In March 2013, the Second Circuit certified to the New York Court of Appeals the issue of whether a medical corporation may be liable for the unauthorized disclosure of medical information, when the employee responsible for the breach was not a physician and was acting outside the scope of her employment (see post).
EDNY Judge Enjoins Enforcement of HHS Mandate
Earlier this week, in Roman Catholic Archdiocese of New York v. Sebelius, U.S. District Judge Brian Cogan in the Eastern District of New York permanently enjoined the government from enforcing regulations mandating coverage for contraceptive and sterilization services by religious organization health plans.
The Patient Protection and Affordable Care Act requires health insurance plans
Lawyers’ Ethical Violation Leads To Qui Tam Dismissal
In U.S. ex rel. Fair Laboratory Practices Associates v. Quest Diagnostic, Inc., the Second Circuit upheld the dismissal of a health care fraud qui tam action because of ethical violations by one of the relators, who was formerly general counsel of defendant Unilab Corporation.
The former general counsel, along with two other former employees
Admission of Wrongdoing Requirement May Make SDNY Less Attractive to Qui Tam Relators
In U.S. ex rel. Wolfson v. Park Avenue Medical Associates, the U.S. Attorney’s Office in the Southern District of New York entered into a $1 million False Claims Act settlement against three related companies for improperly billing Medicare for behavioral health services. The settlement agreement provided that the defendants “admit, acknowledge and accept responsibility
Proposed “Fairness” Amendments to the False Claims Act
Earlier this month, a bill to amend the False Claims Act (“FCA”), the “Fairness in Health Care Claims, Guidance and Investigations Act,” was introduced in the House of Representatives. According to one of the bill’s sponsors, Rep. Howard Coble (R-NC), the bill’s purpose is to ensure that unintentional billing disputes are not penalized as
Are Suits Opposing Obamacare Mandates Ripe?
Over fifty cases across the country have challenged regulations promulgated under the Patient Protection and Affordable Care Act (“PPACA” or “Obamacare”) that require employer group health insurance plans to provide coverage for contraception, sterilization and related counseling (the “HHS Mandate”). Suits have been filed by religiously-affiliated organizations as well as private business owners, asserting that
Health Privacy Liability Issue Proceeds to NY Court of Appeals
In last week’s decision in Doe v. Guthrie Clinic, Ltd., the Second Circuit Court of Appeals certified to the New York Court of Appeals the issue of whether a medical corporation may be liable for the unauthorized disclosure of medical information, when the employee responsible for the breach was not a physician and was
Department of Justice Announces Record-Setting Year of False Claims Act Recoveries
Earlier this week, the Department of Justice announced that it had recovered nearly $5 billion in settlements and judgments under the False Claims Act in fiscal year 2012. The $4.959 billion figure was a new record for a single year, eclipsing the previous one-year record by $1.7 billion.
In breaking down the $5 billion in
Hospital Settles False Claims Act Case For $7 Million
In late October the U.S. Attorney’s Office in the Southern District of New York announced the settlement of a False Claims Act case against Westchester Medical Center (“WMC”) for $7 million, for submitting false reimbursement claims to Medicaid from August 2001 through June 2010 involving outpatient behavioral health services. The settlement is to be
The False Claims Act and Federal Grants
In United States ex rel. Feldman v. van Gorp , decided last week, the Second Circuit ruled on an issue of first impression concerning False Claims Act (“FCA”) damages in the context of a federal grant for medical research funding, and also addressed the FCA’s materiality standard.
In Feldman, Cornell University and a psychiatry