News & Analysis as of

Hospitals Reversal

ArentFox Schiff

Court of Appeal Publishes Peer Review Decision Expanding Anti-SLAPP Protections for Medical Staffs and Hospitals

ArentFox Schiff on

In response to multiple requests from California hospital industry members, the California Court of Appeal ordered publication of its decision in Bonni v. St. Joseph Health System et al. This important decision is a victory...more

Foley Hoag LLP

American Hospital Association et al. v. Becerra et al.: Supreme Court Rejects CMS Policy to Adjust Medicare Part B Payments for...

Foley Hoag LLP on

Earlier this week, the Supreme Court released its opinion in American Hospital Association et al. v. Becerra et al., a case that involves the proper method for the Medicare program to reimburse hospitals for outpatient drugs...more

McDermott Will & Emery

Recent Litigation Shines Spotlight on Hospital and Physician Group Transactions

McDermott Will & Emery on

The US Department of Justice recently intervened in an qui tam alleging false and fraudulent claims involving the acquisition of physician practice locations by a health system and subsequent management of the health system’s...more

Faegre Drinker Biddle & Reath LLP

Fifth Circuit Decision Motivates Covered Entities to Appeal Unreasonable Enforcement Outcomes

The United States Court of Appeals for the Fifth Circuit (the “Court”) vacated a $4,348,000 civil monetary penalty (“CMP”) imposed by the U.S. Department of Health and Human Services’ Office for Civil Rights (“HHS-OCR”) in...more

Sheppard Mullin Richter & Hampton LLP

What Does the Fifth Circuit’s Vacating of HHS HIPAA Fines Mean for Companies This Year?

Will HHS’ approach for imposing penalties in the aftermath of a data breach become a little clearer in 2021? This is a distinct possibility in the wake of a Fifth Circuit decision vacating penalties against MD Anderson Cancer...more

Baker Donelson

Federal Appeals Court Upholds Payment Reduction to 340B Hospitals

Baker Donelson on

On July 31, 2020, the D.C. Circuit Court of Appeals issued a decision reversing a lower court decision and upholding Medicare payment cuts to certain hospitals participating in the 340B drug pricing program that have been in...more

King & Spalding

Court of Appeals Reverses Hospitals’ Victory in 340B Drug Reimbursement Case

King & Spalding on

On July 31, 2020, the U.S. Court of Appeals for the District of Columbia Circuit reversed a district court decision that had found unlawful Medicare’s nearly 30 percent rate cut for separately payable outpatient drugs...more

Bass, Berry & Sims PLC

Update: Third Circuit Allows Allegations of Improper Compensation under the Stark Law to Proceed, but Reverses Controversial...

Bass, Berry & Sims PLC on

On December 20, 2019, the U.S. Court of Appeals for the Third Circuit granted in part a petition for rehearing filed by the University of Pittsburgh Medical Center (UPMC) in a False Claims Act (FCA) case that has generated...more

Bass, Berry & Sims PLC

Third Circuit Holds Allegations of Improper Compensation Methodologies under the Stark Law Survive Motion to Dismiss

Bass, Berry & Sims PLC on

The U.S. Court of Appeals for the Third Circuit recently issued a False Claims Act (FCA) decision calling into question productivity-based physician compensation structures under the Stark Law, in reliance on a controversial...more

McDermott Will & Emery

Third Circuit Perpetuates Tuomey’s Controversial Stark Law “Volume or Value” Standard

McDermott Will & Emery on

The US Court of Appeals for the Third Circuit endorsed two controversial interpretations of the Stark Law’s “volume or value” standard, known as the correlation theory and the practice “loss” theory in U.S. ex rel. J. William...more

King & Spalding

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

King & Spalding on

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

WilmerHale

Common Physician Compensation Arrangement May Face Increased Scrutiny Under Stark Law

WilmerHale on

On September 17, 2019, the Third Circuit Court of Appeals issued a decision with potentially far-reaching implications for healthcare companies and providers facing allegations of violations of the Stark Law. In United States...more

Foley Hoag LLP - Medicaid and the Law

D.C. Circuit Reverses District Court in DSH Case

We have long covered the handful of lawsuits that have been filed over the past several years concerning Medicaid disproportionate share hospital (“DSH”) payment policies. These lawsuits all revolve around some steps that CMS...more

