N.Y. Federal Judge Dismisses Medicare Provider Termination Suit

ROCHESTER, N.Y. - A New York federal judge on Dec. 17 dismissed a suit challenging the termination of a Medicare and Medicaid provider agreement without a pretermination hearing and other administrative review procedures, saying the termination was proper (Blossom South v. Kathleen Sebelius, et al.,...

Supreme Court Justice Halts Birth Control Mandate For Catholic Group

WASHINGTON, D.C. - U.S. Supreme Court Justice Sonia Sotomayor on Dec. 31 temporarily blocked the federal government from enforcing the birth control mandate contained in the Patient Protection and Affordable Care Act (PPACA) against an order of Catholic nuns at the request of the group after a lower...

Preliminary Injunction Granted In Religious Groups' Challenge To Mandate

FORT WAYNE, Ind. - An Indiana federal judge on Dec. 27 granted a preliminary injunction in favor of a group of Catholic organizations in their challenge to the birth control mandate contained in the Patient Protection and Affordable Care Act (PPACA) (Diocese of Fort Wayne-South Bend Inc., et al. v. Kathleen...

Indiana Federal Judge Grants Injunction In Birth Control Suit

SOUTH BEND, Ind. - An Indiana federal judge on Dec. 27 granted a preliminary injunction in favor of two not-for-profit Christ-center institutions of higher learning in their challenge to the birth control mandate contained in the Patient Protection and Affordable Care Act (PPACA) (Grace Schools, et al...

Government Opposes Supreme Court's Halt Of Birth Control Mandate

WASHINGTON, D.C. - The federal government on Jan. 3 filed a brief with the U.S. Supreme Court opposing an emergency injunction pending appellate review or, in the alternative, a petition for a writ of certiorari before judgment and injunction pending resolution following a Dec. 31 order by Justice Sonia...

9th Circuit Vacates Injunctions In Medicare Secondary Payer Class Action Suit

SAN FRANCISCO - A Ninth Circuit U.S. Court of Appeals panel on Jan. 2 filed an amended opinion vacating injunctions entered by a lower court prohibiting the secretary of the U.S. Department of Health and Human Services (DHHS) from demanding "up front" reimbursement for secondary payments from...

Texas Federal Judge Grants Injunction To Halt Implementation Of Mandate

BEAUMONT, Texas - A Texas federal judge on Jan. 2 granted a permanent injunction to halt the implementation of the birth control mandate contained in the Patient Protection and Affordable Care Act (PPACA) against the Catholic Diocese of Beaumont and Catholic Charities of Southeast Texas Inc. but dismissed...

6th Circuit Grants Injunction Pending Appeal In Birth Control Suit

GRAND RAPIDS, Mich. - The Sixth Circuit U.S. Court of Appeals on Dec. 31 granted an injunction pending appeal in favor of two Catholic institutions after a Michigan federal judge on Dec. 27 declined to grant a preliminary injunction in favor of the plaintiffs in their suit seeking to keep the government...

Injunction Pending Appeal Granted After Judge Dismisses Birth Control Case

WASHINGTON, D.C. - A divided District of Columbia Circuit U.S. Court of Appeals panel on Dec. 31 granted an emergency motion for injunction pending appeal in a nonprofit religious organization's case challenging the birth control mandate contained in the Patient Protection and Affordable Care Act...

D.C. Federal Judge Grants Defense Summary Judgment In Medicare Suit

WASHINGTON, D.C. - A District of Columbia federal judge on Jan. 6 granted summary judgment in favor of the U.S. Department of Health and Human Services in a Medicare reimbursement dispute, saying that the secretary's methodology in setting the rates was not arbitrary and capricious (District Hospital...

5th Circuit Affirms Convictions Of 3 People For Health Care Fraud

NEW ORLEANS - A Fifth Circuit U.S. Court of Appeals panel on Jan. 7 affirmed the convictions of three people accused of health care fraud related to Medicare and Medicaid billing (United States of America v. Umawa Oke Imo, et al., No. 11-20791, 5th Cir.; 2014 U.S. App. LEXIS 280).

Judge Dismisses Suit Over Individual, Employer Mandates In Health Care Act

HOUSTON - A Texas federal judge on Jan. 10 dismissed a case challenging the individual and employer mandates contained in the Patient Protection and Affordable Care Act (PPACA), holding that the mandates did not violate the origination clause of the U.S. Constitution or the taking clause of the Fifth...

U.S. Supreme Court Denies Certiorari In Medicare Part D Challenge

WASHINGTON, D.C. - The U.S. Supreme Court on Jan. 13 denied a petition for certiorari in a case seeking review of an appeals court decision affirming a federal trial court order denying judicial review of a challenge to the U.S. Department of Health and Human Services (HHS) Medicare Part D rule allowing...

