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Vol. 18, Nos. 1-44, pp. 1-1514 Jan. 8 - Nov. 12, 2009 A | B | C | D | E | F | G | H | I | J | K | L | M | N | O | P | Q | R | S | T | U | V | W | X | Y | Z
DAMAGES
ADEA, jury award to fired nurse upheld (3d Cir.), 455
Ala., Medicaid drug prices, AstraZeneca, GlasxoSmithKline and Novartis win on appeal, verdict reversed (Ala.), 1400 Average wholesale price inflation of prostrate cancer treatment, $12.9M judgment against AstraZeneca affirmed (1st Cir.), 1289 Boston neurosurgeon awarded $1.6M by jury in retaliation and hostile environment suit (D. Mass.), 243 Call hours excessive, trial court ordered to reduce amount of award to physician (Ark. Ct. App.), 1480 Cap applies to wrongful death claims where medical resident is borrowed servant (Wis.), 987 Effective communication with deaf patients, emotional distress and punitive award in suit against rheumatologist, appeal pending (N.J. Super. Ct. App. Div.), 1359 Emergency cesarean section not performed, jury award against physician and hospital who violated EMTALA by transferring woman whose infant died (N.D. Iowa), 373; jury verdict upheld but damages reduced, 668 Emotional distress, hospital employee whose health records were accessed by fellow workers may not recover due to failure to prove emotional injury (Iowa), 702 False claims, unaudited cost reports material in determining amount hospital management company officials ordered to pay (U.S., rev den), 282 HCQIA immunity, jury award against hospital and individuals who participated in peer review of cardiologist reversed (U.S., rev den), 138 Ky., Medicaid drug prices, jury award of $14.7M against AstraZeneca (Ky. Cr. Ct.), 1400 Liquidated, claim for alleged violation of confidentiality agreement unenforceable because award must be reasonably related to actual harm (Cal. Ct. App.), 139 Mammogram reading error, jury award to woman with incurable breast cancer upheld (Tenn. Ct. App.), 1125 Medicaid average wholesale drug prices
Ala. jury orders Sandoz to pay $78.4M (Ala. Cir. Ct.), 247
Wis. jury finds fraud by Pharmacia Corp. and awards $9M to compensate state (Wis. Cir. Ct.), 247 Nurse debilitated after neurosurgeon used contraindicated dye awarded $38M by jury (Fla. Cir. Ct.), 410 Nursing home, most of compensatory damages allowed, but disfigurement award vacated due to lack of proof (Tenn. Ct. App.), 302 Okla., malpractice reform law signed by governor includes noneconomic damages cap, 735 Penalty for failure to settle applies only to insurer, cap applies to physician (Tex.), 343 Physical therapist's $100,000 judgment against male doctor who repeatedly hugged and kissed her upheld (D. Neb.), 1294 Pregnancy discrimination by oral and maxillofacial surgery practice, jury should consider punitive damages (8th Cir.), 1166 Pulse oximeters maker failed to show competitor's bundling agreements had sufficient impact on market, jury award partially vacated (9th Cir.), 1467 Same juror rule, award in sexual harassment suit remanded because court barred juror who voted against punitive damages from participating in calculation of award (Ohio Ct. App.), 937 Sexual harassment, nurse awarded $15M in suit against hospital (N.Y. Sup. Ct.), 277 Subrogation issues
See generally SUBROGATION
Jury verdict stands despite signed consent form containing independent contractor disclaimer (Ill. App. Ct.), 806
Sexual assault of 6-year-old patient by employee, jury verdict against insurer affirmed (Ark.), 301
Consumer protection law does not apply to surgery-related losses (Wash.), 1309
Wrongful death claim by parent dependent on adult child's services upheld, order reversing jury award overturned (Wash.), 1262
Usual, customary, and reasonable charges database
AMA files class actions against Aetna and CIGNA over out-of-network fees, 2 cases (D.N.J.), 219