Jaburg Wilk

Arizona Court of Appeals Holds MedPay Benefits Are Subject to Health Care Provider Liens

Jaburg Wilk on

The Holding - In Dignity Health v. Farmers Ins. Co. of Ariz., 1 CA-CV-18-0292, 2019 WL1499855 (Ariz. App. June 11, 2019), the Arizona Court of Appeals recently held MedPay benefits are subject to health care provider liens...more

Foley & Lardner LLP

Health Care Company Asks U.S. Supreme Court to Find False Claims Act Unconstitutional

Foley & Lardner LLP on

If one appellant has its way, the False Claims Act (FCA) would be gutted by way of its qui tam provisions struck down as unconstitutional by the United States Supreme Court. That is the position taken by Intermountain Health...more

Carlton Fields

Real Property, Financial Services, & Title Insurance Update: Week Ending April 19, 2019

Carlton Fields on

Real Property Update - • Special Tax District Bond Validation: hospital center special tax district could not validate bonds intended to finance the construction of a hospital outside the geographic boundaries established...more

Payne & Fears

California Supreme Court Clarifies the Law on Second Meal Period Waivers for Health Care Workers

Payne & Fears on

On December 10, 2018, the California Supreme Court unanimously held in Gerard v. Orange Coast Memorial Medical Hospital that section 11(D) of Industrial Welfare Commission (“IWC”) Wage Order No. 5, which permits health care...more

Bass, Berry & Sims PLC

FCA Medical Necessity Cases May Stand on Firmer Footing After Recent Appellate Decisions

Bass, Berry & Sims PLC on

In recent years, healthcare providers have increasingly faced civil and criminal enforcement actions premised on the allegation that services billed to government healthcare programs were not medically necessary. As a result,...more

Payne & Fears

Key California Employment Law Cases: June 2018

Payne & Fears on

This month’s key California employment law cases are from the California Supreme Court and from the California Court of Appeal. Janus v. American Fed’n of State, County, and Mun. Employees, Council 31, 138 S. Ct. 2448...more

Katten Muchin Rosenman LLP

Illinois Appellate Court Upholds Privilege Protections Under the Patient Safety and Quality Improvement Act of 2005

In a case of first impression involving a medical malpractice lawsuit, the Illinois Appellate Court reversed the ruling by the trial court in Daley vs. Ingalls Memorial Hospital, which ordered a hospital to produce three...more

Baker Donelson

Court Rejects CMS's "Predicate Facts" Position

Baker Donelson on

In a decision with implications that could go back 35 years, the United States Court of Appeals for the District of Columbia Circuit rejected a CMS interpretation of its reopening rules as that interpretation affects current...more

Holland & Knight LLP

Religious Institutions Update: June 2018 - Lex Est Sanctio Sancta

Holland & Knight LLP on

Since 1990, the U.S. Supreme Court has expressly construed a neutral law of general applicability as consistent with the free exercise clause. Deeming Colorado's public accommodations law just such a law, the Colorado Court...more

Akerman LLP - Health Law Rx

Reversal of Fortune: Rhode Island Court Withdraws “Tentative” Decision to Grant Summary Judgment to Health Insurer in Health...

In what was a surprise result, on April 23, Judge William Smith (Chief Judge of the District of Rhode Island) reversed the “tentative” decision he had announced last November, in Stewart Health v. Blue Cross & Blue Shield of...more

Baker Donelson

CMS Issues Updated Medicare Payment and Billing Policies for 340B Hospitals

Baker Donelson on

On April 2, 2018, CMS issued updated guidance related to the dramatic Medicare payment reductions that went into effect this year for certain 340B hospitals. The guidance explains the planned application of the payment cuts...more

Baker Donelson

Court Upholds Procedural Validity of HHS's Outlier Reconciliation Instructions

Baker Donelson on

On December 26, 2017, the United States Court of Appeals for the District of Columbia Circuit upheld the procedural validity of 2010 manual instructions setting out the criteria by which Medicare outlier payments might be...more

41 Results
 / 
View per page
Page: of 2

"My best business intelligence, in one easy email…"

Your first step to building a free, personalized, morning email brief covering pertinent authors and topics on JD Supra:
*By using the service, you signify your acceptance of JD Supra's Privacy Policy.
- hide
- hide