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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
E-HEALTH
Prescriptions
See E-PRESCRIPTIONS
Computerized physician order entry use doubled over past five years, AHA releases annual most wired list, 907
Sherman Act claims of internet pharmacy against PBMs time-barred (U.S., rev den), 1465
Vicarious liability, hospital not liable for malpractice by on-call otolarynologist (Tex. App.), 671
Capital crunch at hospitals, In Brief, 142
Health care reform in stimulus package Stimulus bill
Blog post did not violate privacy policy, nursing student reinstated (W.D. Ky.), 1113
Chronic pain research, education, and training Teaching hospitals
Antitrust aspects of information sharing by public and private health insurers, BNA Analysis & Perspective, 990
E-discovery, attorney shares key rules, 914 Federal role in implementation expanded, attorney says, 661 Fla., new law calls for state to develop universal patient release form, 831 Hospital adoption levels low, In Brief, 443 Incentives
Late adopters, advisory panel recommends more time to meet standards, 972
La. loan program, governor signs bill, 988 Md. governor signs new law, 696 Meaningful use definition key to success, attorneys raise questions, 719; policy committee drafts proposal, 794; advisory panel relaxes some elements, 972; payment estimates in flux, 1440 More urged by Health IT Coalition Proposed rules planned for 2009, CMS official says, 595 Quick action by state leaders needed to tap stimulus funds, 289 State-by-state needs to implement mandates outlined by report, 1080 Stimulus provisions challenged on due process and privacy grounds (S.D.N.Y.), 906 Stricter rules on privacy and security addressed by attorneys, 1080 Most wired
Computerized physician order entry use doubled over past five years, AHA releases annual list, 907
Geisinger program began in 1990s, 549 Privacy and security
AMA delegates approve guidance on breaches, 832
Commercial online personal medical records vendors, FTC issues privacy breach notification requirements, 749 Data breach notification mandate hailed and criticized, 275; correction, 335 Expect strong data breach enforcement from states, lawyer says, 693 Federal Trade Comm'n issues final rule, 1112 Identity theft
See IDENTITY THEFT
No harm, House leaders urge HHS to strengthen notice rules, 1331 Notices for breaches proposed by FTC, 521 Red flag rules
See IDENTITY THEFT
States consider breach bills and protection of prescription drug data, 216 Understanding and implementing breach notification rules, BNA Analysis & Perspective, 1234 State law differences and liability fears are barriers, attorney says, 1142 Statutory mandate, challenges of implementation considered, 660
EMTALA waiver of immunity claimed, retaliatory firing suit of physician who reported alleged violations dismissed (U.S., rev sought), 1089; (rev den), 1340
See PATIENT DUMPING
Ambulance services
Attention deficit hyperactivity disorder, emergency room doctor can proceed to trial with ADA and Rehabilitation Act claims (W.D. Pa.), 490 Balance billing
See BILLING
Call coverage
Excessive call hours, trial court ordered to reduce amount of award to doctor (Ark. Ct. App.), 1480
Neurosurgeon who provided telephone advice established doctor-patient relationship as matter of law, jury verdict reversed and remanded (Or. Ct. App.), 1508 On-call payments for physicians who treat uninsured patients do not violate anti-kickback law, advisory opinion, 683 Children Corporate liability doctrine does not apply to hospital's alleged failure to follow policy requiring physicians to examine every emergency room patient (Tenn. Ct. App.), 36 Corporate practice of medicine
No private cause of action under Tex. law, dismissal of suit by emergency room doctors against hospital system upheld (Tex. App.), 1031
Organization of emergency room doctors lacks standing to challenge TeamHealth contracts (Tex. App.), 169 EMTALA issues
See PATIENT DUMPING
Medi-Cal
L.A. Care seeks to overturning ruling plans may not delegate to subcontractors risk of paying for emergency providers for those moved to managed care (Cal. Super. Ct.), 1222
