LexisNexis® Legal Newsroom
Williams Mullen: Preparing for a Data Breach – What to Know about Breach Notification

By Kelsey S. Farbotko Data breaches are at the forefront of the news, and many companies, including those dominant in the health care industry, have found themselves front and center in the headlines. Although recent news stories have focused their attention on attacks on major, nationwide companies...

This is Real Law: Preventive Measures: Arguing for — and Against — New Options for Patients and Public Health

The path to political office frequently starts at a law school. That observation stems from the number of lawyers who, election after election, end up sitting in Congress and in statehouses across the country. The current share of U.S. senators holding J.D.s, for example, is 53—more than half of...

Barnes & Thornburg LLP: Amarin Pharma Preemptively Sues FDA over 1st Amendment Rights

On Thursday, May 7, Amarin Pharma took the unprecedented step of proactively suing the U.S. Food and Drug Administration (FDA) over the agency’s alleged infringement of the company’s First Amendment Rights. The case arises from Amarin’s desire to market its product, Vascepa, for uses...

DLA Piper Health Systems Alert: MACRA: 3 Compliance Implications For Medicare Providers

By: Karen Nelson Much has been written about the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) and its repeal of the Sustainable Growth Rate formula for physician compensation and the potential gainsharing safe harbor. But the Act also includes certain Medicare program integrity provisions...

Barnes & Thornburg: CMS Releases Physician-Level Payment Data Totaling More Than $90 Billion in Medicare Reimbursements for 2013

By Jessica Talati On June 1, the Centers for Medicare & Medicaid Services (CMS) released its second annual installment of Medicare reimbursement data for physicians and other practitioners. The data set contains records for more than 950,000 practitioners who received a collective $90 billion...

Foley & Lardner LLP: CMS Proposes Major Update to Medicaid Managed Care Regulations

By Anil Shankar and Adam J. Hepworth The Centers for Medicare and Medicaid Services (“CMS”) released, on May 26, 2015, the a far-ranging proposal for revising the Medicaid managed care regulations (“ Proposed Rule ”). The number of individuals enrolled in Medicaid managed care...

Foley & Lardner LLP: CMS Proposes Major Update to Medicaid Managed Care Regulations

By Anil Shankar and Adam J. Hepworth The Centers for Medicare and Medicaid Services (“CMS”) released, on May 26, 2015, the a far-ranging proposal for revising the Medicaid managed care regulations (“ Proposed Rule ”). The number of individuals enrolled in Medicaid managed care...

DLA Piper: Federal Court Blocks Rule Restricting Telemedicine Practice In Texas

By Nathan Fish and Frank E. Sheeder A federal court has temporarily enjoined the Texas Medical Board (TMB) from implementing and enforcing a rule restricting the practice of telemedicine pending resolution of an antitrust lawsuit filed by Teladoc, Inc. The temporary injunction represents a small victory...

DLA Piper Health Systems Alert: U.S. Health Care Payment-Driven Transformation Ahead

By David Gruber, MD, MBA* | Healthcare spending is forecast to increase from US$3 trillion in 2014 to US$5.2 trillion in 2023, reflecting a compound annual growth rate of 5.9 percent. US healthcare expenditures on a per capita basis are 1.9-2.6 times the amount spent by other developed nations despite...

DLA Piper Health Systems Alert: Payment-Driven Transformation Ahead For U.S. Healthcare

By David Gruber, MD, MBA* Healthcare spending is forecast to increase from US$3 trillion in 2014 to US$5.2 trillion in 2023, reflecting a compound annual growth rate of 5.9 percent. US healthcare expenditures on a per capita basis are 1.9-2.6 times the amount spent by other developed nations despite...

Steptoe & Johnson PLLC: Under Stark, ‘Value’ Doesn’t Mean ‘Expensive’

The federal Stark law prohibits physician referrals of “designated health services” payable by Medicare to entities with which the physician or an immediate family member has a financial relationship, unless the arrangement meets an exception. Enforcement initiatives aim at extending the...

Barnes & Thornburg LLP: Antitrust Enforcement For Market Allocation By Michigan Hospitals

By Julie Veldman On June 25, 2015, the United States Department of Justice (DOJ) and the Michigan Attorney General (Michigan AG) sued four Michigan hospital systems for entering into agreements with a competitor to unlawfully allocate territories for the marketing of competing healthcare services...

Barnes & Thornburg LLP: HIPAA Settlement – Improper Storage Of EPHI

By Stacy L. Cook On July 10, 2015, the Office for Civil Rights (OCR) announced a HIPAA settlement with St. Elizabeth’s Medical Center (SEMC), a tertiary care hospital in Brighton, Massachusetts. SEMC has agreed to pay $218,400 and adopt a robust corrective action plan. The settlement is the...

