Policy & Compliance
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July 12, 2024
Whistleblower's Attys Get $5.9M After Losing $11.5M Fee Ask
A Massachusetts federal judge awarded a whistleblower's counsel $5.9 million in fees plus $651,845 in costs and expenses after slashing their prior "exorbitant" $11.5 million fee request in May in a decade-old False Claims Act lawsuit alleging Fresenius Medical Care billed Medicare for unnecessary hepatitis tests.
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July 12, 2024
Military's IVF Policy Defense Fails Post-Chevron, Group Says
A nonprofit that's challenging the U.S. military's in vitro fertilization coverage policy for service members told a New York federal judge that federal agencies cannot claim they're entitled to Chevron deference in the wake of the U.S. Supreme Court's recent decision overturning the decades-old precedent.
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July 12, 2024
3 Fla. Labs Settle Medicare Overbilling Case For $2.45M
Three medical labs in Clermont, Florida, have agreed to pay $2.45 million to resolve allegations they were manipulating diagnosis codes, or "code jamming," to submit more lucrative claims to Medicare and Medicaid for reimbursement by having a computer macro tack on extra diagnosis codes before filing the claims with the government.
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July 12, 2024
Boston To Pay $1M To End Health Dept. Harassment Case
A high-profile sexual harassment case against the city of Boston and its former health director settled for $1 million earlier this month, according to a copy of the agreement released Friday.
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July 12, 2024
Widower Drops Suit Over Surgical Robot-Related Death
A widower agreed Thursday to drop his suit against Intuitive Surgical Inc. over an alleged defect in its da Vinci surgical robots that allowed electricity to arc during his wife's surgery, burning her small intestine and leading to her death.
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July 12, 2024
7 Gender-Affirming Care Cases To Watch In 2024's 2nd Half
The U.S. Supreme Court has agreed to review a constitutional challenge by the federal government to Tennessee's ban on gender-affirming care for minors, while other appeals courts are weighing the constitutionality of states' and employers' restrictions on gender dysphoria treatment. Here are seven cases involving gender-affirming care access that attorneys will be tracking in the second half of the year.
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July 12, 2024
Biggest Washington Decisions Of 2024: A Midyear Report
The first half of 2024 in Washington courts was punctuated by a fizzled startup's $72 million trial win against The Boeing Co., and Monsanto Co.'s appellate reversal of a $185 million verdict in one of a series of high-profile PCB poisoning cases. Here is a closer look at some of the biggest decisions in Washington state and federal courts in the first half of 2024.
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July 11, 2024
Panel Says Kansas BCBS Unit Can't Face Rehab Suit In Colo.
A Kansas Blue Cross Blue Shield unit can't be sued in Colorado for terminating the coverage of a patient who was receiving treatment for an autoimmune syndrome, a state appellate panel ruled Thursday.
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July 11, 2024
9th Circ. Signals Dr.'s Vax-Refusal Case Deserves New Chance
Ninth Circuit judges signaled Thursday that they were likely to revive a doctor's case claiming he was wrongfully fired from his Washington State University residency for refusing to get a COVID-19 vaccination, with two judges questioning if the school went far enough to accommodate his religious beliefs.
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July 11, 2024
Fed. Circ. Pauses Ouster Of Teva Patents From Orange Book
Teva can keep challenged asthma inhaler device patents listed on, and protected by, an important government database after the Federal Circuit agreed Wednesday to pump the brakes on the patents' delisting while the Israeli drugmaker appeals an order won by Amneal in an infringement lawsuit.
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July 11, 2024
Opiate MDL Judge Flags Evidence Preservation Shortfall
An Ohio federal judge has said "at least some" of the plaintiff local government entities in four chosen bellwether cases against pharmacy benefit managers for the multidistrict litigation over the opioid epidemic failed to preserve documents and evidence for trial, warning the parties he may replace those cases.
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July 11, 2024
Hospital Urges 4th Circ. To Back Win In Worker's Vax Bias Suit
A Virginia health system told the Fourth Circuit to let its win stand in a former nurse's lawsuit claiming she was unlawfully fired for refusing the COVID-19 vaccine because of her Christian beliefs, saying the nurse raised only her personal misgivings, not religion, in her exemption request.