Payments allegedly inadequate, physicians file proposed class action (Cal. Super. Ct.), 163 Out-of-state hospitals, Pa. cannot condition payment for trauma services by W. Va. DSH 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's right to refuse treatment does not justify battering hospital personnel (Wis. Ct. App.), 774 Racial bias claim based on allegedly unjustified reprimand letter, no adverse employment action against African American physician (S.D.N.Y.), 1307 Underpayment alleged, hospital's claims against plan administrator and external review organization may proceed (E.D. Cal.), 1151 Vicarious liability, stipulated release of claims against hospital also released claims against emergency room physician based on negligence of attending nurse employee (Wash. Ct. App.), 849
Disability benefits
ERISA plans
See ERISA
Pregnancy, Ohio law requires reasonable maternity leave regardless of general leave policy (Ohio Ct. App.), 455 Retiree benefits
See RETIREE BENEFITS
See ERISA
Age
See PATIENT DUMPING
Antitrust, dialysis services company may amend complaint to cure Sherman Act pleading deficiencies but predatory hiring allegations fail (D. Colo.), 1165
Health and welfare fund beneficiary termination after learning of Medicare eligibility due to ESRD violates MSP law (E.D. Tenn.), 1114 Nutritional supplement program expansion not basis for penalties, advisory opinion, 902 Out-of-network dialysis center, MSP law is not violated by lower reimbursement rates (N.D. Ga.), 255 Renal dialysis facility prospective payment system rule proposed, In Brief, 1225
Deferred prosecution agreements
Expect strong data breach enforcement from states, lawyer says, 693 FCA amendments Health care fraud
Economy increases false claims risk requiring greater focus on compliance, attorney says, 387
HEAT, joint Justice Dep't and HHS effort praised by witnesses, 1471 Physicians under increased scrutiny, IG official says, 654 Preparing for 2009, BNA audioconference, 45 Prosecutions, BNA audioconference, 45 State-based Medicaid Fraud Control Units recovered $1.3B in FY2008, 1078
Annual work plan for FY2010 includes ARRA-mandated reviews, 1340
Expects to recover more than $2.4B for first half of 2009, In Brief, 811
ARRA funds will strengthen enforcement, speaker says, 333
Contract and policy changes needed, lawyers say, 495 Guidance on methods to protect information issued by HHS, 523; stakeholders need more specifics, 691 HHS Civil Rights Office to enforce security rule, 1049 New laws present triple threat to technology managers, BNA Analysis & Perspective, 537 Next phase, BNA Analysis & Perspective, 308 Privacy and security laws, new liability and compliance challenges, BNA Analysis & Perspective, 1273 Understanding and implementing breach notification rules, BNA Analysis & Perspective, 1234
See IDENTITY THEFT
Kan. hospital agrees to pay to settle hazardous waste claims, 673
Medical waste incinerators emission standards tightened, final rule, 1267
Female hospital vice president's pay claim may proceed but retaliation claim fails (W.D. Pa.), 1325
Cal. 6-month residency requirement for prenatal care for low-income patients is unconstitutional (Cal Super. Ct.), 26
Cook County, Ill. public hospital, doctors' claims survive motion to dismiss (N.D. Ill.), 208 Gender reassignment surgery, state Medicaid agency's refusal to cover procedure not unconstitutional (W.D.N.Y.), 980 HCQIA immunity, constitutional challenge dismissed (M.D. Fla.), 603 Mass. reproductive health clinic buffer zone law challenge rejected (1st Cir.), 954
DME
Hospital bed defect alleged cause of injury, suit is premises liability claim not health care action, expert report not required (Tex.), 1181
Arbitration
Breach of contract claims brought against plan by provider are not preempted (9th Cir.), 1253
Clause enforceable in benefits denial case despite violations (8th Cir.), 181; (U.S., rev den), 1361 Authorization for treatment, state law claim not preempted (9th Cir.), 1208 Autism therapy
Equitable relief unavailable for plan participant alleging administrator breached fiduciary duty in classifying treatment as experimental (E.D. Mich.), 369; class certification denied, 461
