CMS and OIG Finalize Waivers for ACOs in the Medicare Shared Savings Program Effective October 29, 2015, the Centers for Medicare & Medicaid Services (“CMS”) and the Office of Inspector General (“OIG”) of the Department of Health & Human Services (“HHS” or “the Department”) finalized the waivers of certain fraud and abuse laws to specified arrangements involving accountable care organizations (“ACOs”) in the Medicare Shared Savings Program (“MSSP”) ...
Empezaron las eliminatorias al próximo Mundial pero las investigaciones por sobornos de la FIFA continúan – tendrán cobertura bajo pólizas de seguros las compañías y altos ejecutivos siendo investigados?El Comité de Ética de la FIFA anunció el 8 de octubre la suspensión provisional por 90 días de Joseph Blatter, presidente de la FIFA, y de Michel Platini, presidente de UEFA y vicepresidente de FIFA, entre otras suspensiones que fueron anunciadas en ese mismo momento ...
It’s no surprise that the National Cybersecurity Center of Excellence (NCCOE) has extended the public comment period for one of its newest guides, “Securing Electronic Health Records on Mobile Devices ...
On September 25, 2015, the Texas Board of Pharmacy (“TBP”) issued proposed rules that will allow pharmacists to substitute interchangeable biological products for brand name drugs. Currently, Texas regulations only allow for the substitution of lower-priced, generically equivalent drugs instead of certain brand name drugs. In contrast, the proposed rules allow pharmacists to dispense interchangeable biological products ...
In a short three-week period, the U.S. Department of Justice announced three large, multi-million dollar False Claims Act settlements involving Stark Law violations. Each of the three cases alleged that health systems compensated physicians in excess of fair market value, and in excess of collections for services personally performed by those physicians, in order to induce referrals ...
On August 18, 2015, the Tribunal administratif du Québec (TAQ) confirmed the decision of a health institution to not renew the status and privileges of one of its physicians after he refused to undergo refresher training to acquire skills that were necessary to perform his new duties.1 The physician in question, a hematology specialist, had been hired as a researcher several years ago ...
The financial pressures resulting from the “narrow network” phenomenon are well-known to healthcare providers and payers. Many providers have been eliminated from existing networks in order to allow participating providers access to a greater volume of patients. Those remaining providers have seen lower reimbursement rates and other cost containment measures ...
Argentina has thwarted debt security holders’ attempts to collect on their bond default judgments stemming from the nation’s 2001 economic collapse and subsequent repayment moratorium.EM Ltd. and NML Capital, Ltd ...
A Texas federal court recently ordered an insurer to reimburse an oil and gas company for costs and expenses incurred while defending against environmental claims. The court found that a duty to defend existed even though the insured failed to immediately notify the insurer of the occurrence, giving rise to the claim as required by the insurance policy, and despite alleged willful miscon- duct that was excluded from coverage under the policy ...
The federal securities laws require public companies to make and keep detailed and accurate “books, records, and accounts.” One might assume that a securities law relating to books and records covers materials used in the preparation of financial statements. But in practice, the U.S. Securities and Exchange Commission applies a much broader definition that seems to encompass every piece of paper and data in a company’s possession ...
When not conducted carefully, internal investigations cancause more harm than good. Deciding to investigate a suspected problem is onlythe first of several key determinations. The responsible executive must planand execute the investigation deliberately to avoid self-inflicted harm. Anorganization can protect itself—while still conducting an investigation that isconfidential, full and fair—only by carefully thinking about how best touncover the alleged wrongdoing or compliance issues ...
The New England Patriots may play the first quarter of the 2015-16 season without quarterback Tom Brady, as he was suspended for failing to cooperate with an investigation related to footballs deflated below league standards being used in the 2014-15 season AFC championship game with the Indianapolis Colts ...
The FDA recently issued final guidance regarding the size, shape, and other physical characteristics of generic-manufactured tablet and capsule dosage forms. The guidance noted that differences in physical characteristics of a dosage form could affect patient compliance and acceptability of medication regimens, or could lead to medication errors. The main reason for the FDA’s guidance appears to be that many patients can experience difficulty swallowing tablets and capsules ...
