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October 28, 2024
Surge In Nicotine Fee Suits Shows Wellness Program Risks
A recent crop of suits accusing large employers of violating nondiscrimination provisions in federal benefits law by making workers who use nicotine pay more for health insurance underscore the risk of using fees to offset healthcare costs, attorneys say. Here are five nicotine surcharge suits to keep an eye on.
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October 28, 2024
HHS Says In-Home Evals Raised Insurers' Medicare Payments
Private Medicare insurers collected an estimated $4.2 billion in extra federal payments last year from in-home health assessments they conducted, even though the evaluations led to no treatment, according to a report by the U.S. Department of Health and Human Services' internal watchdog.
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October 28, 2024
Conn. Healthcare Co.'s $1.5M Data Breach Deal Gets Final OK
A Connecticut federal judge has given his final approval to a class action settlement that requires Merritt Healthcare Advisors to pay thousands of people whose personal information was exposed in a data breach.
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October 28, 2024
Mass. Court's Wiretap Ruling May Be Bad Omen For Plaintiffs
A ruling by the Massachusetts high court rejecting wiretap claims over website operators' use of tracking software like Meta Pixel and Google Analytics shows the steep climb plaintiffs may continue to face as they try to apply older laws to modern technologies, experts told Law360.
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October 28, 2024
5th Circ. Affirms Texas Health Coordinator Is Not Tax-Exempt
A Texas nonprofit corporation that coordinates healthcare mostly for privately insured patients does not qualify for tax-exempt status because its business fails to help the larger community, the Fifth Circuit ruled Monday in affirming a U.S. Tax Court decision.
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October 28, 2024
Hospital Wants NC County's 'Monopoly' Suit Tossed
Owners of an Asheville, North Carolina, hospital accused of understaffing its emergency room and driving up wait times say the county suing them for unjust enrichment is actually trying to get paid twice for healthcare its emergency responders have already provided.
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October 28, 2024
Crown Settles Customer Dispute To Close $924M Revance Buy
Revance Therapeutics has settled a distribution-related dispute with customer Teoxane SA, potentially clearing the path for its planned $924 million acquisition by skincare company Crown Laboratories.
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October 25, 2024
NLRB Wins Injunction, Defeats Constitutional Claims In Mich.
A Michigan federal judge handed the National Labor Relations Board two victories Friday in the agency's dispute with a hospital, ordering the hospital to resume recognizing the Service Employees International Union affiliate it ousted last year and rejecting the hospital's argument that the agency's structure is unconstitutional.
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October 25, 2024
Jury In Formula Trial Told Baby's Condition Likely Genetic
An expert witness for Abbott and Mead Johnson in the first joint trial against the baby formula makers told a St. Louis jury Friday he believes the child at the center of the case has a genetic condition that's responsible for most of his intellectual impairment.
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October 25, 2024
NJ Ethics Board Faces Contempt Bid In Retaliation Fight
Counsel for a New Jersey health official who claimed his firing during the COVID-19 pandemic was retaliatory asked a court to hold the State Ethics Commission in contempt for stalling discovery under the guise that the state health regulator initiated the termination, despite "well documented" evidence that it was the commission and Gov. Phil Murphy.
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October 25, 2024
Premera Rejection Seems Sparse, 9th Circ. Judges Say
A Ninth Circuit judge pressed Premera Blue Cross on Friday to defend refusing coverage for a Washington teen's lengthy mental health residential treatment, questioning if the insurer engaged in a meaningful dialogue as required with the youth's family in letters explaining why the treatment was medically unnecessary.
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October 25, 2024
Tenn. Hospitals Want Former Execs Nixed From Kickback Row
A hospital system on Friday urged a North Carolina federal court to dismiss whistleblower claims from former executives alleging the system excessively paid physicians to make referrals in order to receive Medicare and Medicaid money.
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October 25, 2024
2nd Circ. Says Man Can't Challenge Removal Over Atty Failure
The Second Circuit on Friday denied a man's bid to reopen removal proceedings based on his former attorney's failure to submit important documents, saying the man should have provided evidence supporting his claim of ineffective assistance of counsel earlier.
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October 25, 2024
Dental Exec Flees Ahead Of Possible 7-Year Fraud Sentence
An arrest warrant was issued Friday for the former CEO of a dental device company who pled guilty to defrauding investors out of $10.7 million after he did not show up for his sentencing hearing, where Washington federal prosecutors were asking for seven years in prison.