Anthem Blue Cross allegedly uses flawed or manipulated database information, 2 cases (Cal. Super. Ct.) (C.D. Cal.), 1050 Ingenix report released by Senate panel, 866 Methodology challenge, provider must exhaust remedies, claim dismissed (D.N.J.), 496 N.Y. settlement with UnitedHealth Group announced, 98; out-of-network providers, attorney general announces intent to sue HMO over use of Ingenix database, 188; Cuomo announces settlement with CIGNA and plans to sue Excellus, 218; Wellpoint settlement announced, 256; agreements with Excellus and Capital District Physicians' Health Plan announced, 370; Health Net agrees to pay and to end use of Ingenix database, 833 Wellpoint sued by AMA and several state medical groups (C.D. Cal.), 434
Assisted suicide
See ASSISTED SUICIDE
See HOSPICE CARE
Asset test is not mandatory, hospital entitled to reimbursement for bad debts (D.D.C.), 1177
Charity care, court approves settlement between Ill. hospitals and undetermined class over billing overcharges and collection methods (Ill. Cir. Ct.), 106 Discovery, patient may obtain information on charges and discounts to prove unfair pricing claims (Fla. Dist. Ct.), 605 Dual eligibles
See DUAL ELIGIBLES
Usury, Minn. attorney general sues Allina Health System alleging excessive interest charged on debts (Minn. Dist. Ct.), 142; hospitals agree to reimburse patients charged more than 8 percent interest, 535
Ind., assumption of risk rejected in medical malpractice action but patient's knowledge can be shown based on understanding of risks from prior procedures (Ind.), 847
Medical monitoring claim for unapproved device implanted in infant allowed (E.D. Pa.), 342; cases certified for immediate appeal, 1228
Omnicare settles allegations of Medicaid overcharges by switching prescriptions, In Brief, 759 Privacy, BCBS fined for violations due to printing error leading to disclosure of personal health information, 65
Clinical laboratories competitive bidding injunction kept intact although Congress repealed statute (S.D. Cal.), 440
Elective angioplasty, community hospitals without on-site cardiac surgery facilities may participate (N.J. Super. Ct. App. Div.), 1199 Gainsharing
Current projects have structure and specific statutory requirements, 427
Hospitals chosen, 1122 Recovery audit contractors (RACs)
Congenital deformity of jaw, coverage for surgery may be mandated by state law (D. Or.), 1170
Corporate practice of medicine barred, business services agreements between orthodontists and Orthodontic Centers of Am. are illegal and unenforceable (5th Cir.), 42 Dental implant designer and adviser not liable for harm to injured patients (La. Ct. App.), 881 In-school dentistry, FTC staff urges La. legislature to reject bill prohibiting, 589 Medi-Cal eliminates dental and other optional benefits, suit by nonprofit community clinics fails (Cal. Super. Ct.), 872 Out-of-network dentists' inadequate payment claims against Wellpoint not barred by failure to exhaust administrative remedies (S.D. Fla.), 157 Pregnancy discrimination, dental assistant fired because she could not take X-rays of patients, claim rejected (Cal. Ct. App.), 1435 P.R. dental surgeons' claims handling suit against insurance companies should not have been remanded, Class Action Fairness Act may apply (1st Cir.), 1473 Sexual harassment and forcing female employees to participate in Church of Scientology religious practices, Chicago dentist will pay to settle suit (N.D. Ill.), 92 Staff privileges, dental surgeon's civil rights claims for denial of full medical staff membership properly rejected (10th Cir.), 372; (U.S., rev sought), 1087; (rev den), 1337
Diabetes Treatment Centers, whistleblower suit settles (M.D. Tenn.), 365
Drug and alcohol dependence, plan administrator abused discretion when it relied solely on peer reviews in denying anesthesiologist's claim for partial disability (W.D. Mich.), 133
See also REHABILITATION ACT
ADA De-institutionalization of mentally ill, advocacy groups urges more aggressive implementation of Olmstead decision, 874 Effective communication with deaf patients
Deliberate indifference alleged, claims reinstated (2d Cir.), 1359
