Tag archives: Supreme Court

ACA Survives “[T]hird Installment in [U.S. Supreme Court’s] epic Affordable Care Act [T]rilogy”

On Thursday, June 17, 2021, in a 7-2 opinion, the U.S. Supreme Court upheld the Affordable Care Act (“ACA”) in the case California v. Texas. The Court held that Texas, the other plaintiff states, and the two individual plaintiffs did not have standing to challenge as unconstitutional the ACA’s minimum essential coverage provision. The plaintiffs … Continue reading

Supreme Court to Hold Oral Arguments on Certain Republican States’ Challenge to the ACA on November 10

By Thomas Dowdell (US) and Jeff Wurzburg (US) on August 19, 2020 Posted in General, News from DC, Regulatory

The U.S. Supreme Court will hear oral arguments on certain red states’ challenge to the Affordable Care Act on November 10, one week after the November 3 presidential election, according to the court’s online docket released on Wednesday, August 19. The central argument in the case is whether the entire ACA is invalid without a … Continue reading

COVID-19 Update: CMS Approves First Section 1135 Waiver

By Yvonne Puig (US), Daphne Calderon (US) and Jeff Wurzburg (US) on March 17, 2020 Posted in Coronavirus, General, News from DC

Following President Trump’s declaration of a national emergency on March 13, 2020, CMS approved the first Section 1135 waiver related to Medicaid on Monday. The State of Florida received permission to eliminate the limits on instances of care furnished and how many participants receive care from an out-of-state provider for the duration of the 1135 … Continue reading

Allina Update: Supreme Court holds Medicare statute requires notice and comment for DSH payment change

By Yvonne Puig (US), Thomas Dowdell (US), Frances Morgan (US) and Jeff Wurzburg (US) on June 4, 2019 Posted in News from DC

In a decision with potentially far reaching implications for Medicare hospital reimbursement, on June 3 the U.S. Supreme Court ruled 7-1 against the U.S. Department of Health and Human Services (“HHS”) in Azar v. Allina Health Services. The Court affirmed the U.S. Court of Appeals for the D.C. Circuit decision that vacated a rate calculation … Continue reading

The Supreme Court resolves circuit split on FCA statute of limitations period

By Maxwell Karasek (US), Carol Poindexter (US) and Zach Smith (US) on May 14, 2019 Posted in Enforcement

On May 13, the U.S. Supreme Court unanimously affirmed a decision by the U.S. Court of Appeals for the 11th Circuit, holding that the False Claims Act’s (“FCA”) limitations period in 31 U.S.C.(b)(2) applies to “relator-initiated actions” in which the Government declines to intervene and that a relator in a nonintervened suit is not “the … Continue reading

South Africa: Covering doctors have an immediate legal duty of care to patients

By Deniro Pillay (ZA) on October 2, 2018 Posted in International

A doctor who covers for a colleague has an immediate legal duty to care for his colleague’s patients whilst on call. This was recently confirmed by the Supreme Court of Appeal in South Africa in a case where a doctor (gynaecologist/obstetrician) agreed to cover for a colleague. The doctor positively responded to a telephone call … Continue reading

Twenty states file a lawsuit alleging the ACA is unconstitutional without the individual mandate penalty

By Jeff Wurzburg (US) on February 28, 2018 Posted in News from DC

A group of twenty states has filed a lawsuit against the Trump administration alleging that the Affordable Care Act (ACA) is unconstitutional. Plaintiffs take the position that the elimination of the individual mandate penalty in the Tax Cuts and Jobs Act (Pub. L. No. 115-97), without a corresponding elimination of the individual mandate, renders the … Continue reading

Court applies Escobar, overturns $350M False Claims Act verdict

By on January 16, 2018 Posted in Enforcement

In Universal Health Services v. U.S. ex rel Escobar, the United States Supreme Court emphasized the importance of the materiality standard in False Claims Act cases. Since that decision, litigants have anxiously awaited further guidance on how Escobar’s instructions would be applied by lower courts. In U.S. ex rel Ruckh v. Salus Rehabilitation, LLC et … Continue reading

Judge doubles down on finding of materiality in FCA case

By Joseph Keillor (US) and Sarah Jean Kilker (US) on September 26, 2017 Posted in Enforcement

Federal courts continue to grapple with applying the “materiality” standard that is needed to cause a Stark Law violation or other underlying compliance matter to trigger False Claims Act liability. Although we have recently begun to gain a clearer view of what contractual requirements will not likely be viewed as material, at least one federal … Continue reading

SCOTUS applies ERISA exemption to plans established by church-affiliated hospitals

By Yvonne Puig (US) and Eric Hoffman (US) on June 7, 2017 Posted in Regulatory

In an 8-0 decision, the Supreme Court unanimously held that ERISA’s exemption of “church plans” from its regulation of employee benefit plans extends to church-affiliated hospitals even if an actual church did not establish the plan. The Petitioners, Advocate Health Care Network, Saint Peter’s Healthcare System, and Dignity Health, are church-affiliated nonprofits that run hospitals … Continue reading