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|U.S. Supreme Court Directs Lower Court to Rebalance Religious Freedom With Government Mandated Women’s Contraceptive Health Benefits for Religious Nonprofit Organizations|
Dave C. Bromund; Taft Stettinius & Hollister LLP;
March 25, 2015, previously published on March 12, 2015In its continuing consideration of the proper balance of religious freedom against government mandated women’s contraceptive health benefits, the U.S. Supreme Court vacated the 7th Circuit Court of Appeals’ 2014 decision against the University of Notre Dame’s religious objections...
|First Risperdal Trial Ends With $2.5 Million Verdict Against J&J|
Lieff Cabraser Heimann Bernstein LLP;
March 24, 2015, previously published on February 25, 2015A Philadelphia jury returned a $2.5 million verdict against healthcare giant Johnson & Johnson for a 20-year-old autistic man from Alabama who allegedly developed large breasts as a teenager while prescribed the antipsychotic medication Risperdal. The lawsuit charged that Johnson & Johnson...
|Tort Of Intrusion Upon Seclusion And Breaches Of Personal Health Information:|
Borden Ladner Gervais LLP;
March 24, 2015, previously published on March 9, 2015In 2012, in the context of an action against a bank employee for reviewing the plaintiff’s confidential financial information without authorization and for the defendant’s personal reasons, the Court of Appeal imported the tort of intrusion on seclusion from American law into Ontario...
|Same-Sex Marriage and its Effect on Health Plans Offering Spousal Coverage|
Laura Fischer; Berenbaum Weinshienk PC;
March 24, 2015, previously published on November 7, 2014The United States Supreme Court’s decision on October 6, 2014 to deny review of various appellate court rulings (including the Tenth Circuit, the federal appeals court covering Colorado), which had struck down bans on same-sex marriage as unconstitutional, effectively legalized same-sex...
|New York Whistleblower Court First to Address What It Means to Identify Overpayment under ACA's 60 Day Rule|
A.G. (Alec) Alexander; Breazeale, Sachse & Wilson, L.L.P.;
March 24, 2015, previously published on January 21, 2015For the first time since its enactment as part of the Affordable Care Act (ACA) in 2010, a federal court in a whistleblower action will consider a provision requiring providers to return overpayments within sixty days of when they are “identified.” The upcoming decision by the United...
|Health Care E-lert - The Supreme Court Appears Closely Divided on the Fate of Tax Credits Under the Affordable Care Act|
March 24, 2015, previously published on March 4, 2015The US Supreme Court heard oral arguments on Wednesday, March 4, 2015 in King v. Burwell to determine the interpretation of a six-word phrase in the Affordable Care Act (“ACA”). The six-word phrase states the federal government can offer tax credits in the form of subsidies to help...
|Smile Magic Dental Clinics Settle Texas Medicaid Fraud Allegations for $4.5 Million|
Waters Kraus LLP;
March 23, 2015, previously published on March 19, 2015Four dental clinics of the Texas Smile Magic chain have agreed to settle Medicaid fraud charges for a total of $4.5 million. The four clinics that will pay the record-setting settlement include: Smile Magic of Denton, PLLC; Smile Magic of Lewisville, PLLC; Smile Magic of Garland, PLLC; and Smile...
|Stripping the ACA of Both the Carrot and the Stick: Sticking it to Consumers On and Off the Federal Exchange|
Florence T. Wang, Ken Yood; Sheppard, Mullin, Richter & Hampton LLP;
March 23, 2015, previously published on March 13, 2015Even as we write and you read, the Supreme Court in King v. Burwell is considering whether qualifying (often low income) individuals and families who have an opportunity to purchase healthcare coverage through the Affordable Care Act’s (“ACA’s”) federal exchange also have...
|Medicare ACO v. 3.0—More Risk, More Money?|
Aytan Dahukey, Florence T. Wang; Sheppard, Mullin, Richter & Hampton LLP;
March 23, 2015, previously published on March 12, 2015The Centers for Medicare and Medicaid (CMS) announced on March 10, 2015 that it is adding a new Accountable Care Organization (ACO) model to its cadre of innovative models. Titled the “Next Generation ACO Model,” CMS’ new ACO model allows provider groups to assume higher levels of...
|Time is Running Out to Avoid the Negative Effects of 2016 Value-Based Physician Payment Modifiers: CMS Releases Results of Medicare’s Value-Based Payment Modifier for 2015 as Final PQRS Participation Deadlines for 2016 Adjustments Approach|
Eric A. Klein, Rachel Landauer; Sheppard, Mullin, Richter & Hampton LLP;
March 23, 2015, previously published on March 11, 2015CMS recently released results of Medicare’s value-based payment modifier for 2015. This is the first year in which physicians are subject to adjustments under the payment system and, in this first phase of implementation, only affects practices with 100 or more eligible professionals.