This is the age of government regulation. Businesses pay millions of dollars each year to comply with ever-increasing regulatory requirements intended to avoid catastrophic loss to persons and property. While corporate America underwrites the lion’s share of the cost associated with enhanced safety, the benefits are realized primarily by consumers, politicians and insurers. Yes, insurers. A dollar spent on preventing loss is a dollar saved by insurance companies ...
When one thinks of resolving disputes in Serbia, the first thing that comes to mind is the long, costly, inefficient dispute before a court, in a dusty court-room in a socialist architecture grey building. Even though these conditions still are reality, Serbia is making efforts in recent years to achieve higher efficiency in resolving disputes through various types of judicial reform including arbitration as one of dispute resolution mechanisms ...
In a decision rendered on April 30, 20151, the Administrative Tribunal of Québec (the "ATQ") upheld a decision of the board of directors of a university hospital centre that refused to renew the status and privileges of a physician who failed to fulfill the obligations associated with the enjoyment of these privileges. Firstly, it should be noted that the applicant's clinical competence was not questioned in this case ...
Following Cuba’s removal from the list of State Sponsors of Terrorism on May 29, 2015, the United States and Cuba took an additional step towards normalizing relations by announcing the reopening of embassies after more than five decades of their closure. The announcement of an agreement to reopen embassies, which was made today, is the first step in converting each country’s present “Interests Section” into formal embassies ...
On June 6th, 2015, Law No. 20,850, which creates the Financial Protection System for Diagnostics and Treatment of High Costs, and pays posthumous tribute to Luis Ricarte Soto Gallegos, has been published. This law creates a financial protection system for diagnostics and high cost treatments which will be defined by the Ministry of Health by means of a Supreme Decree ...
In a decisive victory for the Plaintiffs in class actions against the three Canadian leading tobacco companies1, the Québec Superior Court ordered the Defendants to pay more than 15 billion dollars in moral damages2 and punitive damages. There were more than 253 hearing days3 and 16 years of proceedings. THE ACTIONS In February 2005, Justice Pierre Jasmin authorized two class actions against JTI-Macdonald (JTM), Imperial Tobacco (ITL) and Rothmans, Benson & Hedges (RBH) ...
FIFA Kickback and Bribery Allegations & Insurance For Related Third-Party Investigations Bribes of $40,000 stuffed in envelopes, a flight to Europe solely to retrieve a briefcase full of cash and a$10 million payoff to secure votes for choosing the World Cup host country are among the allegations in the recent indictment against FIFA representatives and related business associates ...
Bribes of $40,000 stuffed in envelopes, a flight to Europe solely to retrieve a briefcase full of cash, and a $10 million payoff to secure votes for choosing the World Cup host country are among the allegations in the recent indictment against FIFA representatives and related business associates. The indictment contains charges of racketeering, wire fraud and money laundering arising out of alleged kickbacks and bribes that the defendants gave or received ...
Prolonged and torrential rains have caused widespread flooding in Texas, Oklahoma and surrounding areas. It is important that policyholders remain mindful of the substantial benefits that may be available to them for resulting economic and physical losses under ordinary business insurance policies ...
In employees’ compensation or personal injuries claims, it is not uncommon for the employer or its insurers to directly settle a claim with the injured person before any legal proceedings are commenced. The recent case of Chan Kwok Man v New World First Bus Services Limited DCEC No.186 of 2013 highlights the importance of ensuring that the wording used in discharge forms is clear, unambiguous and consistent and that the discharge form is properly executed ...
While the worst of the housing crisis may be over, a significant number of existing foreclosures remain, and new foreclosures continue apace. According to RealtyTrac, there were 122,060 new foreclosure filings in March 2015,and there are 842,773 properties in the U.S. in some stage of foreclosure.For those properties that are subject to judicial foreclosure, many will involve borrowers, who have asserted a variety of counterclaims against the mortgagee ...