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July 11, 2024
Sens. Say Medical Debt Acute 'Symptom' Of Chronic Issues
A Senate health committee panel said that medical debt is a "symptom" of high costs in the healthcare system in a hearing on Thursday, with lawmakers and federal agencies proposing solutions to stabilize the issue that impacts consumers and providers.
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July 10, 2024
Drug Test Co. Pays $1M To Settle Medicare Fraud Claims
A Los Angeles drug testing lab will pay at least $1 million to settle claims it doubled-billed Medicare for toxicology tests for people undergoing treatment for opioid use disorder, Boston federal prosecutors said Wednesday.
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July 10, 2024
Buyers Say Teva Had Multipart Scheme To Delay Inhaler Rivals
Employee benefit funds accusing Teva of orchestrating a decadelong scheme to delay generic competition for its QVAR asthma inhalers told a Massachusetts federal court the drugmaker is trying to end the case by addressing merely one aspect of a multipart scheme.
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July 09, 2024
Pharma Co. Fined $16.9M For Fake Scripts, Ex-VP Arrested
A subsidiary of bankrupt DMK Pharmaceuticals Corp. faces a $16.9 million criminal fine after pleading guilty to conspiring in a scheme to ship drugs using false prescriptions, federal prosecutors announced Tuesday, adding that the subsidiary's former vice president of sales was also arrested.
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July 09, 2024
With Chevron's End, LGBTQ+ Healthcare Regs Face New Risk
The end of Chevron deference is already disrupting regulation meant to protect LGBTQ+ access to healthcare, with three federal judges blocking enforcement of a Biden administration rule prohibiting discrimination based on gender identity in healthcare.
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July 09, 2024
Healthcare Cases To Watch: A 2024 Midyear Report
Courts across the U.S. this year will oversee key cases to the healthcare industry, from multidistrict litigation over the Change Healthcare hack to a challenge of a state gender-affirming care ban at the Supreme Court. Here are the healthcare cases to watch in the second half of 2024.
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July 09, 2024
Jarkesy Decision May Hit Key Healthcare Enforcement Tool
Healthcare companies battling civil fines imposed by federal health regulators are already embracing a U.S. Supreme Court decision weakening agencies' power to impose monetary penalties without a jury trial. Many healthcare attorneys predict that a first wave of industry pushback will build to something seismic for civil penalties and federal health regulation.
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July 09, 2024
Calif. Health Players Back Managed Care Tax Amid Uncertainty
A ballot measure backed by some of the biggest healthcare players in California is designed to protect billions of dollars in revenue for the state's Medicaid program. Its impact may hinge on persuading more doctors to serve low-income patients.
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July 09, 2024
FTC Says Drug Middlemen Inflate Costs, Squeeze Pharmacies
The Federal Trade Commission said Tuesday that its study of pharmacy benefit managers has shown that six large companies now control 95% of all prescriptions filled in the U.S., allowing them to profit at the expense of patients and independent pharmacies.
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July 09, 2024
Ga. Doc Can't Get Emergency Protection In Med Mal Death Suit
In a split opinion, the Georgia Court of Appeals revived a medical malpractice case against a doctor who allegedly misdiagnosed a patient's brain condition, finding he's not shielded by a statute that sets a gross negligence standard for liability in emergency medical situations.
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July 09, 2024
Independence Blue Cross Elevates Atty To Deputy GC
Independence Blue Cross has promoted an attorney who has worked for more than 13 years for the Philadelphia-based insurance provider to serve as vice president and deputy general counsel.
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July 08, 2024
Ex-Ga. Insurance Chief Wants Lighter Term In Kickback Case
Former Georgia Insurance Commissioner John Oxendine has objected to the government's recommendation that he serve 44 months in prison and pay a $700,000 fine for his role in a multimillion-dollar medical testing kickback scheme, arguing that he is deserving of a lesser sentence.
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July 08, 2024
Ohio Woman Says Clinic Fired Her Because Of Disabled Son
A Cleveland-based kidney dialysis clinic allegedly fired a technician for telling it she might have to return to a less demanding work schedule to help treat her son's medical condition, according to a complaint filed Monday.
