Health Care Counsel Blog

On July 7, 2015, the US Court of Appeals for the Ninth Circuit overruled a 23-year-old False Claims Act precedent, relaxing its test for deciding when a whistleblower can overcome a motion to dismiss because the allegations in the complaint were publicly disclosed. 

On June 10, 2015, the U.S. Department of Health and Human Services, Office for Civil Rights, announced that it had entered into a resolution agreement with St. Elizabeth’s Medical Center, a Massachusetts hospital, to resolve potential HIPAA violations.

Last week, the U.S. Department of Health and Human Services Office of Inspector General (OIG) announced the creation of a new litigation team focused solely on using the OIG’s authority to impose civil monetary penalties and exclude individuals and businesses from Medicare and Medicaid.

King v. Burwell understandably took the attention of the health care industry a couple of weeks ago when it upheld a key component of the ACA. A day later, the Supreme Court released another decision that may have a more significant going-forward impact on the health care industry: Obergefell.

The United States Court of Appeals for the District of Columbia Circuit released a decision requiring the Department of Health and Human Services to reconsider a 2008 rule prohibiting certain per-click leasing arrangements under the Stark Law.

Who can make healthcare decisions for an incompetent patient when there is no person available to give consent?  

In the long awaited decision in King v. Burwell, the Supreme Court ruled this morning in a 6-to-3 decision that the Affordable Care Act (ACA) permits tax credits for individuals who purchase their health insurance through a Federal health insurance marketplace (Federal Exchange), not just for indivi

The US Attorney General announced a “takedown” of 243 defendants over the last three days, representing the largest health care fraud enforcement effort in the Medicare Fraud Strike Force’s eight-year history and the largest criminal health care fraud action in the history of the Justice Department.

On June 17, 2015, the Health Resources and Services Administration (HRSA) published a long-awaited proposed rule setting forth revisions to the current regulations governing the 340B Drug Discount Program (340B Program) as set forth in 42 C.F.R. part 10 (Proposed Rule).

The Department of Health and Human Services Office of the Inspector General issued a Fraud Alert, reminding physicians that they will be held liable under the anti-kickback statute for compensation arrangements that do not reflect fair market value compensation for bona fide services they provide.

Charitable organizations that want to provide financial assistance to patients for the costs of health care are challenged with ensuring that their programs do not run afoul of federal fraud and abuse laws.

The United States Department of Justice (DOJ) announced that pharmacy benefits manager Medco Health Solutions Inc. (Medco) agreed to pay the government $7.9 million to resolve allegations that Medco’s arrangements with pharmaceutical manufacturer AstraZeneca violated the False Claim Act.

The US Supreme Court on Tuesday decided a closely watched False Claims Act (FCA) case, Kellogg Brown & Root Services, Inc. v. United States ex rel. Carter, with important implications for companies confronting FCA claims.

Pharmaceutical manufacturers could face a new line of attack related to Hatch-Waxman reverse payment settlement agreements (so-called, “pay-for-delay” settlements).

The Chairman of the U.S. Senate Committee on Health, Education, Labor, and Pensions recently started an investigation into whether agency “guidance” is being used as a means to impose obligations on the public while circumventing the formal rule making process. 

Health care lawyers are familiar with the term “underground rulemaking,” which refers to efforts by federal agencies to impose obligations on providers and suppliers informally, without using the processes required by law. That issue has recently attracted the attention of the US Senate. 

Arent Fox LLP is proud to announce that, for the thirteenth year in a row, Health Care partner Linda A. Baumann served as editor-in-chief of a comprehensive desk reference focused on fraud and abuse for lawyers in the health care industry.

Arent Fox LLP is proud to announce the publication of a comprehensive and definitive book for health care industry leaders focused on risk management and litigation.

The US Department of Health and Human Services Office of Inspector General, the Association of Healthcare Internal Auditors, the American Health Lawyers Association, and the Health Care Compliance Association jointly released an educational resource for governing boards.

On March 31, 2015, the Supreme Court of the United States issued a 5-4 decision in the case of Armstrong v. Exceptional Child Center, Inc., 575 U.S. __ (2015), holding that health care providers do not have the right to sue a state Medicaid program under Section 30(A) of the federal Medicaid Act (Se

This change in policy also could make a tremendous difference to provider operations since it would allow them to have access to certain funds during the very lengthy period while they wait for the ALJ determination.

California’s 4th District Court of Appeal issued its opinion in Gerard v. Orange Coast Memorial Medical Center, invalidating the portion of California IWC Wage Order No. 5 that permitted non-exempt health care employees to waive a second meal period for shifts longer than 12 hours.

Arent Fox partner Lowell C. Brown, head of the firm’s Health Care practice, was quoted in a recent Bloomberg BNA article following a novel and groundbreaking decision by the New Mexico Supreme Court.

When the Bylaws specifically and directly speak, for example, in matters of credentialing criteria, peer review processes, and Medical Staff hearing procedures, the pronouncements are not viewed as suggestions or hints. Rather, the Medical Staff Bylaws set forth requirements.

On February 10, 2015, in this most recent win for the federal enforcement agency, the US Court of Appeals for the Ninth Circuit affirmed the FTC’s injunction against St. Luke’s Health System and a large physician group in Idaho.