civil cases involving fraud and abuse claims. As in years past, the substantial majority of these...more

ArentFox Schiff

Investigations Newsletter: Major Retail and Health Care Company Faces Fraudulent Billing Lawsuit

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Omnicare and CVS Face Fraudulent Billing Lawsuit - On Tuesday, the US Attorney’s Office for the Southern District of New York announced a False Claims Act lawsuit against Omnicare, Inc. and its parent company, CVS Health...more

Holland & Knight LLP

Healthcare Law Update: October 2019

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In recent years, the healthcare industry has been turning greater attention to the need to engage or involve patients in developing new technologies and systems to improve healthcare delivery. These patient engagement...more

King & Spalding

False Claims Act Case Based on Stark Law Violations to Continue After the Third Circuit Revives Whistleblowers’ Claims

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On September 17, 2019, the U.S. Court of Appeals for the Third Circuit revived three whistleblowers’ claims alleging that the University of Pittsburgh Medical Center (UPMC) and neurosurgeons employed by three subsidiary...more

Dorsey & Whitney LLP

Relator Failed to Sufficiently Plead its FCA Action by Relying on Big Data Alone, Resulting In Big Dismissal

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In early August, the U.S. District Court for the Western District of Texas granted a hospital system’s motion to dismiss a False Claims Act case that illustrates the increasing intersections in FCA litigation between data...more

King & Spalding

Texas Court Dismisses False Claims Act Allegations Against Texas Hospital System

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On August 4, 2019, U.S. District Judge David A. Ezra dismissed with prejudice a $61.8 million False Claims Act (FCA) case brought by relator Integra Med Analytics LLC (Plaintiff) against Baylor Scott & White Health, Baylor...more

King & Spalding

Eleventh Circuit Issues Decision Underscoring the Stark Law’s Favorable Treatment of Indirect Financial Relationships

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In an opinion issued last Wednesday, the Eleventh Circuit affirmed the district court’s entry of final judgment in favor of a multi-state hospital system by dismissing the qui tam relator’s claims under the federal False...more

ArentFox Schiff

Investigations Newsletter: Telemarketing Business Agrees to Pay $2.5 Million to Settle FCA Allegations of Telemedicine Scheme

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Telemarketing Business Agrees to Pay $2.5 Million to Settle FCA Allegations of Telemedicine Scheme - The US Attorney’s Office for the Middle District of Florida, in collaboration with the US Attorney’s Office for the...more

McDermott Will & Emery

Eighth Circuit Rejects FCA Claim for Failure to Allege Actual Claims for Payment

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On February 11, 2019, the Eighth Circuit affirmed the dismissal of a group of relators’ qui tam suit against Crawford County Memorial Hospital for failure to meet the pleading standards required by Federal Rule of Civil...more

K&L Gates LLP

K&L Gates Triage: Triage in 2019: Health Care Topics to Watch in the New Year

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As K&L Gates begins its third season of Triage: Rapid Legal Lessons for Busy Health Care Professionals, Hilary Bowman previews several topics that the health care practice group anticipates will have a significant impact on...more

Bass, Berry & Sims PLC

Adding Insult to Injury: When an FCA Complaint Begets Follow-On Corporate Litigation

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The Delaware Supreme Court recently affirmed a decision by the Delaware Court of Chancery addressing a plaintiff’s ability to acquire key documents from a defendant company based on allegations against that company in an...more

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