Court Orders Stay of Order Declaring Individual Mandate Unconstitutional and Inseverable [Health Law Informer Blog]

We previously reported that District Court Judge Reed O’Connor of the Northern District of Texas declared on December 14, 2018 (1) that the Affordable Care Act’s (ACA) individual mandate is unconstitutional and (2) that the remaining provisions of the ACA are “inseverable” and therefore...

Federal Court Enjoins Medicare Recoupment [Health Law Informer Blog]

A Houston federal judge preliminarily enjoined the government from recouping alleged Medicare overpayments made to an ambulance service company facing bankruptcy.  See Adams EMS, Inc. v. Azar, No. H-18-1443, 2018 BL 391263 (S.D. Tex. 2018). As you may be aware, there is a massive backlog in the...

CMS Releases Final ACO Regulations [Health Law Informer Blog]

This morning CMS released a final rule regarding its most popular program for accountable care organizations (ACOs), the Medicare Shared Savings Programs. The final rule is based on the proposed rule for the program that was published in August.  The final rule adopts the major structural overhaul...

“A Slow Game of Jenga:” Has a Federal Judge Toppled the Affordable Care Act? [Health Law Informer Blog]

Last Friday, in Texas v. United States, Judge Reed O’Connor of the Northern District of Texas (1) declared the Affordable Care Act’s (ACA) individual mandate to be unconstitutional.  In so doing, the Judge, a President George W. Bush appointee, also (2) declared the remaining provisions of the ACA...

Medicare’s New Virtual Check-In Code: 7 Things You Need to Know [Health Law Informer Blog]

On November 1, 2018, CMS issued a 2,379 page final rule titled “Revisions to Payment Policies under the Medicare Physician Fee Schedule, Quality Payment Program and Other Revisions to Part B for CY 2019.”  While there are some interesting changes related to remote patient monitoring for chronic...

Anthem Agrees to Record $16 Million Settlement for Alleged HIPAA Violations [Health Law Informer Blog]

In the wake of the largest U.S. health care data breach in history, Anthem, Inc., has agreed to pay $16 million to the Office for Civil Rights, which is a record settlement for alleged HIPAA violations. According to the Department of Health and Human Services ("HHS"), the previous high was a $5.55...

Don't Misrepresent Your U.S. - E.U. Privacy Shield Status: FTC Brings An Enforcement Action [Health Law Informer Blog]

As US companies continue to spend time and effort complying and responding to all of the new privacy laws and regulations both in the United States and aboard (i.e. GDPR and California Consumer Privacy Act of 2018) companies cannot forget the basics.  If you represent something in your Privacy...

Governor Wolf Signs Amendment to PA Medical Marijuana Act [Health Law Informer Blog]

On June 22, 2018 Governor Wolf signed HB 2477 (“Amendment”) into law breathing new life into Chapter 20 of the Medical Marijuana Act (“Act”), the country’s first-of-its-kind law for cannabis research. This follows Commonwealth Court Judge Patricia McCullough’s May 22, 2018 issuance of a preliminary...

Third Circuit Provides Guidance on Handling of EMTALA Whistleblower Claims [Labor & Employment Alert]

Bobbi Britton Tucker discusses the court's decision in Marie Gillispie v. Regionalcare Hospital Partners, Inc., and how the court rules that the EMTALA’s whistleblower provision protects employees who inform personnel in a covered facility of an alleged EMTALA violation, even though the employee does not also inform any governmental or regulatory agency.

Court Temporarily Enjoins CMS from Withholding Medicare Payments from Home Health Agency [Health Law Informer Blog]

A home health agency has scored a second win in its fight to prevent CMS from withholding Medicare payments (to effectuate a recoupment of alleged overpayments), at least for the time being.  We previously reported on the home health agency’s first win before the Fifth Circuit (which reversed the...

New Jersey Enacts “Out-of-Network Consumer Protection, Transparency, Cost Containment and Accountability Act” [Health Law Informer Blog]

On June 1, 2018, New Jersey Governor Phil Murphy signed into law the Out-of-Network Consumer Protection, Transparency, Cost Containment and Accountability Act (the “Act”), available at: http://www.njleg.state.nj.us/bills/BillView.asp?BillNumber=A2039, which becomes effective on the 90th day after...

Court of Appeals Finds Jurisdiction in Medicare Appeals Backlog Case [Health Law Informer Blog]

The Fifth Circuit has recently held that its courts have jurisdiction to hear a lawsuit seeking to enjoin Medicare from recouping funds until after a hearing because (1) the provider’s claim is collateral to the underlying recoupment and (2) the recoupment may result in the provider’s bankruptcy and...

MedPAC Report: A Wake Up Call for Telehealth [Health Law Informer Blog]

The recent Medicare Payment Advisory Commission (“MedPAC” or “Commission”) report should serve as a shot across the bow to telehealth advocates seeking broader Medicare coverage of telehealth. In reading the telehealth chapter, it is clear to me that the MedPAC commissioners are not fully sold on...

Hospital Tier Status in Payor Network Agreements [Health Law Informer Blog]

Bergen County Superior Court Judge Robert Contillo issued a recent decision deemed favorable by Horizon Healthcare Services Inc. (“Horizon”) in a case involving three healthcare providers (“Providers”) that challenged Horizon’s newer tiered health coverage plan for hospitals: OMNIA. The Providers...

