Health Law Reporter Index-Summary

BACTERIA

– Methicillin-resistant Staphylococcus aureus infections, new Wash. law requires hospitals to report, 598

BAD DEBTS

BALANCE BILLING

BANKRUPTCY

– ERISA, plan administrator's fiduciary liability limited to extent it exercised control of plan funds in terminating contract with bankrupt employer (6th Cir.), 1143
– Forum Health wins contract concessions from unions, 1119
– Parents of deceased infant may pursue wrongful death claims although mother did not list claim in bankruptcy petition (Tenn. Ct. App.), 848
– Reforms considered by Senate panel, 1403
– Unlisted malpractice claim, trustee may pursue after discharge (Tex. App.), 1506
– Venue change to transfer lease breach case to La. where involuntary hospital bankruptcy case pending (D. Minn.), 1198

BCBS

See BLUE CROSS AND BLUE SHIELD PLANS (BCBS)

BILLING

– Allstate settles nationwide class action related to medical billing review system's allegedly incorrect calculations for auto and homeowner claims (Ill. Cir. Ct.), 1115
– Balance billing

– – Cal. rules restricting for emergency room care upheld (Cal.), 62; ruling expected to spur class actions against providers who billed for unreimbursed amounts, 253

– Charity care

– – Advocate Health Care agrees to implement free and discounted uninsured patient care plan (Ill. Cir. Ct.), 151
– – Overcharges alleged, court approves settlement between Ill. hospitals and undetermined class (Ill. Cir. Ct.), 106

– Clinical trials, BNA audioconference, 45
– False claims

See FALSE CLAIMS

– Medical errors, Mass. regulators adopt rules to bar claims for care due to serious reportable events, 660
– Medical transcription companies, fraud and unjust enrichment claims against MedQuist may proceed (D.N.J.), 493
– Physical therapy, state law allows physicians to bill for therapy services although not licensed as physical therapists (Ky.), 570
– Psychologist-patient privilege, subpoena quashed due to lack of consent by patient (Mich. Ct. App.), 339
– Quest Diagnostics improper billing claims, class certification denied (D.N.J.), 211
– Sleep lab owners agree to pay to settle FCA allegations, 58
– Tenn. law on recovery of erroneous payments made by insurers

See TENNESSEE

– Uncompensated care pool charges inappropriate, Boston hospital and community health center agree to pay to settle allegations (D. Mass.), 57

BIOTECHNOLOGY

See GENETICS AND BIOTECHNOLOGY

BLOOD AND BLOOD PRODUCTS

– Plasma derivative protein therapies, class actions allege Baxter and Victoria engaged in anticompetitive conspiracy (N.D. Ill.), 1465
– Reusable blood tube holders ban upheld (D.C. Cir.), 463

BLOODBORNE PATHOGENS

– Hepatitis

See HEPATITIS

– HIV

See AIDS AND HIV

BLUE CROSS AND BLUE SHIELD PLANS (BCBS)

– Anthem BCBS in Ohio, Ind., and Ky., insurance agency's group boycott claims dismissed (6th Cir.), 22
– Ark. any willing provider law, providers may pursue claims against health insurers in state court (8th Cir.), 61
– California

– – Anthem Blue Cross agrees to pay fine and offer coverage to rescinded policyholders in agreement with state regulators, 220; temporary stay in suit by Los Angeles city attorney (Cal. Ct. App.), 694
– – Anti-assignment of benefits provision does not violate state unfair competition law (Cal. Ct. App.), 595
– – Avastin approved for ovarian cancer after coverage decision reversed (Cal. Super. Ct.), 338
– – Blue Shield settles rescission-related enforcement action with state regulator, 64
– – Directed verdict against couple who stipulated after Blue Shield gave up claims against them (Cal. Super. Ct.), 727
– – Infertility treatment, state law does not require insurer to provide full coverage (Cal. Ct. App.), 976
– – Negligence in making benefit determination claim reinstated (Cal. Ct. App.), 524
– – Notice allegedly misleading, Los Angeles suit against Anthem Blue Cross may proceed (Cal. Super. Ct.), 160; motion to stay while Anthem appeals earlier ruling denied, 557; Cal. physicians file amicus brief (Cal. Ct. App.), 1116
– – Residential mental health treatment exclusion may be superseded by state laws, dismissal denied (N.D. Cal.), 1170
– – “Usual and customary” rates, suits allege Anthem uses flawed or manipulated database information, 2 cases (Cal. Super. Ct.) (C.D. Cal.), 1050
– – Workers' compensation fund did not violate Cal. antitrust law by use of BCBS to handle claims (Cal. App. Ct.), 1213