Summary plan description does not trump plan which is silent on issue of administrator discretion, no deference due decision to deny payment for treatment (D. Or.), 368 Cal. emergency care payment law not preempted (Cal. Ct. App.), 633 Claims processor allegedly interfered with contractual relations, hospital's suit not preempted (E.D. Cal.), 187 Computer-assisted knee replacement surgery investigational label abused discretion, insurer liable for claim (E.D. La.), 1442 Delayed or denied payments
Acute rehabilitative care delay allegedly led to injury, claim preempted (D.N.J.), 1214
State law claims by Mo. physicians against health insurers are preempted and must be litigated in federal court (S.D. Fla.), 157 Disclosure of health insurance limitations
Mich. insurance rules not preempted (6th Cir.), 400
Mont. insurance commissioner prohibition aimed at industry and affects risk-pooling (9th Cir.), 1441 Dual-role administrators
Benefit claims review standards, new approach as courts adjust to Glenn decision, 53
Conflict only one factor, termination of disability benefits upheld (4th Cir.), 60 De novo review inconsistent with Glenn but denial of disability benefits improper (2d Cir.), 59 Eligibility for coverage allegedly misrepresented by employer, former plan participant may pursue claims that he was wrongfully terminated (S.D.N.Y.), 435 Equitable accounting, disgorgement, and restitution unavailable for participants' suit against administrator for alleged breach of emergency care under health plan (E.D. Mich.), 461 Equitable restitution to recover payments to providers for participant's minor child who was not enrolled denied (W.D. Wis.), 1443 Explanation of benefits allegedly fraudulent, dismissal of RICO claim affirmed (8th Cir.), 336; (U.S., rev sought), 1021; (rev den), 1333 Failure to convert to individual policy, former plan participant has no claim for benefits (W.D. Va.), 29 Fair share laws, San Francisco ordinance requiring employee health care expenditures by local business, restaurant group brief arguing for en banc review accepted (9th Cir.), 64; rehearing en banc denied, 330; emergency stay sought (U.S., application filed), 399; (application for stay denied), 433; (U.S., rev sought), 761; city opposes review (brief filed), 1144; Solicitor General brief sought (order), 1332 Full and fair review violated by raising new grounds for denying benefits, case remanded for further proceedings (5th Cir.), 398 Health care reform issues raised by hearing speakers, 866 HMO violated Mo. rule by charging copayment and coinsurance for single service (W.D. Mo.), 799 Internal guidelines cited as reason for speech therapy coverage denial must be disclosed, reversed due to administrator's violation of duty (7th Cir.), 335; (U.S., rev den), 1334 Malpractice claims against physicians who were plan medical directors preempted (N.J. Super. Ct. App. Div.), 290 Mo. prompt payment law preempted (8th Cir.), 336 Out-of-network
Dentists' inadequate payment claims against Wellpoint not barred by failure to exhaust administrative remedies (S.D. Fla.), 157
Incentives offered to patients by provider allegedly interfered with managed care organization's relationship with in-network providers, claim is not preempted (D.N.J.), 556 Negligent misrepresentation that knee treatment was in-network expense, state claim is not preempted (S.D. Ohio), 731 PBM price disclosure, D.C. law preempted (D.C. Cir.), 401 Penalties time-barred by Va. statute of limitations (W.D. Va.), 30 Physical therapy or chiropractic treatment payments allegedly denied or delayed by United Healthcare, claims of group of medical providers and plan participants allowed (D. Ariz.), 597 Physician's breach claims against former practice group including premature cancellation of health coverage not preempted, remanded to state court (W.D. Tenn.), 803 Pre-certification, hospital's state contract breach claim preempted (S.D. Ohio), 596 Privacy, claims that insurer negligently gave participant's address to ex-husband not preempted (C.D. Cal.), 695 Prohibited transactions claim allowed in dispute over administrator's failure to pay benefits (D. Ariz.), 597 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 (D.N.J.), 1051 Removal to federal court unwarranted, attorneys' fees award affirmed (6th Cir.), 28 Retroactive reinstatement of employer's coverage is equitable remedy allowed under §502 (10th Cir.), 1081 Subrogation
