NY Judge Halts DOJ Bid For Trans Youth Medical Records

By Stewart Bishop

A New York federal judge Wednesday barred the U.S. Department of Justice from seeking medical records of transgender patients who received gender-affirming care as minors in the wake of a grand jury subpoena to NYU Langone Health System, saying the government's investigation doesn't outweigh the patients' privacy interests.

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Claritev Can't Use 'Unclean Hands' Defense In Antitrust MDL

By Gianna Ferrarin

Healthcare data firm Claritev and a group of major insurers can't assert an unclean hands defense in multidistrict litigation accusing payors of scheming to fix reimbursement rates through the data firm's pricing tools, an Illinois federal judge ruled Wednesday.

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Analysis

With Data And AI, Whistleblowers Set Off An FCA Tidal Wave

By Phillip Bantz

Whistleblowers are increasingly using artificial intelligence to comb through public data in search of potential False Claims Act cases, unleashing a flood of new complaints that are shaking up white collar defense and government enforcement efforts while subjecting more companies to potentially false allegations, experts say.

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Doc's Defamation Claim Against Cigna Barred By ERISA

By P.J. D'Annunzio

In a precedential opinion dealing with an issue of first impression, the Third Circuit on Wednesday held that the Employee Retirement Income Security Act preempts a doctor's defamation claim against Cigna because the statements stemmed from the administration of his patients' health plans.

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11th Circ. Urged To Toss Convictions In $1.4B Hospital Fraud

By Carolina Bolado

Two brothers convicted in a $1.4 billion scheme to bill insurers inflated rates for drug tests told the Eleventh Circuit on Wednesday that there was insufficient evidence to support their convictions and that they should have been allowed an evidentiary hearing after potential juror misconduct emerged following the trial.

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Judge Denies Nurses' Bid To Add New Classes In FLSA Suit

By Zach Dupont

A Colorado federal judge on Wednesday denied a motion to add new plaintiff members and classes to a Fair Labor Standards Act class and collective action from travel nurses accusing two staffing agencies of unpaid overtime.

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Florida AG Opens Probe Over CVS' Ownership Of Caremark

By Matthew Perlman

Florida state enforcers are investigating CVS Corp. over concerns that its ownership of the pharmacy benefits manager Caremark allows it to steer patients to its own retail pharmacies while taking steps to hinder independent rivals.

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Pfizer Defeats Generic Drug Claims From State AGs

By Matthew Perlman

A Connecticut federal court tossed the claims against Pfizer Inc. in one of three cases by state enforcers accusing dozens of generic-drug makers of price-fixing, finding Pfizer was not responsible for the alleged price increases on several drugs.

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UnitedHealthcare Turns Blame On MassHealth In Fraud Case

By Carolyn Muyskens

UnitedHealthcare said it plans to defend itself against accusations that it overcharged Massachusetts for senior care, claiming the state's Medicaid program was not properly administered as it moved the case to federal court. 

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Insurer Says No Coverage For Home Care Co. In Abuse Suits

By Hope Patti

A Liberty Mutual unit told a Pennsylvania federal court that it owes no coverage to a home care service provider in litigation over the abuse and death of a patient by a caregiver who was convicted of neglect and financial exploitation.

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Delta Dental Says Wash. Antitrust Suit Echoes Faulty Claims

By Rachel Riley

Delta Dental of Washington said Tuesday an Evergreen State dentist targeting the dental insurer in a proposed antitrust class action has excluded its national affiliates from the case to "escape from a federal court's rejection of identical arguments" that the companies conspired to stifle insurer competition and suppress reimbursement rates.

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Wholesalers Say Novo Can't Duck GLP-1 Antitrust Suits

By Bryan Koenig

Drug buyers want a New York federal judge to preserve proposed class claims accusing Novo Nordisk of paying Teva to delay generic competition with its Victoza GLP-1 drug, arguing that whatever the underlying deal was, no generic version materialized when it could have.  

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Mich. Tribe Says BCBS Hid Facts Behind ERISA Time Bar

By Susan Smiley

Counsel for the Saginaw Chippewa Indian Tribe of Michigan told a Sixth Circuit panel Wednesday that claims against Blue Cross Blue Shield that it did not seek lower, Medicare-like rates for the tribe's plan members should not be time-barred because tribe members did not know until 2014 that the insurance company had been overpaying for coverage.

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Gene Therapy Co. Sangamo Gets Initial OK For $30M DIP

By Alex Wittenberg

A Delaware bankruptcy judge on Wednesday granted interim approval of a $30 million Chapter 11 financing package for biotechnology company Sangamo Therapeutics Inc., funds that the debtor will use to support a sale process for its assets.

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New Timeline For Benefits Cases May Increase FCA Litigation

Recent reforms designed to speed enforcers’ intervention decisions in False Claims Act suits involving state-administered benefits will likely encourage more qui tam relators to litigate cases without the government’s imprimatur, and increase defendants’ discovery burdens, defense costs and business disruptions, say attorneys at Morgan Lewis.

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A Midyear Look At Antiterrorism Act Jurisprudence And Policy

Plaintiffs have filed comparably fewer new actions under the Antiterrorism Act this year, though a handful of key decisions further defined the statute’s aiding-and-abetting standard and highlighted continuing risks for financial services companies, say attorneys at Skadden.

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Why Highly Specialized Experts May Risk Exclusion At Trial

Expert witnesses with highly specific areas of focus may be vulnerable to exclusion in court, making it important for attorneys to check how potential witnesses' qualifications can be bolstered by their publications and other professional activities, say Evan Weisberg and Christopher Cunio at Hunton, and Kevin Cahill at FTI Consulting.

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How 3 Courts Are Approaching AI Adoption

By Emily Sawicki

The rules surrounding artificial intelligence experimentation in courts run the gamut from court systems offering proprietary tools and training to unwritten policies that essentially amount to don't ask, don't tell.

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Conn. Justices Threaten Sanctions For AI Errors

By Andrea Keckley

The Connecticut Supreme Court has threatened to sanction GLG Law LLC and one of its attorneys for submitting documents in two cases "that misrepresented the law through the use of generative artificial intelligence," according to a Tuesday order that summoned them to appear in court next month.

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Atty DQ Over Inadvertent Doc Disclosure Overturned

By Y. Peter Kang

A California state appeals court has upended the disqualification of defense counsel in a sexual battery suit, saying documents undermining the case that were accidentally produced via a Dropbox link were not privileged.

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DOJ Nominee Questioned About Deleted Social Media Posts

By Courtney Bublé

A nominee for a top U.S. Department of Justice position, who is a real estate attorney turned tech entrepreneur, came under fire on Wednesday for past social media posts that he's now deleted.

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Booker, Cassidy Press DOJ On Trump Immunity Deal

By Courtney Bublé

Sens. Bill Cassidy, R-La., and Cory Booker, D-N.J., wrote to acting Attorney General Todd Blanche on Wednesday expressing "serious concerns" about the alleged immunity for President Donald Trump, his family and businesses in the controversial settlement he reached with the IRS.

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