Medical Manufacturer Settles Whistleblower Suit for $37.5 Million

A California-based manufacturer of durable medical equipment (DME) has settled a lawsuit brought against it by the Department of Justice (DOJ) for $37.5 million. The suit accused the company of violating the Anti-Kickback Statute of the False Claims Act, alleging they had paid money, and offered other incentives, to those that offered their equipment. The suit came about due to whistleblowers at the company reporting their practices to the DOJ, and a part of the settlement is directed to redressing whistleblower grievances. Continue reading “Medical Manufacturer Settles Whistleblower Suit for $37.5 Million”

Fifth Circuit Affirms ACA Individual Mandate is Unconstitutional

U.S. ConstitutionThe Fifth Circuit of the United States Court of Appeals has affirmed a district court ruling in part that says the individual mandate of the Affordable Care Act (ACA) is unconstitutional. While the district court went further to argue that the entire ACA, more colloquially known as Obamacare, was unconstitutional, the Fifth Circuit narrowly ruled on the constitutionality of the individual mandate. It then remanded the case back to the district court to determine what provisions, if any, were severable from the individual mandate. Continue reading “Fifth Circuit Affirms ACA Individual Mandate is Unconstitutional”

Google Faces Scrutiny Over Healthcare Data Sharing

laptop with Google on screenGoogle is facing legal scrutiny after a whistleblower revealed the tech company was collecting the healthcare data of millions of Americans as part of a partnership with Ascension Health, a large Catholic health care provider. In an initiative called “Project Nightingale,” Google gained access to information on as many as 50 million Americans, including details such as their names, addresses, birth dates, and full medical history. Critics are concerned about the purposes to which Google might put the data they collect, and whether they are complying with privacy laws to protect patient data. Continue reading “Google Faces Scrutiny Over Healthcare Data Sharing”

CMS Proposes Cuts for Hospital-Owned Outpatient Services

Facebook’s BooksThe Centers for Medicare and Medicaid Services (CMS) have proposed changes to Medicare payments that would significantly reduce payments to many physicians and hospital outpatient healthcare services. The changes in policy would also increase the wage index (the degree to which payments are adjusted based on regional average wages) for low-income hospitals, like those found in many rural areas, while decreasing the wage index for higher-income hospitals. The move is set to gradually reduce the payments to hospital-owned, off-campus clinics over the course of two years, which CMS predicts will save Medicare more than $800 million per year. Continue reading “CMS Proposes Cuts for Hospital-Owned Outpatient Services”

Important Considerations Before Launching a Lawsuit

Lawsuit ChecklistIn deciding whether or not to sue there are three important considerations, and without all three a lawsuit generally cannot succeed: (1) there must be a liability (or a basis for getting relief); (2) there must be damages (and under New York law damages are sometimes not easy to prove and may require expert testimony unless it is plain and easy to calculate); and (3) there must be a “pocket” or source of funds from the parties who are liable for the damages, to pay a judgment.

Many people commence lawsuits without having all three factors in mind. If you don’t have at least two of the three factors clearly defined in your mind — and at least a reasonable chance that the third factor exists — usually the lawsuit should not be brought. Continue reading “Important Considerations Before Launching a Lawsuit”