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Appeals Remand Health Care Providers

Marshall Dennehey

Pennsylvania Superior Court Vacates Summary Judgment Due to Procedural Error in Response Time

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Jordan v. Lynde, 330 A.3d 817 (Pa. Super. Ct. 2024) - The Pennsylvania Superior Court ruled that the trial court abused its discretion by failing to grant the appellants the 30-day response period required under Pa. R.Civ.P....more

Foley Hoag LLP

American Hospital Association et al. v. Becerra et al.: Supreme Court Rejects CMS Policy to Adjust Medicare Part B Payments for...

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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

Holland & Knight LLP

AseraCare Announces Settlement of Landmark False Claims Act Case for $1 Million

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After litigation spanning more than a decade, hospice provider AseraCare announced its $1 million settlement with the U.S. Department of Justice (DOJ) in a closely-watched False Claims Act (FCA) case in the U.S. District...more

King & Spalding

Eleventh Circuit Denies Preliminary Injunction for New National Liver Transplant Allocation Policy

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On September 25, 2019, the United States Court of Appeals for the Eleventh Circuit affirmed a lower court’s decision to deny a motion for a preliminary injunction to stay the implementation of the new policy for allocating...more

King & Spalding

False Claims Act Case Based on Stark Law Violations to Continue After the Third Circuit Revives Whistleblowers’ Claims

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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

Baker Donelson

Disagreements over a Medical Judgment Cannot Form the Basis for Liability Under the False Claims Act

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A new federal court decision offers a ray of light to those providers defending false claims actions based on an alleged lack of medical necessity. On September 9, 2019, the United States Court of Appeals for the Eleventh...more

Foley Hoag LLP - White Collar Law &...

Eleventh Circuit Holds Differences in Clinical Judgment Do Not Create FCA Liability for Hospice Provider

The Eleventh Circuit agreed with the trial court that the government must do more than present expert evidence that a physician’s clinical judgment was inaccurate to establish falsity under the False Claims Act. Nonetheless,...more

K&L Gates LLP

K&L Gates Triage: Recent Developments Impacting Drug Pricing and the 340B Program: Part 2

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In Part Two of this two-part series on recent developments in pharmacy law and the 340B drug pricing program, Richard Church and Ryan Severson discuss several recent developments related to the 340B drug pricing program,...more

Morgan Lewis - Health Law Scan

The Zombification of Auer: Supreme Court Cabins Agency Deference in Kisor v. Wilkie

Paired with the recent decision in Azar v. Allina, the healthcare industry in particular can hope for a greater voice in the regulatory process in the wake of the US Supreme Court’s directives. With Allina’s requirement that...more

K&L Gates LLP

K&L Gates Triage: Medicare Overpayment Recoupment Halted by Court

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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

Baker Donelson

Court of Appeals Reverses D.D.C. Order Requiring HHS to Eliminate Medicare Appeals Backlog by December 31, 2020

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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

Bass, Berry & Sims PLC

Deeper Dive: Meeting the FCA’s Intent Requirement

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The FCA continues to be the federal government’s primary civil enforcement tool for investigating allegations that healthcare providers or government contractors defrauded the federal government. In the coming weeks, we will...more

Snell & Wilmer

Is Your Arbitration Agreement Enforceable?

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Health care providers may favor arbitration due to the perception that it is a faster, less expensive alternative to litigation. State and federal policy favors arbitration for the same reasons.  Because of the strong public...more

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