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October 25, 2024
High Court Bar's Future: Mitchell Law's Jonathan F. Mitchell
The pantheon of U.S. solicitors general doesn't include many lawyers who've openly challenged the U.S. Supreme Court's authority or sought to undermine its landmark precedents. But there aren't many lawyers like Jonathan F. Mitchell, a crusading conservative who rescued former President Donald Trump's reelection run — and in the process positioned himself to become the government's top oral advocate.
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October 25, 2024
Ga. Woman Gets 12 Years For $30M COVID Fraud Scheme
A Georgia woman was sentenced to 12 years in prison Thursday for her role in filing more than 5,000 fraudulent COVID-19 unemployment insurance claims with the Georgia Department of Labor, which resulted in at least $30 million in stolen benefits.
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October 25, 2024
Masimo Infringed 2 Apple Watch Patents, Jury Finds
Healthcare tech company Masimo Corp. was found to have infringed two of Apple Inc.'s patents Friday at the close of a five-day U.S. District Court jury trial in Delaware that put more future tech prospects than current cash on the line.
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October 25, 2024
Pharmacy Must Pay $39.2M In Conn. Kickback Case
A defunct compounding pharmacy must pay $39.2 million in damages and penalties for its role in a kickback scheme that made illegal payments to Connecticut state employees and retirees, a state court judge ruled Friday while letting the company's proprietor off the hook.
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October 25, 2024
UK Litigation Roundup: Here's What You Missed In London
This past week in London has seen the Competition and Markets Authority take action against a mattress retailer after it was caught pressuring its customers with misleading discounts, Lenovo and Motorola target ZTE Corporation with a patents claim, Lloyds Bank hit by another claim relating to the collapse of Arena Television and U.K. tax authority HMRC sued by the director of an electronics company that evaded millions of pounds in VAT. Here, Law360 looks at these and other new claims in the U.K.
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October 25, 2024
Kirkland-Led Nautic Closes Largest-Ever Fund At $4.5B
Kirkland & Ellis LLP-advised Nautic Partners LLC on Friday announced that it closed its largest fund yet after securing $4.5 billion from investors.
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October 24, 2024
FTC Official Doubts Election Will Deter Antitrust 'New Era'
The Federal Trade Commission's Bureau of Competition director defended the agency's new guidelines and its track record during a wide-ranging discussion at the 34th annual Golden State Institute on Thursday, and he expressed confidence that whichever presidential candidate wins, a new administration won't deter this "new era" of FTC antitrust enforcement actions.
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October 24, 2024
Mich. AG Claims Express Scripts, Optum Fueled Opioid Crisis
The state of Michigan has taken aim at Express Scripts and OptumRx for their role in the opioid crisis in a complaint filed in state court Thursday, the latest state to claim the companies for years boosted sales of opioids by giving them favorable placement on drug lists in exchange for rebates.
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October 24, 2024
11th Circ. Seeks Bias Test Briefing In Fla. Trans Patients' Suit
The Eleventh Circuit has ordered Florida health officials and transgender individuals to provide additional briefing in the state's appeal to reverse a ruling blocking its ban on Medicaid coverage for gender-affirming care, directing the parties to present their positions on whether hostile discrimination analysis applies to certain classes of people.
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October 24, 2024
Colo. Justices Grill State On Biz Names, ID Theft Law
Colorado Supreme Court justices pressed state prosecutors Thursday on why a man's reversed conviction for identity theft should be reinstated, saying the identity theft law's use of "name" as a type of personal information seems to suggest the law refers only to people and not corporations.
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October 24, 2024
2nd Circ. Says Healthcare Arbitrations Were Properly Halted
The Second Circuit affirmed Thursday that a lower court properly halted a group of healthcare providers from pursuing thousands of arbitrations against State Farm as part of an alleged massive fraudulent scheme, ruling in a novel opinion the injunction did not violate federal arbitration law.
Expert Analysis
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11th Circ. Kickback Ruling May Widen Hearsay Exception
In a $400 million fraud case, U.S. v. Holland, the Eleventh Circuit recently held that a conspiracy need not have an unlawful object to introduce co-conspirator statements under federal evidence rules, potentially broadening the application of the so-called co-conspirator hearsay exception, say attorneys at ArentFox Schiff.