Credit for copayments, challenge to health plan lien on third-party settlement rejected due to failure to exhaust administrative remedies (N.D. Cal.), 1212
Insurer may recover payments without intervening in earlier litigation (W.D. Ky.), 292 Make whole doctrine, trial needed to determine whether health plan participant who received payment from her underinsured motorist policy must reimburse plan (D. Or.), 402 Withdrawal of policy from N.Y. small group market, group health insurer failed to establish rules for eligibility (S.D.N.Y.), 1020 Wrongful termination of plan alleged, employer's state law claim preempted (N.D.N.Y.), 663
Participation in 12-step program, medical license suspension precludes constitutional claims related to board requirement (U.S., rev den), 841
AMA guidance on responsibilities in case of breach of electronic health information approved by delegates, 832
Drug and device industry codes for interactions with health care professionals, opportunities for mischief remain according to IG official, 863 Gifts
See GIFTS
See ASSISTED SUICIDE
Arizona
Burden of proof, new law raises to clear and convincing for medical malpractice suits against emergency room doctors, 1030
Spoliation claim dismissed, no state cause of action for intentional or negligent loss of allegedly defective prosthesis (Ariz. Ct. App.), 1183 Cat's paw, trial judge should have made threshold decision on sufficiency of proof (7th Cir.), 426 EMTALA, insufficient proof of motor vehicle accident victim emergency condition diagnosis or inadequate screening, claim dismissed (N.D.W. Va.), 1089; reconsideration denied, 1410 Expert testimony
See EXPERT WITNESSES
Key causation proof submitted months after judge's deadline, exclusion upheld (9th Cir.), 502; (U.S., rev sought), 919 Res ipsa loquitur
See CAUSATION
Chiropractors excluded from managed care organization panel did not prove violation of state HMO law (Tenn. Ct. App.), 435
Clinical laboratories, revocation of certification for sending samples to another laboratory upheld, review petition denied (10th Cir.), 754 Executive of Cal. nursing home chain agrees to permanent exclusion, IG announces, 939 Health and welfare fund beneficiary termination after learning of Medicare eligibility due to ESRD violates MSP law (E.D. Tenn.), 1114 Medicaid benefits termination due to residuary trust, judicial review available because claims remedial (10th Cir.), 99 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 Public interest in providing uninterrupted funding to nursing home, temporary restraining order bars termination of Medicare and Medicaid agreements (W.D. La.), 223
Details of nonprofit hospital practices in final report on IRS study, 205
Financial data from largest health insurance companies sought by House committee, 1141 Initial contract exception, IRS exploring impact on comparable salary information, 922 Mass. attorney general announces increased oversight of nonprofit charitable health organizations, 1200 Nonprofit corporate law developments in 2008, BNA Analysis & Perspective, 73 N.D. regulator seeks BCBS data on compensation and travel policies after report finds excessive expenses, 1255 Recent corporate governance developments, BNA Analysis & Perspective, 776 Repeal of rebuttable presumption of reasonableness proposed by Grassley (R-Iowa), 1247; Grassley does not offer amendments as part of markup, 1344
Medicare Part D doughnut hole challenge dismissal upheld (3d Cir.), 1057
NPDB report challenge must first be administratively reviewed by HHS Sec'y (D. Nev.), 947 Out-of-network dentists' inadequate payment claims against Wellpoint not barred (S.D. Fla.), 157 Physician who was subjected to discipline by state licensing board after license had expired must pursue administrative remedies, suit dismissed (Kan.), 135 Refusal to attend hearing doomed doctor's suit to reinstate staff privileges (N.J. Super. Ct. App. Div.), 1088 Stark law claims of cardiologists and catheterization labs dismissed due to potential for indirect administrative challenge (D.D.C.), 517 State tax costs, mandamus petition filed by 27 hospitals seeking to reopen cost reports dismissed due to failure to exhaust (D.D.C.), 348 Subrogation and credit for copayments, challenge to health plan lien on third-party settlement rejected due to failure to exhaust remedies (N.D. Cal.), 1212 Translator policy, review of HHS guidance denied due to lack of ripeness (9th Cir.), 408 TRICARE, hospitals must seek administrative remedies against managed care contractors before filing suit (3d Cir.), 1210 Usual, customary, and reasonable charges methodology challenged, provider must exhaust remedies, claim dismissed (D.N.J.), 496 Wage index calculation allegedly incorrect, magistrate recommends remand of action filed by hospitals due to lack of reviewable final action by CMS (D.D.C.), 408
