Health Care Counsel Blog

Natarajan addressed an important question: When may physicians who are the subject of a peer review hearing challenge the hearing officer in their cases on the ground that the hearing officer is biased?

Headlines that Matter for Companies and Executives in Regulated Industries

The California Court of Appeal gave licensees of health care facilities good news by expanding the scope of the “reasonable licensee” defense when the California Department of Public Health (CDPH) issues a citation and imposes penalties.

In what is widely considered to signal intensified focus by the Federal government on Medicaid supplemental payments and related State Medicaid financing mechanisms, the CMS on November 18, 2019 proposed the Medicaid Financing and Accountability Regulation.

Headlines that Matter for Companies and Executives in Regulated Industries

CMS issued an Interim Final Rule with comment period that further delays the inclusion of the US territories in the definitions of “States” and “United States” for purposes of the Medicaid Drug Rebate Program from April 1, 2020 until April 1, 2022.

Headlines that Matter for Companies and Executives in Regulated Industries

Headlines that Matter for Companies and Executives in Regulated Industries

Headlines that Matter for Companies and Executives in Regulated Industries

Governor Newsom signed AB 51, codified as Labor Code section 432.6, which prohibits California employers from requiring an employee to sign an arbitration agreement “as a condition of employment, continued employment, or the receipt of any employment-related benefit.” 

Headlines that Matter for Companies and Executives in Regulated Industries

In a decision very favorable to California hospitals and medical staffs, the Court of Appeal rejected a physician’s argument that he was denied due process during his peer review hearing because of hearing officer alleged bias.

The Federal Trade Commission issued a decision last week illustrating that even sophisticated executives need reminding that emails and texts will be “Exhibit A” of an antitrust violation.

Headlines that Matter for Companies and Executives in Regulated Industries

With the news media covering the link between marijuana vaping, deaths, and lung conditions, California’s push to add THC to the Proposition 65 harmful chemicals list could mean financial, legal, and reputational challenges for cannabis businesses.

A federal court in Nebraska recently rejected a health plan’s fiduciary breach claims under the Employee Retirement Income Security Act of 1974 against third-party service providers, holding that the service providers were not ERISA fiduciaries and did not breach fiduciary duties under ERISA.

Headlines that Matter for Companies and Executives in Regulated Industries

Headlines that Matter for Companies and Executives in Regulated Industries

Late Friday, September 27, 2019, President Trump signed the Fair and Accurate Medicaid Pricing Act into law as part of the Continuing Appropriations Act.

The US District Court for the District of Columbia ruled that the Centers for Medicare & Medicaid Services (CMS) exceeded its statutory authority when it cut the Medicare payment rates for hospital services provided in the grandfathered off-campus provider-based department setting.

On September 10, 2019, CMS ssued a final rule with comment period, titled Program Integrity Enhancements to the Provider Enrollment Process (the “Final Rule”), which enhances the government’s authority to deny or revoke health care providers from participating federal health care programs.

Headlines that Matter for Companies and Executives in Regulated Industries

FDA issued a Compliance Policy delaying enforcement of the DSCSA’s saleable returns verification requirement by one year. So now, instead of wholesale distributors having to comply by November 27, 2019, FDA will exercise enforcement discretion until November 27, 2020.

Headlines that Matter for Companies and Executives in Regulated Industries

Headlines that Matter for Companies and Executives in Regulated Industries