DOJ’s New Self-Disclosure Policy and Corporate Whistleblower Awards Pilot Program
AGG Talks: Healthcare Insights Podcast - Episode 4: What to Do When Insurance Companies Deny Behavioral Health Claims
Video: Braidwood v. Becerra – Challenging the Affordable Care Act’s Preventive Services Coverage Provision – Thought Leaders in Health Law
Updates to Statute 1557 that Healthcare Providers Need to Know
The No Surprises Act: A Cost Saving Opportunity for Employer Plan Sponsors
Podcast: Health Equity – Behind the Buzzwords – Diagnosing Health Care
Opting Out of Medicare: When and How to Do It
The Burr Broadcast April 2023 - The Official End of COVID-19 Emergencies
Video: Health Care's Past, Present, and Future - Diagnosing Health Care Podcast
Taking the Pulse, A Health Care and Life Sciences Video Podcast | Episode 117: Chris Severn, Co-Founder & CEO, Turquoise Health
Taking the Pulse, A Health Care and Life Sciences Video Podcast | Episode 115: Dr. Michael Havig, CEO, HealthMe
Taking the Pulse, A Health Care and Life Sciences Video Podcast | Episode 106: Dr. James McElligott, MUSC & Dr. Shawn Stinson, BlueCross BlueShield of SC
PODCAST: Williams Mullen's Benefits Companion - Health Plan Transparency Requirements
Thinking About a Concierge Medical Practice? Assure Compliance with Payor Requirements and the Law
PODCAST: Williams Mullen's Benefits Companion - New Prescription Drug and Health Coverage Reporting Requirements
Video: Getting Ready for the No Surprises Act - Thought Leaders in Health Law
Podcast: What Is the Future of the Acute Care Hospital Industry? - Diagnosing Health Care
PODCAST: Williams Mullen's Benefits Companion - Can Employers Impose a Health Insurance Surcharge on Plan Participants Not Vaccinated for COVID-19?
Compliance Into The Weeds - Delta Airlines Responds to the Delta Variant
AGG Talks: Solving Employers’ Problems - The American Rescue Plan Act’s COBRA Subsidy: What Is It and How Does It Work?
Welcome to the Summer 2024 issue of “FCA Enforcement & Compliance Digest,” our quarterly newsletter in which we compile essential updates on False Claims Act (FCA) enforcement trends, litigation, agency guidance, and...more
On April 12, New York Attorney General (AG) Letitia James announced that her office has reached a settlement with Northwell Health, New York’s largest health care network, related to allegations of misleading billing...more
Fiscal year 2023 saw record recoveries and the highest number of settlements and judgments ever under the Federal False Claims Act. According to a new report released by the United States Department of Justice (“DOJ”), the...more
As if corporate healthcare businesses needed an enforcement reminder, DOJ recently announced a settlement with Cigna Group for $172 million to resolve claims that Cigna exaggerated patient illnesses to extract more money from...more
In this post, we summarize noteworthy False Claims Act (FCA) decisions from the second quarter of 2023. U.S. Supreme Court Decisions. The second quarter was particularly noteworthy because the Supreme Court decided two...more
A Florida communications firm and its owner agreed to pay $293,771 to resolve False Claims Act (FCA) allegations that they failed to secure personal information on a federally funded Florida children’s health insurance...more
Earlier this year, Assistant Attorney General Jonathan Kanter, who leads the Department of Justice’s (DOJ) Antitrust Division, announced that the Antitrust Division would eschew settlements in merger challenges in...more
While too many of us get overdosed with clownish depictions - from doctors, hospitals, insurers, and corporations, especially Big Pharma firms - of how the civil justice system operates, it’s always worth a reminder of the...more
IRC completes acquisition of kidney care provider ARA - In Oct., it was revealed that Franklin, Tenn.-based Innovative Renal Care (IRC), an affiliate of equity firm Nautic Partners, would purchase American Renal...more
In recent years, there has been an increase in litigation involving sexual abuse, as evidenced by recent lawsuits involving the Boy Scouts of America, numerous Catholic dioceses, and sports figures such as Larry Nassar. While...more
Report on Patient Privacy 20, no. 12 (December 10, 2020) - In late September, Anthem Inc. entered into a $39.5 million settlement for a 2014 data breach that affected nearly 79 million individuals. About a week later,...more
Compliance Today (December 2020) - The Blue Cross Blue Shield insurance group has negotiated a possible settlement to sweeping antitrust lawsuits that alleged the group benefited from anticompetitive measures that...more
When a law firm settles or resolves a personal injury claim on behalf of a client, the client’s health insurer has a right to be reimbursed for its past expenditures on the related injury. Reimbursement requests become...more
Concluding one of the longest merger reviews in history, on September 4, Judge Richard Leon, District Judge for the District of Columbia, issued his final ruling in United States v. CVS Health, approving the proposed...more
In response to the Affordable Care Act’s (ACA) 30-hour threshold for employee coverage, many employers, including retailers and restaurants, considered cutting employee hours to avoid offering health insurance....more
The United States Department of Justice Antitrust Division announced on November 15 that it was settling its antitrust lawsuit against Atrium Health (formerly known as Carolinas Health System)....more
On October 15, 2018, the U.S. Department of Health and Human Services, Office for Civil Rights (OCR) announced that Anthem, Inc. will pay $16 million to settle OCR’s investigation of its potential violations of the Health...more
A federal district court in Indiana recently granted preliminary approval of a settlement between Anthem and a class seeking coverage of Applied Behavior Analysis (“ABA”) treatment for autism disorders. The three-year old...more
Aetna will pay almost $17.2 million to settle a federal class action lawsuit stemming from a 2017 mailing that disclosed the HIV status of health plan members. ...more
Anthem Inc. has reportedly agreed to pay a settlement of $115 million to its customers that were affected by what is being called one of the largest data breaches in U.S. history....more
After a series of compliance failures leading to the resignation of company’s CEO, the privately-held health care brokerage company Zenefits was just hit with a $7 million dollar settlement by the California Department of...more
This summer, the Sixth Circuit rejected class action litigants’ filing of the bulk of their class settlement documents under seal. Shane Grp., Inc. v. Blue Cross Blue Shield of Mich., 825 F.3d 299 (6th Cir. 2016). The Sixth...more
In a case with far-reaching implications, the Eleventh Circuit Court of Appeals issued an opinion concluding that the Medicare Secondary Payer Act (MSP) permits a private insurance company/PART C Medicare Advantage...more
Non-disclosure and confidentiality provisions can be an important aspect of resolving a case through settlement. But when one of the parties is a purported class, and the allegation is an antitrust violation, settlement and...more
Lessons From the Frontlines: Strategies for Supporting Informed Consumer Decision-Making in the Health Insurance Marketplace - Editor's Note: As marketplaces prepare for the third open enrollment period, consumers are...more