Emotional distress and punitive damages awarded in suit against rheumatologist, appeal pending (N.J. Super. Ct. App. Div.), 1359 Md. hospital settles charges, 1260 Home- or community-based care, TennCare settlement agreement modified by ruling that states are not required to provide certain levels of service (6th Cir.), 359 Ind. Medicaid agency should not be held in contempt for alleged violations of consent decree covering eligibility determinations (7th Cir.), 767 Mich., Medicaid officials must consider whether beneficiaries currently receiving Family Independence Program benefits qualify under disability-related category before terminating benefits, injunction granted (E.D. Mich.), 701 Plan acted arbitrarily when it refused to enroll participant's disabled adult son (N.D. Ill.), 437 Pregnancy discrimination, dental assistant fired because she could not take X-rays of patients, claim rejected (Cal. Ct. App.), 1435 Washington
Adults, temporary restraining order bars eliminating services but class certification denied (W.D. Wash.), 982
Children, temporary restraining order halts Medicaid funding cuts to in-home care (W.D. Wash.), 912; state agrees to restore services, 1407 Medicaid adult day program rehabilitation therapy cuts enjoined (W.D. Wash.), 1222; negotiations continue, 1407
Burden of proof, hospital peer review committee erred in ruling anesthesiologist had to prove she did not mishandle controlled substances (Cal. Ct. App.), 844
Cal., driving under influence arrests nexus sufficient to allow sanction for physician's off-duty conduct (Cal. Ct. App.), 1175 Fines
See PENALTIES
Hospitals fail to report physician sanctions, In Brief, 739 Ind. Medicaid agency should not be held in contempt for alleged violations of consent decree covering eligibility determinations for disabled persons (7th Cir.), 767 Iowa, state medical board has authority to discipline physician who did not seek to renew lapsed license (Iowa Ct. App.), 840 Kan., physician who was subjected to discipline by state licensing board after license had expired must pursue administrative remedies, suit dismissed (Kan.), 135 Lack of specificity, sanctions against HMO and its lawyers in underpayment class action vacated (3d Cir.), 1211 Ohio physician failed to show prejudice due to 5-year delay in proceedings (Ohio Ct. App.), 1302 Physician sanction by medical board for ineffective use of biofeedback machine to diagnose allergies, expert testimony not needed (Wash.), 766 Utterly frivolous MSP qui tam suits, bad faith definition appealed (U.S., rev den), 136 Vt., unprofessional conduct by ophthalmologist assessing and treating patients with cataracts, discipline affirmed (Vt.), 1176
Assignment of benefits, provider entitled to seek plan documents (E.D. La.), 132
Corporate integrity agreement documents not protected under state law (Tenn. Ct. App.), 758 Doctor-patient privilege False Claims Act
Dismissal due to previous public disclosure of suit alleging geropsychiatric unit admissions of patients with dementia who could not benefit from program (9th Cir.), 655
State and local administrative audits do not bar FCA jurisdiction (U.S., rev grant), 826 Wound care facility billing allegations publicly disclosed and relator not original source (7th Cir.), 900 FOIA Mental health records disclosed during discovery in divorce case, claim reinstated (Ill. App. Ct.), 1448 N.Y., new law requires hospitals to disclose nursing quality indicators and patient outcomes, 1301 Payments and gifts to physicians Pa. Right-to-Know Law covers Medicaid managed care program provider agreements, disclosure ordered (Pa. Commw. Ct.), 769 Self-disclosure
Kickbacks related to referrals, protocol being refined, IG Open Letter, 427
States increasingly adopt voluntary protocols for revealing compliance problems, 657
Insurers must disclose changes in provider manuals, new law signed, 808
PPO discount disclosure law signed by governor, 908
Bundled discounts and combination products, antitrust implications of Norvir, BNA Analysis & Perspective, 1128
Discovery, patient may obtain information to prove unfair pricing claims (Fla. Dist. Ct.), 605 Medigap insurers contracting with hospitals to create preferred provider networks no basis for sanctions, advisory opinion, 1046 PPOs
