By Jerry Gaffaney The U.S. District Court for the Southern District of Florida found on June 20, 2013 that defendant Community Health Systems, Inc., and its affiliated hospital, Salem Hospital (collectively, “CHS”) properly terminated a Professional Services Agreement it had with Managed Care Solutions, Inc. (“MCS”) for breach of contract after determining that Nichole Scott, …
Legal Issues in Keeping Patients’ Credit Card Information on File
Many physicians find credit cards to be the easiest way of accepting payment, and some will even keep their patient’s credit card information on file in case a patient fails to pay their bill. What many of these physicians do not realize, however, is that electronically storing a patient’s credit card information opens them up …
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Reminder: Compliance Dates for Revising Your Business Associate Agreements for Compliance with the HIPAA Omnibus Rule
By Rose J. Willis The required compliance dates for revising business associate agreements (“BAA”) between covered entities and business associates, or business associates with subcontractors, respectively, to reflect the new requirements of the Health Insurance Portability and Accountability Act (“HIPAA”) “omnibus” regulations issued on January 17th, 2013 (the “Final Rules”) are approaching. As a reminder, …
The Supreme Court Holds Human Genes are Unpatentable
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 …
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IRS Issues Transition Relief on the One-Year Delay in ACA’s Information Reporting and Employer Shared Responsibility Rules
By Jordan Schreier On July 9, 2013, the IRS issued Notice 2013-45 which provides additional information regarding the delay in the information reporting and employer shared responsibility provisions of the ACA announced earlier in July. Notice 2013-45 does not provide much in the way of substantive detail other than to confirm the delay in the …
Health Insurers in Rhode Island and Western New York Sued by Providers for Alleged Antitrust Violations
By James M. Burns In the last two months, two new antitrust actions have been filed against health insurers that raise interesting issues about an insurer’s obligation to contract with a health care provider that it chooses not to deal with, and whether a refusal to do so can give rise to antitrust liability. In …
Supreme Court Holds That “Pay for Delay” Pharmaceutical Patent Settlements May Violate the Antitrust Laws
By James M. Burns On June 17, the United States Supreme Court issued its highly-anticipated decision in FTC v. Actavis Inc., a case with significant implications for patent law, antitrust law and healthcare law. The case involved a settlement of a patent infringement lawsuit brought by a branded drug manufacturer against a generic drug maker, …
FTC Commissioner Addresses Tension Between the ACA, ACOs, and Antitrust Law
By Scott Roberts In a recent speech to a healthcare trade group in Washington, Federal Trade Commissioner Julie Brill addressed an issue of concern to many in the healthcare industry – the apparent tension between the Affordable Care Act (“ACA”), Accountable Care Organizations (“ACOs”), and antitrust law. Addressing this perceived tension, Commissioner Brill sought to …
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New Guidance for Healthcare Providers Regarding Screening of Employees and Contractors for “Excluded Persons”
By Rose Willis Under the Federal “Exclusions Statute,” a health care provider that arranges or contracts with a person that the provider knows or should know is an excluded person, may be subject to Civil Money Penalties (“CMP”) liability, or exclusion, if the excluded person provides services that are payable, directly or indirectly, by a …
State Efforts to Restrict Health Insurer Use of “Most Favored Nation” Clauses in Provider Contracts Continue to Multiply
By James M. Burns Over the last several years, several states have considered legislation that prohibits health insurers from including “most favored nation” clauses – provisions that guarantee the insurer is receiving as favorable a reimbursement rate from the provider as it offers any other insurer – in their provider contracts. The frequency with which …