New York Court of Appeals Upholds Adult Home Admission Regulations

By Kevin P. Mulry on February 20, 2025

Posted in Hospitals and Health Care Facilities, Regulatory Issues

New York Department of Health (DOH) regulations provide that an adult home may not admit additional residents with serious mental illness if it has a capacity of 80 or more beds and its resident population is over 25% persons with serious mental illness. In Oceanview Home for Adults, Inc. v. Zucker, the New York Court of Appeals held that these regulations do not facially discriminate against persons with disabilities.

In 1999, the United State Supreme Court held that the Americans with Disabilities Act imposes an affirmative obligation on states to prevent the segregation of persons with disabilities in institutionalized settings that are more restrictive than appropriate for their needs. In October of 2012, New York’s Office of Mental Health (OMH) issued two Clinical Advisories stating that certain large adult homes provided housing experiences for persons with serious mental illness that were not clinically appropriate to their needs and were not conducive to their rehabilitation or recovery. Shortly thereafter, DOH issued the challenged regulations. Continue Reading New York Court of Appeals Upholds Adult Home Admission Regulations

Second Circuit Adopts At-Least-One-Purpose Rule For Anti-Kickback Statute Violations

By Kevin P. Mulry on January 3, 2025

Posted in False Claims Act, Fraud and Abuse and Stark, Litigation, Medicaid and Medicare

At the end of December, the Second Circuit joined several other circuit courts in holding that a plaintiff adequately pleads an Anti-Kickback Statute (“AKS”) violation when she states with the requisite particularity that at least one purpose of the alleged scheme was to induce fraudulent conduct, the “at-least-one-purpose” rule.

In United States ex rel. Camburn v. Novartis Pharmaceuticals Corp., Relator Steven Camburn alleged that Novartis violated the AKS, and the False Claims Act (“FCA”), in marketing its drug Gilenya, which is prescribed for multiple sclerosis (“MS”). Since approving Gilenya in 2010, the FDA has imposed a first-dose observation requirement for new patients, who must be monitored by a doctor while attached to an electrocardiogram machine for six hours.Continue Reading Second Circuit Adopts At-Least-One-Purpose Rule For Anti-Kickback Statute Violations