Subscribers seeking rates after exceeding annual benefit amounts cannot proceed without preferred providers, suit dismissed (W.D. Wash.), 908
Tenn., disclosure law signed by governor, 908
Debt collection, patient may obtain information on charges and discounts to prove unfair pricing claims (Fla. Dist. Ct.), 605
Decisionmaking process, New York City required to produce documents in suit opposing HIP Health Plan merger, motion for reconsideration denied (S.D.N.Y.), 653 Electronic records, attorney shares key rules, 914 EMTALA inadequate screening claim, emergency room records of other chest pain patients must be produced (D.N.J.), 528 Ex parte contact with plaintiff's nonparty physicians may not be barred, no HIPAA preemption (Tex.), 805 Fla. constitutional amendment
Hospital must provide adverse medical incident reports on patient falls and fall protections (Fla. Dist. Ct. App.), 842; rehearing denied, 1147
Nursing homes not covered, no requirement to provide malpractice plaintiffs incident reports (Fla.), 37 Independent medical examination
Automobile accident case, medical malpractice statute of limitations applies to alleged injury (N.Y.), 878
Physician-patient relationship implied, expert testimony required (Tenn. Ct. App.), 951 Mental health records disclosed during discovery in divorce case, claim reinstated (Ill. App. Ct.), 1448 Nonparty medical records not discoverable in private litigation (Ohio), 913 Peer review documents are privileged and not subject to disclosure (N.C. Ct. App.), 948 Peer review privilege
See generally PEER REVIEW AND PEER REVIEW ORGANIZATIONS (PROs)
Pregnancy discrimination, plaintiff's obstetrics/gynecology records may not be disclosed without judicial review to determine relevance (Ohio Ct. App.), 222 Records of state disciplinary action leading to voluntary surrender of medical license, physician lacks standing to assert privilege (Neb.), 1148 Work product privilege exception, general counsel must produce tax accrual work papers in response to IRS administrative summons, en banc decision (1st Cir.), 1163
Age
Calculation, low-income population excluded retroactively, HHS authority affirmed (U.S., rev sought), 35; (rev den), 299
Cost reports, HHS withdraws appeal of order to correct payments, case dismissed (D.D.C.), 438 Hospital groups urge lawmakers not to reduce DSH funds, 563 Ohio charity care program, participating hospitals are ineligible for DSH funding (U.S., rev den), 466 Out-of-state hospitals, Pa. cannot condition payment for trauma services by W. Va. hospital on requirement that it be accredited by Pa., temporary restraining order granted (M.D. Pa.), 946; preliminary injunction entered against state officials and agencies, 1372 Patient assistance program, pharmaceutical company may provide certain products to large DSH hospitals without penalties, advisory opinion, 1046 Physician services billed separately so could not be included in hospital services, disallowance of claim upheld (D.D.C.), 438 Reduction in order to fund health care reform agreed to by hospital groups, 942 States can access stimulus funds to help cover uninsured, 405 Wash., state medically indigent and general assistance unemployable patients should not be included in DSH calculation (W.D. Wash.), 1374
Doctor's tortious interference claim may proceed due to question of whether hospital followed own bylaws in summary suspension after adverse patient incident (D.D.C.), 1338
HIV misdiagnosis suit dismissed, physical danger required for negligent infliction of emotional distress claim (D.C.), 1342 Nonconsensual elective surgery for mentally retarded adults claims dismissed but question of attempt to obtain consent allowed (D.D.C.), 67 PBM price disclosure laws preempted by ERISA (D.C. Cir.), 401 Workers' compensation claim of physician harmed by nerve block injections by medical colleague while both were on duty not compensable (D.C.), 1263
See generally DURABLE MEDICAL EQUIPMENT (DME)
See ASSISTED SUICIDE
Antitrust issues
See ANTITRUST
Average wholesale price inflation
