Articles and Blogs

In a matter of first impression, the Third Circuit yesterday held that conflicting medical opinions can create a genuine dispute of material fact as to the element of falsity in a False Claims Act action.[1] Facts of the Case In U.S. v. Care Alternatives, relators alleged that Care Alternatives, a hospice facility, “admitted patients who…Read More

On February 26, 2020, the National Labor Relations Board issued its final rule establishing the standard for determining whether two employers are joint employers under the Act (“New Rule”). History of Joint Employer Standard As explained by the NLRB, a joint employer finding has significant implications for rights and obligations under the NLRA relative to…Read More

Supreme Court Agrees to Hear ACA Validity Case Today, the Supreme Court agreed to hear a third major Affordable Care Act (“ACA”) case. The Court will consider whether a legislative change to the ACA’s individual mandate rendered the landmark law unconstitutional. Learn more from a recent Hall Render article here. By granting petitions from democratic…Read More

On February 11, 2020, the U.S. Court of Appeals for the District of Columbia (D.C.) Circuit upheld the decision of a lower court granting summary judgment in favor of the Secretary of the Department of Health and Human Services (“HHS”) in a wage index calculation Medicare reimbursement case. The Court held that the Secretary’s refusal…Read More

Pharmacogenetic Testing and the FDA’s 2018 Warning The advent of direct-to-consumer genetic testing has yielded an explosion in the development of various types of genetic tests for clinical treatment and diagnostic purposes. These tests include pharmacogenetic tests, which are used to better understand the role genetics play in an individual patient’s reaction to certain drugs…Read More

It is no secret why the novel coronavirus (“2019-nCoV”) outbreak in Wuhan City, Hubei Province, China quickly raised health concerns on an international scale. The coronavirus family contains member viruses with a similarly sinister and deadly past; viruses that seemingly appeared out of nowhere and rapidly spread. For example, two betacoronaviruses were the culprits behind…Read More

On February 20, 2020, the Centers for Medicare & Medicaid Services (“CMS”) issued proposed revisions (“Proposed Rule”) to the regulations governing the Comprehensive Care for Joint Replacement (“CJR”) program. Among other things, the Proposed Rule would extend mandatory participation in the CJR program an additional three years for certain current participants, revise the reconciliation and…Read More

The United States Court of Appeals for the First Circuit issued an opinion creating a national divide on when a relator is an “original source” of an FCA claim, finding that a relator’s secondhand knowledge of fraud was “direct” knowledge. Facts of the Case In United States ex rel. Banigan v. PharMerica, Inc.[1], a former…Read More