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8 Childhood Lessons That Can Help You Be A Better Attorney
A new school year is underway, marking a fitting time for attorneys to reflect on some fundamental life lessons from early childhood that offer a framework for problems that no legal textbook can solve, say Chris Gismondi and Chris Campbell at DLA Piper.
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Navigating Complex Regulatory Terrain Amid State AG Races
This year's 10 attorney general elections could usher in a wave of new enforcement priorities and regulatory uncertainty, but companies can stay ahead of the shifts by building strong relationships with AG offices, participating in industry coalitions and more, say Ketan Bhirud and Dustin McDaniel at Cozen O’Connor.
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Sublimit And Policy Interpretation Lessons From Amtrak Case
The recently settled dispute between Amtrak and its insurers over sublimit coverage illustrates that parties with unclear manuscript policies may wish to avoid litigation in favor of settlement — as the New York federal court declined to decide the case by applying prior term interpretations, says Laura Maletta at Chartwell Law.
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Opinion
This Election, We Need To Talk About Court Process
In recent decades, the U.S. Supreme Court has markedly transformed judicial processes — from summary judgment standards to notice pleadings — which has, in turn, affected individuals’ substantive rights, and we need to consider how the upcoming presidential election may continue this pattern, says Reuben Guttman at Guttman Buschner.
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Navigating HHS' New Reproductive Healthcare Privacy Rule
The U.S. Department of Health and Human Services' new final rule regarding protections for the privacy of reproductive health information will require regulated entities to grapple with difficult questions about whether to comply with state law requirements or federal privacy prohibitions, says Christine Chasse at Spencer Fane.
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Mental Health Parity Rules: Tips For Plans And Issuers
Following federal agencies' release of final mental health parity rules, plan sponsors and health insurance issuers should develop protocols for preparing compliant nonquantitative treatment limitation comparative analyses, say attorneys at Ropes & Gray.
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Series
Playing Diplomacy Makes Us Better Lawyers
Similar to the practice of law, the rules of Diplomacy — a strategic board game set in pre-World War I Europe — are neither concise nor without ambiguity, and weekly gameplay with our colleagues has revealed the game's practical applications to our work as attorneys, say Jason Osborn and Ben Bevilacqua at Winston & Strawn.
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Mental Health First Aid: A Brief Primer For Attorneys
Amid a growing body of research finding that attorneys face higher rates of mental illness than the general population, firms should consider setting up mental health first aid training programs to help lawyers assess mental health challenges in their colleagues and intervene with compassion, say psychologists Shawn Healy and Tracey Meyers.
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Opinion
FTC's Report Criticizing Drug Middlemen Is Flawed
The Federal Trade Commission's July report, which claims that pharmacy benefit managers are inflating drug costs, does not offer a credible analysis of PBMs, and its methodology lacks rigor, says Jay Ezrielev at Elevecon.
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Series
Collecting Art Makes Me A Better Lawyer
The therapeutic aspects of appreciating and collecting art improve my legal practice by enhancing my observation skills, empathy, creativity and cultural awareness, says attorney Michael McCready.
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Plan Sponsors Must Prep For New Mental Health, Drug Rules
To comply with newly published health insurance rules requiring parity between access to mental health and substance use services compared to medical and surgical services, employers with self-insured plans will need to update third-party administrator agreements and collect data, among other compliance steps, say attorneys at Kilpatrick.
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Navigating The Complexities Of Cyber Incident Reporting
When it comes to cybersecurity incident response plans, the uptick in the number and targets of legal and regulatory actions emphasizes the necessity for businesses to document the facts underlying the assumptions, complexities and obstacles of their decisions during the incident response, say attorneys at Troutman Pepper.
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Takeaways From Novo Nordisk's Fight For Market Exclusivity
Generic competitors’ challenge to Novo Nordisk’s patents in hopes of capturing a portion of the rapidly expanding Type 2 diabetes and obesity treatment market highlights the role of abbreviated new drug application litigation, inter partes review and multidistrict litigation in patent defense, says Pedram Sameni at Patexia.
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Secret Service Failures Offer Lessons For Private Sector GCs
The Secret Service’s problematic response to two assassination attempts against former President Donald Trump this summer provides a crash course for general counsel on how not to handle crisis communications, says Keith Nahigian at Nahigian Strategies.