Legal and practical healthcare information.
By Alexandra Hall & Jessica Russell The Mental Health Parity and Addiction Equity Act (Parity Act) requires health plans to provide the same coverage for mental health conditions as they provide for physical conditions, and that financial requirements and treatment limitations applicable to mental health and substance use disorder benefits be no more restrictive than …
Continue reading “Recent Developments in Mental Health Benefit Denials”
By Keith C. Dennen In Kellogg Brown & Root Services, Inc. v. United States ex rel. Carter, 575 U.S. ___) (2015), Justice Alito stated “[t]he False Claims Act’s qui tam provisions present many interpretive challenges.” Lawyers and judges who struggle with those challenges understand the truth of that statement. The United States Supreme Court recently …
Continue reading “Qui Tam Lawsuits and the Statute of Limitations”
By Keith C. Dennen A woman is seriously injured in a car accident. It is not her fault. She is taken to the emergency room where she is treated. When she is released, the hospital bills total $100,000. The woman has health insurance. The hospital submits its claim and the health insurance company pays $25,000.00 …
By James M. Burns On December 18, 2013, the Pennsylvania House Health Committee held a hearing on Pennsylvania House Bills 1621 and 1622, two bills that would require that any health provider in the state that operates as part of an integrated delivery system (i.e., a health system that also has its own health plan, …
Continue reading “Hearing Held on Pennsylvania’s Novel “Any Willing Insurer” Legislation”
By Joan Ellis, Ph.D. In a unanimous decision written by Justice Thomas, the Supreme Court held that naturally-occurring DNA sequences are unpatentable. The Court has long held that certain subject matter is not patent eligible under 35 USC § 101. Patent exempt subject matter includes laws of nature, natural phenomenon, and abstract ideas. In this …
Continue reading “The Supreme Court Holds Human Genes are Unpatentable”
By Rodney D. Butler Within the last few weeks, the Office of Inspector General (OIG) issued a letter to the State of Tennessee regarding its Medicaid Fraud False Claims Acts. Unfortunately for the State of Tennessee, the OIG provided notice that their statutory framework failed to meet the requirements of section 1909 of the Social …