– Conn., breach notification law violation possible after loss of confidential unencrypted data on physicians, state attorney general says, 1499
– Del., fine for privacy violations due to printing error leading to disclosure of personal health information, 65
– Ga., MSP law is not violated by lowering reimbursement rates for treatment at out-of-network dialysis center (N.D. Ga.), 255
– Louisiana

– – Computer-assisted knee replacement surgery “investigational” label abused discretion, insurer liable for claim (E.D. La.), 1442
– – Conversion to for-profit entity, plan may be entitled to refund of some income taxes (M.D. La.), 956
– – “Full and fair” review violated by raising new reason for denying benefits, case remanded for further proceedings (5th Cir.), 398

– Mass., average wholesale price inflation of prostrate cancer treatment, $12.9M judgment against AstraZeneca affirmed (1st Cir.), 1289
– Michigan

– – Autism applied behavior analysis therapy coverage denied as experimental, equitable relief unavailable under ERISA for alleged breach of fiduciary duty (E.D. Mich.), 369; class certification denied, 461
– – Dueling claims about assurances require trial for dispute between hospital and insurer (E.D. La.), 433
– – Equitable accounting, disgorgement, and restitution unavailable for participants' ERISA suit against administrator for alleged breach of emergency care under health plan (E.D. Mich.), 461
– – Subsidiary's acquisition of for-profit companies, suit by state attorney general dismissed (Mich. Cir. Ct.), 97; attorney general appeals ruling, 188

– Mo., state law claims by physicians alleging delay or denial of payments are governed by ERISA and must be litigated in federal court (S.D. Fla.), 157
– Mont., state regulators reasonably restricted exclusion of coverage for injuries covered by auto or premises liability insurance policies (Mont.), 1335
– New Jersey

– – Bayonne Hosp. alleges Horizon used unlawful tactics to deter patients from using emergency room (D.N.J.), 1019
– – Eating disorders treatment, Horizon Blue Shield agrees to expand coverage, settlement of 2 class actions approved (D.N.J.), 556
– – Non-network hospitals sued by Horizon BCBS over waivers of charges to patients and related counterclaim filed, 3 cases (N.J. Super. Ct.), 729
– – Psychotherapy telephone consultations used billing code for face-to-face sessions, insurer's termination of plan participants on the basis of fraud was arbitrary, state law claims preempted by ERISA (D.N.J.), 1051
– – Unbundling alleged, Horizon sues out-of-network diagnostic lab alleging fraudulent claims (N.J. Super. Ct.), 939

– N.D. regulator seeks data on compensation and travel policies after report finds “excessive expenses,” 1255
– Ohio, hospital's state contract breach claim based on pre-certification preempted by ERISA (S.D. Ohio), 596
– Pennsylvania

– – Drugs with no generic version placed in highest copayment tier no violation of plan, proposed ERISA class action dismissed (E.D. Pa.), 833
– – Merger of Highmark and Independence Blue Cross abandoned, 125

– State legislative health care and insurance issues report released, 248
– Tenn. BCBS sued by Tenn. Med. Ass'n over efforts to collect alleged overpayments from physicians (Tenn. Ch. Ct.), 834
– Tex. plan agrees to stop using cost-based doctor rating system under deal with state attorney general (Tex. Dist. Ct.), 496
– Wash., suit by subscribers seeking discount rates cannot proceed without preferred providers, dismissed (W.D. Wash.), 800

BONDS

– Surety, CMS final rule requires DME suppliers to post as condition of participation, 36
– Tax-exempt, AHA asks Frank (D-Mass) to include in any legislation to provide temporary relief to municipal securities market, 674

BREAST CANCER

– Failure to diagnose, expert reports must state standard of care for physician and physician's assistant separately (Tex. App.), 502
– Mammogram reading error, jury award to woman with incurable disease upheld (Tenn. Ct. App.), 1125
– Treatment ongoing, termination letter assumed clerk was too sick to work, ADA settlement approved (D. Md.), 1013

BRIBERY

– Foreign Corrupt Practices Act

See FOREIGN CORRUPT PRACTICES ACT (FCPA)

BUDGET, U.S.

See also specific agencies and departments
– FY2010

– – Antifraud funding and other proposals for savings, 279
– – Cuts to pay for health reform, 277; complete budget submission proposes $309B in savings from reduced spending, 630
– – H1N1 influenza, Obama requests $1.5B in funding, 593
– – Management and Budget Off. defends Obama proposal, 331
– – Resolutions

See LEGISLATION, FEDERAL, HConRes 85, SConRes 13

– – Senate debate begins, 429