Eighth Circuit Reverses Dismissal of Putative Class Claims
DE Under 3: Reversal of 2019 Enterprise Rent-a-Car Trial Decision; EEOC Commissioner Nominee Update; Overtime Listening Session
Revisiting McGirt: New Legal Developments Challenge Oklahoma’s Landmark Ruling
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The Immediate and Lasting Impacts of McGirt: A Novel Ruling for Oklahoma
The Dangers of Untimely Filings – What Employers Need to Know
Nota Bene Episode 98: The U.S. Supreme Court’s Mark on U.S. Antitrust Law for 2020 with Thomas Dillickrath and Bevin Newman
#BigIdeas2020: NLRB’s Actions Impact Employers in 2020 - Employment Law This Week® - Trending News
Jones Day Talks: Women in IP: The Supreme Court's "Copyright Day"
Podcast: South Dakota v. Wayfair
E17: Carpenter Decision Builds Up Privacy from #SCOTUS
I-16 – Kneeling, Indefinite Leave, DC Updates, Non-Compete Consideration, and Pretty as a Protected Class
On November 3, the Centers for Medicare & Medicaid Services (CMS) issued an update to its Medicare Part B drug payment policy for hospitals participating in the 340B drug pricing program and reversed payment cuts in place...more
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
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
William F. Gould In United States v. Merino, No. 19-50291, 2021 WL 754589 (9th Cir. Feb. 26, 2021), the court of appeals reversed the conviction of Marina Merino of conspiracy to commit healthcare fraud in violation of 18...more
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
In the Care Alternatives False Claims Act (FCA) appeal, a panel of the US Court of Appeals for the Third Circuit on March 4 reversed the summary judgment granted to hospice provider Care Alternatives at the district court,...more
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
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
Last week, the 11th Circuit Federal Court of Appeals reversed summary judgment given to AseraCare in its hospice false claims case, setting up more litigation on the question whether AseraCare’s certifications were made in...more
In a 3-0 decision issued September 9, 2019, the U.S. Court of Appeals for the Eleventh Circuit affirmed a three-year-old district court ruling in United States v. AseraCare, Inc. that a Medicare claim for hospice services...more
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
In a recent decision, the Northern District of Texas, Dallas Division, granted a health care provider a preliminary injunction to prevent the Centers for Medicare & Medicaid Services ("CMS") from withholding Medicare payments...more
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
On March 27, 2018, the United States Court of Appeals for the Fifth Circuit published an opinion that provides Family Rehabilitation, Inc. (Family Rehab) a second chance to postpone recoupment of about $7.6 million in...more
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
For much of the past decade, hospitals and CMS have battled over whether providers may claim, as Medicare reasonable costs, the full amount of provider tax assessments levied upon them by the states in which they operate. In...more
Hopes were dashed for sooner relief from the backlog of Administrative Law Judge (ALJ) appeals. With the backlog of Medicare reimbursement appeals steadily growing, a reversal by the U.S. Court of Appeals for the District of...more
OIG Advisory Opinions - Manufacturer's Free Replacement of Spoiled Pharmaceutical Products Authorized - On Aug. 25, 2017, the U.S. Department of Health and Human Services' (HHS) Office of Inspector General (OIG)...more
Hospitals affected by HHS's 2014 decision to include Medicare Part C enrollees as part of the Medicare fraction of the disproportionate share calculation obtained relief late last month when that position was voided by the...more
On October 27, 2016, a three-judge panel for the United States Court of Appeals for the First Circuit issued an opinion concluding that a Medicare fiscal intermediary (Intermediary) does not have the authority to enter into a...more
On July 25, 2016, the United States District Court for the District of Columbia issued an opinion favoring provider flexibility in the reasonable collection of Medicare bad debt. Winder HMA, LLC, et al. v. Sylvia Burwell. The...more
Caring Hearts Personal Home Care Services provided physical therapy and skilled nursing services to homebound Medicare patients. During an audit, CMS determined that Caring Hearts provided services to patients who didn’t...more
For 23 years, the Ninth Circuit required that a relator establish three elements to qualify as an “original source” under the False Claims Act: (1) the relator must have direct and independent knowledge of the information on...more
Medicare does not cover supplies or services for persons who are incarcerated at the time the services are rendered. However, Medicare had purportedly paid providers in error for many such claims and sought to recover those...more
In Sebelius v. Auburn Regional Medical Center, No. 11-1231 (Jan. 22, 2013), the Supreme Court reversed a decision of the D.C. Circuit which had held that the 180-day time limit for hospitals to file a cost report appeal with...more