Johnson & Johnson Remicade and Procrit claims dismissal, trial court failed to adequately explain rationale, reversed and remanded (1st Cir.), 1290
Prostrate cancer treatment, $12.9M judgment against AstraZeneca affirmed (1st Cir.), 1289 Publications, class action against First DataBank Inc. and Medi-Span, revised settlement approved (D. Mass.), 363; pharmacy industry attempt to overturn settlement fails (1st Cir.), 1202 Bundled discounts and combination products, implications of Norvir, BNA Analysis & Perspective, 1128 Class actions
See CLASS ACTIONS
See E-PRESCRIPTIONS
Generic drugs
See GENERIC DRUGS
See GIFTS
Imports
See IMPORTATION
Mass. Medicaid drug pricing cases
See MASSACHUSETTS
Merck/Schering-Plough merger, FTC requires dual divestitures (FTC), 1466 Nurse debilitated after neurosurgeon used contraindicated dye awarded $38M by jury (Fla. Cir. Ct.), 410 Omnicare Inc. securities class action, fraud claim remanded for pleading standards review but dismissal of other claims affirmed (6th Cir.), 1452 OTC
Bad debts
Cross-subsidization ban, limit on amount of reimbursement upheld (6th Cir.), 1056; rehearing en banc denied, 1477
Denial of reimbursement to SNF for Part B therapy services upheld (D.C. Cir.), 1055
Disciplinary proceedings against physician, doctor failed to show prejudice due to 5-year delay (Ohio Ct. App.), 1302
Driving under influence arrests, nexus sufficient to allow disciplinary action for physician's off-duty conduct (Cal. Ct. App.), 1175 First Amendment rights of public employees are limited, physician failed to state a claim in suit alleging employer settled malpractice action without his knowledge and reported outcome to NPDB (N.D. Ill.), 392; reconsideration motion denied, 1121 HCQIA immunity, constitutional challenge dismissed (M.D. Fla.), 603 Health IT, proposed class action challenges stimulus provision (S.D.N.Y.), 906 Lengthy suspension of radiologist during Medi-Cal fraud investigation no violation (Cal. Ct. App.), 945 La., clinic's claim for Medicaid reimbursement time-barred (M.D. La.), 1306 Mass. reproductive health clinic buffer zone law challenge rejected (1st Cir.), 954 Medi-Cal suspension of doctor charged with using misbranded medical devices upheld, state action had no effect on liberty interests, rehearing denied (9th Cir.), 136 Medical resident discharged for inadequate performance not entitled to same protections as employee (S.D.), 303 Nonconsensual elective surgery for mentally retarded adults claims dismissed but question of attempt to obtain consent allowed (D.D.C.), 67 N.C. hospital that suspended physician may not be sued under federal civil rights law because it was not operating under color of state law (4th Cir.), 946 Peer review action lasting nearly 9 years, summary judgment for hospital denied, ruling on doctor's allegations deferred (E.D. Cal.), 1307 Retaliatory firing claims of physician who reported alleged EMTALA violations dismissed (U.S., rev sought), 1089; (rev den), 1340 RN disqualified from holding certain posts because of felony conviction, no violation (Minn. Ct. App.), 24 Staff privileges, dental surgeon's civil rights claims for denial of full medical staff membership properly rejected (10th Cir.), 372; (U.S., rev sought), 1087; (rev den), 1337 Substantive, state peer review privilege invoked by medical school director who refused to provide information to another hospital does not violate constitution (11th Cir.), 703; (U.S., rev sought), 1341 Surgery out-of-plan not shown to be medically necessary and superior, denial of reimbursement upheld (U.S., rev den), 1374 Wash., Medicaid disabled rehabilitation therapy cuts enjoined (W.D. Wash.), 1222; negotiations continue, 1407
Accreditation requirement for pharmacies selling to Medicare beneficiaries delayed, president signs new law, 1403
Competitive bidding end urged by Rep. Shuler (D-NC), 214 Kickbacks through sham DME provider, nursing chain agrees to pay to resolve allegations (N.D. Miss.), 1367 Surety bonds, CMS final rule requires suppliers to post as condition of participation, 36 Wheelchairs
See WHEELCHAIRS
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