Expert Analysis
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Reading Between The Lines Of HHS' National Lab Opinion
The U.S. Department of Health and Human Services' Office of Inspector General recently rejected a national laboratory's request to pay a referring lab to process specimens, but the request might have been an attempt to exploit the OIG's advisory opinion process for a competitive advantage, says Mary Kohler at Kohler Health Law.
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A Closer Look At Proposed HHS Research Misconduct Rule
The U.S. Department of Health and Human Services' proposed updates to its policies on research misconduct codify many well-known best practices, but also contain some potential surprises for the research community and counsel, say attorneys at Hogan Lovells.
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Handling Religious Objections To Abortion-Related Job Duties
While health care and pharmacy employee religious exemption requests concerning abortion-related procedures or drugs are not new, recent cases demonstrate why employer accommodation considerations should factor in the Title VII standard set forth by the U.S. Supreme Court’s 2023 Groff v. DeJoy ruling, as well as applicable federal, state and local laws, say attorneys at Epstein Becker.
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Why Hemp-Synthesized Intoxicants Need Uniform Regs
State laws regulating hemp-synthesized intoxicants are a patchwork with little consistency between any given state, and without the adoption of a uniform regulatory framework, producers and consumers alike will need to be very cautious, say Dylan Anderson and Seth Goldberg at Duane Morris.
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Attorneys, Law Schools Must Adapt To New Era Of Evidence
Technological advancements mean more direct evidence is being created than ever before, and attorneys as well as law schools must modify their methods to account for new challenges in how this evidence is collected and used to try cases, says Reuben Guttman at Guttman Buschner.
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The Self-Funded Plan's Guide To Gender-Affirming Coverage
Self-funded group health plans face complicated legal risks when determining whether to cover gender-affirming health benefits for their transgender participants, so plan sponsors should carefully weigh how federal nondiscrimination laws and state penalties for providing care for trans minors could affect their decision to offer coverage, say Tim Kennedy and Anne Tyler Hall at Hall Benefits Law.
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ESG Around The World: The UK
Following Brexit, the U.K. has adopted a different approach to regulating environmental, social and governance factors from the European Union — an approach that focuses on climate disclosures by U.K.-regulated entities, while steering clear of the more ambitious objectives pursued by the EU, say attorneys at Dechert.
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3 Tips For Defending Against Data Breach Litigation
As cyberattacks become more prevalent, companies responding to data breaches must consider several strategies to better position themselves in the event of litigation even during their preliminary investigations and breach notifications, say attorneys at Davis Wright.
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Tips For Litigating Against Pro Se Parties In Complex Disputes
Litigating against self-represented parties in complex cases can pose unique challenges for attorneys, but for the most part, it requires the same skills that are useful in other cases — from documenting everything to understanding one’s ethical duties, says Bryan Ketroser at Alto Litigation.
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Air Ambulance Ch. 11s Show Dispute Program Must Resume
Air Methods’ recent bankruptcy filing highlights the urgent need to reopen the No Surprises Act’s independent dispute resolution program for air ambulances, whose shutdown benefits insurance companies and hurts providers, says Adam Schramek at Norton Rose.
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Pro Bono Work Is Powerful Self-Help For Attorneys
Oct. 22-28 is Pro Bono Week, serving as a useful reminder that offering free legal help to the public can help attorneys expand their legal toolbox, forge community relationships and create human connections, despite the challenges of this kind of work, says Orlando Lopez at Culhane Meadows.
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Playing In A Rock Cover Band Makes Me A Better Lawyer
Performing in a classic rock cover band has driven me to hone several skills — including focus, organization and networking — that have benefited my professional development, demonstrating that taking time to follow your muse outside of work can be a boon to your career, says Michael Gambro at Cadwalader.
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The Pop Culture Docket: Judge Espinosa On 'Lincoln Lawyer'
The murder trials in Netflix’s “The Lincoln Lawyer” illustrate the stark contrast between the ethical high ground that fosters and maintains the criminal justice system's integrity, and the ethical abyss that can undermine it, with an important reminder for all legal practitioners, say Judge Adam Espinosa and Andrew Howard at the Colorado 2nd Judicial District Court.