High Court Will Not Review ERISA Benefit And Disclosure Claims

WASHINGTON, D.C. - The U.S. Supreme Court on Jan. 13 denied a plan participant's petition for a writ of certiorari seeking review of an 11th Circuit U.S. Court of Appeals ruling that a health plan insurer did not abuse its discretion in calculating benefits and that the insurer was not liable for...

Supreme Court Denies Petition In Suits Over Medicaid Reimbursements

WASHINGTON, D.C. - The U.S. Supreme Court on Jan. 13 denied a petition for writ of certiorari in two cases in which the Ninth Circuit U.S. Court of Appeals vacated preliminary injunctions prohibiting the California Department of Health Care Services and its director from implementing Medi-Cal reimbursement...

Pennsylvania Court: Methodology For Setting Medicaid Reimbursement Rational

HARRISBURG, Pa. - A Pennsylvania court on Jan. 8 affirmed that the Pennsylvania Department of Public Welfare's (DPW) new methodology for determining Medicaid reimbursement rates was rational (Armstrong County Memorial Hospital v. Department of Public Welfare, No. 711 C.D. 2013, Pa. Comm., 2014 Pa...

8th Circuit Affirms Dismissal Of Medicare False Billings Case

ST. LOUIS - An Eighth Circuit U.S. Court of Appeals panel on Jan. 9 affirmed the dismissal of a Medicare false claims billing case, saying the plaintiff failed to plead fraud with the sufficient particularity required (United States of America, ex rel. Michael Dunn v. North Memorial Health Care, et al...

9th Circuit Reverses Injunction In California Medi-Cal Dispute

SAN FRANCISCO - A Ninth Circuit U.S. Court of Appeals panel on Jan. 9 reversed a decision affirming a preliminary injunction prohibiting the California Department of Health Care Service (DHCS) from implementing Medicaid reimbursement rate reductions, saying the lower court erroneously interpreted the...

Michigan Federal Judge Grants Injunction In Birth Control Case

DETROIT - A Michigan federal judge on Jan. 13 granted a preliminary injunction in favor of five religious organizations challenging the birth control mandate contained in the Patient Protection and Affordable Care Act (PPACA) (The Ave Marie Foundation, et al. v. Kathleen Sebelius, et al., No. 13-15198...

Arkansas Federal Judge Affirms Decision Disallowing Medicare Payments

LITTLE ROCK, Ark. - An Arkansas federal judge on Jan. 10 granted summary judgment in favor of the federal government in a challenge to a final decision of the secretary of the U.S. Department of Health and Human Service (DHHS) to disallow Medicare payments to a diagnostic audiological testing facility...

Judge: Act Authorizes Tax Credits For Insurance Bought On Federal Exchanges

WASHINGTON, D.C. - A District of Columbia federal judge on Jan. 15 granted summary judgment in favor of the federal government in a suit challenging an Internal Revenue Service regulation imposed under the Patient Protection and Affordable Care Act (PPACA) that extends eligibility for premium assistance...

Podiatrist Admits Lying To Grand Jury Investigating Orthofix Health Care Fraud

BOSTON - A Virginia podiatrist on Jan. 15 pleaded guilty to lying to a federal grand jury during an investigation into health care fraud and kickbacks related to bone growth stimulators sold by Orthofix Holdings Inc. (United States of America v. Ilene Terrell, No. 1:13-10180, D. Mass.).

Federal Magistrate Declines To Transfer Denial Of Benefits Case To Other Court

MILWAUKEE - A Wisconsin federal magistrate judge on Jan. 15 denied a defendant's motion to transfer a wrongful denial of benefits case to another federal court (Ryan M. Redmond v. Sirius International Insurance Corp., No. 12-587, E.D. Wis.; 2014 U.S. Dist. LEXIS 5089).

N.J. Federal Judge Remands Reimbursement Dispute; No Federal Jurisdiction Exists

NEWARK, N.J. - In an unpublished opinion, a New Jersey federal judge on Jan. 21 granted a plaintiffs' motion to remand its health care reimbursement suit, saying neither complete preemption nor an embedded federal question of jurisdiction existed (MHA d/b/a Meadowlands Hospital Medical Center v....

N.Y. Federal Judge Declines To Reinstate Injunction Pending Appeal Of Dismissal

ROCHESTER, N.Y. - A New York federal judge on Jan. 16 denied a motion by a nursing home operator to reinstate a preliminary injunction pending its appeal of a decision dismissing its suit challenging the termination of its Medicare and Medicaid provider agreement (Blossom South v. Kathleen Sebelius,...