Foley & Lardner LLP: Congress Wows With Medicare Telehealth Parity Act Of 2015, But Will It Succeed?

Rep. Mike Thompson (D-CA) and co-sponsors Rep. Gregg Harper (R-MS), Rep. Diane Black (R-TN), and Rep. Peter Welch (D-VT) announced, on July 7, 2015, the introduction of the Medicare Telehealth Parity Act of 2015 , forward-looking, bi-partisan legislation intended to modernize the way Medicare pays for...

Williams Mullen: Health Care Providers Lacked Standing to Sue as ERISA Beneficiaries: Rojas v. Cigna Health and Life Insurance Company

By Mark S. Thomas The U. S. Court of Appeals for the Second Circuit has affirmed a dismissal of claims by two physicians and their medical practice asserting standing under ERISA to enjoin an insurer from removing them from its coverage network. Rojas v. Cigna Health and Life Insurance Company , Case...

Williams Mullen: Affirming the Need to Fix the Medicare Appeals Backlog: The AFIRM Act of 2015

By: Kelsey S. Farbotko If you are one of the many health care providers wanting to appeal a Medicare contractor’s reimbursement decision, you may need to be prepared for a long wait. Over the last few years, the backlog of appeals to the administrative hearing level has grown into an untenable...

Sands Anderson: Electronic Health Records -- Improving Care or Complicating Litigation?

By Matthew L. Curtis and Michelle L. Warden Electronic Health Records (EHR) were generally promised to decrease costs and improve health-care outcomes. Setting aside whether those promises were well founded, EHR have posed new challenges for litigators. What makes sense in a clinical setting may not...

Barnes & Thornburg: 2nd Circuit Upholds Connecticut State Dental Commission ‘Economic Protectionism’

By Serj Mooradian On July 17, 2015, the United States Court of Appeals for the 2nd Circuit affirmed a district court decision that the Connecticut State Dental Commission did not violate the Equal Protection and Due Process Clauses of the federal Constitution when it promulgated a regulation that...

Barnes & Thornburg LLP: Illinois Becomes 11th State To Join Interstate Medical Licensure Compact

By Serj Mooradian On July 20, Illinois Governor Bruce Rauner signed HB 3680 , the Interstate Medical Licensure Compact Act, making Illinois the eleventh state to sign on to the Interstate Medical Licensure Compact (the Compact). Illinois follows Alabama, Idaho, Iowa, Minnesota, Montana, Nevada...

DLA Piper LLP Health Systems Alert: CON Laws, COPAs And The FTC: 7 Antitrust Points For The Health Care Sector

By Lesli C. Esposito and Steven Levitsky The Federal Trade Commission is on a roll in its attack on what it considers anti-competitive effects in the healthcare industry. And that roll has consistently involved challenging activity that once appeared to be protected by state laws. Now, the FTC...

Ballard Spahr LLP: EPA Proposes New Rules for Pharmaceutical Hazardous Waste Management and for Other Hazardous Waste Generators

The U.S. Environmental Protection Agency (EPA) has announced two new proposed hazardous waste rules that EPA believes would clarify and simplify requirements for health care facilities and retail pharmacies to manage their unused pharmaceuticals that meet hazardous waste criteria, and would offer flexibility...

McNees Wallace & Nurick: Health Care Consolidations: Complex Maneuvers In A High-Stakes Environment

By John W. Greenleaf III In today’s shifting health care landscape, providers are consolidating and forming strategic partnerships that position them to offer comprehensive, high-quality services at reasonable costs. Motivations vary, but in any merger, all parties want the same outcome –...

DLA Piper Health Care Alert: DOJ Pursues Individual Liability For Corporate Misconduct – Yates Memo Signals Policy Shift

By Frank E. Sheeder The US Department of Justice has made it a priority to hold individuals accountable for organizational misdeeds – both civil and criminal. Through the recent Yates Memo, the DOJ is sending a message of deterrence to corporate leaders and their governing bodies. The Memo details...

Steptoe & Johnson PLLC: Make Sure Your Peer Review Program Is Ready Before You Need It

A 2015 decision by the West Virginia Supreme Court of Appeals highlights the importance of following procedural formalities by making it clear that a failure to apply and maintain clear distinctions in what health care providers intend to classify as “peer review,” both before and during...

Barnes & Thornburg: Another State (N.Y.) Enforces HIPAA –Settles Case With Health Center

By Stacy L. Cook The New York attorney general recently entered into a settlement agreement with the University of Rochester Medical Center (URMC) for HIPAA violations. The enforcement action by New York comes on the heels of a HIPAA enforcement action by the Connecticut attorney general in early...