On March 31, 2015, a 5-4 plurality of the Supreme Court of the United States ruled that Medicaid providers do not have a private right of action under the Medicaid statute to challenge reimbursement rates. The Supreme Court’s...more
On February 25, 2015, the Supreme Court of the United States held that the North Carolina Dental Board (“Board”) was not insulated from federal antitrust liability under the so-called “state action” doctrine when it engaged...more
On March 9, 2015, the Supreme Court ruled unanimously that when a federal administrative agency wants to amend or repeal an “interpretive rule,” it does not have to follow the notice-and-comment procedures set forth in the...more
Perhaps never before have employers faced so many challenges when it comes to health care issues affecting their workforce. Congress may try to amend the Affordable Care Act (“ACA”). The Supreme Court of the United States is...more
2/26/2015
/ Affordable Care Act ,
Department of Labor (DOL) ,
Employer Group Health Plans ,
Equal Employment Opportunity Commission (EEOC) ,
Flexible Spending Accounts ,
GINA ,
Health Insurance ,
Health Insurance Portability and Accountability Act (HIPAA) ,
Health Savings Accounts ,
Individual Mandate ,
Preexisting Conditions ,
SCOTUS ,
Tax Credits ,
Telehealth ,
Telemedicine ,
Wellness Programs
On August 29, 2014, two whistleblower developments of particular interest to health care and life science entities emerged from the Securities and Exchange Commission ("SEC") and the Eighth Circuit Court of Appeals,...more
On July 22, 2014, the U.S. Court of Appeals for the D.C. Circuit and the U.S. Court of Appeals for the Fourth Circuit issued conflicting opinions on a key aspect of the Affordable Care Act ("ACA"). The cases are Halbig v....more
7/30/2014
/ Affordable Care Act ,
Appeals ,
Barack Obama ,
Employer Mandates ,
En Banc Review ,
Halbig v Burwell ,
Health Insurance ,
Health Insurance Exchanges ,
Healthcare Reform ,
King v Burwell ,
SCOTUS ,
Subsidiaries ,
Tax Credits
For employers with employees in the 36 states with a federally facilitated exchange, the question arises how the Halbig decision impacts their decision and strategy to provide health coverage to their employees when the...more
Especially in the District of Columbia Circuit, the home base for many fraud cases in which the government is opposed to health care providers and defense contractors, there had been considerable doubt that the...more
Employers attempting to manage corporate compliance programs while balancing privacy concerns and whistleblower protections might find a certain irony, perhaps empathy, in the Obama administration's recent petition for U.S....more
3/7/2014
/ CFTC ,
Confidentiality Agreements ,
Dodd-Frank ,
Lawson v FMR ,
NTSA ,
Retaliation ,
Sarbanes-Oxley ,
SCOTUS ,
Securities and Exchange Commission (SEC) ,
Separation Agreement ,
Training ,
Transportation Security Administration ,
Whistleblower Protection Policies
On October 15, 2013, a divided three-judge panel of the United States Court of Appeals for the Eighth Circuit rendered a federal False Claims Act ("FCA") judgment against Bayer Healthcare Pharmaceuticals ("Bayer"), based on a...more
A unanimous Supreme Court has issued its opinion in Sebelius v. Auburn Regional Medical Center, No. 11-1231 (Jan. 22, 2013), rejecting a challenge by hospitals to Medicare's Supplemental Security Income ("SSI") fraction...more
In a long-awaited decision, on December 3, 2012, a divided panel (2–1) of the U.S. Court of Appeals for the Second Circuit vacated the conviction of Alfred Caronia, a former pharmaceutical sales representative for Jazz...more