Autism, applied behavior analysis therapy
See AUTISM
Computer-assisted knee replacement surgery investigational label abused discretion, insurer liable for claim (E.D. La.), 1442 Radio frequency ablation treatment for lung cancer, negligence in making benefit determination claim reinstated against plan administrator (Cal. Ct. App.), 524
See also CAUSATION
Ala., case alleging injury from steroid epidural requires expert testimony (Ala.), 704 Ariz., expert qualification standards statute does not violate state constitution (Ariz.), 375 Death nearly two years after open-heart surgery on infant, proffered expert testimony on negligent act by surgeon not scientifically reliable (E.D. Pa.), 1149 Elderly man fell in hospital shower, expert not required to prove health aide negligence (Okla. Ct. App.), 105 Emergency room physician may provide testimony on standard of care of emergency room nurses (N.D.W. Va.), 1089; reconsideration denied, 1410 Emotional distress, hospital employee whose health records were accessed by fellow workers may not recover damages due to failure to prove emotional injury (Iowa), 702 EMTALA, federal rules preempt state law on evaluating testimony (S.D. Tex.), 40 Expert reports to establish standard of care
See TEXAS
Hour delay in completing delivery of dead baby, expert evidence not needed to prove emotion distress claims (Ill.), 1505 Independent medical examination in personal injury case implies physician-patient relationship, expert standard of care testimony required (Tenn. Ct. App.), 951 Ind., expert testimony based solely on knowledge and experience not subject to state evidence reliability requirement, judgment for doctor in delivery malpractice suit reversed (Ind. Ct. App.), 880 Key expert causation proof submitted months after judge's deadline, exclusion upheld (9th Cir.), 502; (U.S., rev sought), 919 Morbidity and mortality testimony not based on scientifically reliable data, excluded in heart surgery technique suit (E.D. Pa.), 705 Necessity of treatment, exclusion of expert testimony in auto accident negligence suit upheld (Ind. Ct. App.), 344 N.C., treating physicians may testify in malpractice suit without being designated as expert before trial, bright line exception to law (N.C. Ct. App.), 533 Okla., malpractice reform law signed by governor includes requirement for written expert opinions in malpractice cases, 735 Patient compensation fund's expert testimony on preexisting risk of harm allowed if relevant to amount of damages (Ind.), 345 Physician who submitted standard of care testimony may not represent plaintiffs as lawyer (Tenn. Ct. App.), 533 Res ipsa loquitur
See CAUSATION
Wheelchairs, claims for injury to unattended woman reinstated, no expert testimony required (Ohio Ct. App.), 1411 Wis., suicide due to psychiatric unit negligence claim may be pursued under custodial care provisions, expert medical testimony not needed (Wis. Ct. App.), 735
Antitrust, eye surgery instrument maker's tying suit dismissed for failure to plead price coercion, reconsideration denied (S.D.N.Y.), 1165
Cal. restrictions on opticians working in same locations as optometrists and ophthalmologists not subject to strict scrutiny, case remanded (9th Cir.), 736 Children Optician fired for insubordination after repeatedly complaining about allegedly illegal store practices may proceed with wrongful discharge claim (E.D. Tenn.), 1295 Unprofessional conduct by ophthalmologist assessing and treating patients with cataracts, discipline affirmed (Vt.), 1176 Upcoding of eye exams determination by Medicaid agency erroneous (Iowa), 981 Vision Service Plan not entitled to tax exemption (U.S., rev den), 71 Contact the Webmaster at webmaster@bna.com Copyright © The Bureau of National Affairs, Inc. All Rights Reserved. |