2018 Telemedicine Benchmark Survey Shows Industry Trends [Health Law Informer Blog]

Each year, REACH Health publishes an industry benchmark survey that provides great insight into what telemedicine industry leaders are thinking.  Its most recently published survey is no different.  The 2018 survey was conducted among healthcare executives, physicians, and other professionals during...

DOH Finalizes Temporary Regulations for Clinical Registrants and Academic Clinical Research Centers [Health Law Informer Blog]

The Pennsylvania Department of Health (DOH) published the much anticipated final version of the temporary regulations under the Medical Marijuana Act applicable to Clinical Registrants and Academic Clinical Research Centers (ACRC) in Pennsylvania (“Temporary Regulations”). The Clinical...

CMS Approves Medicaid Waiver Requiring “Community Engagement” [Health Law Informer Blog]

As a first in the history of the Medicaid program, the Centers for Medicare & Medicaid Services (CMS) approved, on January 12, 2018, Kentucky’s section 1115 waiver application that imposes on many beneficiaries a “community engagement” requirement as a condition of Medicaid eligibility.  This is...

Legal issues Involving Teleradiology [The Practical Lawyer]

Coryell Barlow discusses the most common legal issues that arise with teleradiology in the ALI CLE's The Practical Lawyer.

Overcoming the Obstacles in TCPA on Patient Engagement [Data Protection Law & Policy]

Ryan P. Blaney discusses consent requirements when the TCPA and HIPAA intersect.

Next Generation ACOs: CMMI Doubles Down on the Two-Sided Risk ACO Model [Health Law Alert]

While one part of the Affordable Care Act, exchange subsidies, hangs in the balance with the Supreme Court’s upcoming decision in King v Burwell, CMS is moving forward aggressively with the evolution of a less controversial ACA-created innovation, the Medicare ACO.

Pennsylvania Federal Court Reiterates EMTALA’s Inapplicability to Transfers of “Admitted Patients”

On February 23, 2015, the District Court in Baney v. Fick held that a patient’s complications arising from elective surgery do not fall under the purview of the Emergency Medical Treatment and Labor Act, 42 U.S.C. § 1395dd, (EMTALA). See 2015 BL 45710, M.D. Pa., No. 4:14-cv-2393 (Feb. 23, 2015). Plaintiffs, a husband and wife, alleged that the medical team managing Brian Baney’s care at Mount Nittany Medical Center should have immediately arranged for his transport to another hospital when he received an esophageal injury following an elective neurosurgical procedure at Mount Nittany Medical Center, and that the team’s care of Baney amounted to a failure to properly stabilize and properly manage Baney’s injury as required under EMTALA. However, the Baney court (citing to Torretti v. Main Line Hospitals, Inc., 580 F.3d 168, 174-75, 177 (3d Cir. 2009), dismissed the plaintiffs’ EMTALA claim with prejudice because the claim “did not fit within EMTALA’s scope.”

Supreme Court Delivers another Blow to State Action Antitrust Immunity [Antitrust & Regulatory Alert]

Today, in North Carolina State Board of Dental Examiners v. Federal Trade Commission, the Supreme Court held that a state dental board, created by the legislature, but comprised primarily of dentists elected by other dentists, did not qualify for immunity under the antitrust laws. This is the second time in two years that the Court has significantly limited the applicability of the state action exemption, under which states themselves are immune from the federal antitrust laws. Actions by private parties, including quasi-governmental entities, pursuant to a state regulatory regime may also be immune, but only under certain circumstances. Given the prevalence of state quasi-governmental bodies in regulating a broad range of industries such as energy, professional services, health care and transportation, these decisions will likely force states, and regulated industries, to reconsider their policy and legal strategies.

Summary of OIG'S 2015 Work Plan [ALHA]

Ryan Blaney, a member in the firm's Washington, D.C. office contributes to the OIG's summary of new and ongoing reviews and activities that OIG plans to pursue with respect to HHS programs during the current Fiscal Year and beyond.

IRS Releases Guidance on Private Business Use, and ACOs and Management Contracts [Public Finance and Health Law Alert]

Recent Developments - October 2014 [ABA Health Care and Pharmaceuticals Committee]

Ryan Blaney, a member of Cozen O’Connor’s Health Law practice group, was a contributor in the October edition of the ABA Health Care and Pharmaceuticals Committee Recent Developments. Recent Developments contains summaries of recent federal and state court cases, government enforcement actions, and other ‘’recent developments’’ involving antitrust and privacy issues in the health care and pharmaceutical industries.

Pre-Emption of State-Law Design-Defect Claim Against Generic Drug Company [Intellectual Property Alert]

On June 24, 2013, in a 5-4 decision, the U.S. Supreme Court in Mutual Pharmaceutical Co., Inc. v. Bartlett held that state-law design-defect claims based on the inadequacy of a generic drug’s labeled warnings are pre-empted by federal law. This decision reversed the 1st Circuit’s affirmance of a jury verdict awarding Bartlett more than $21 million on her design-defect claim against Mutual Pharmaceutical under New Hampshire law.

Supreme Court: Reverse Payment Settlements Subject to Antitrust Scrutiny [Intellectual Property Alert]

On June 17, 2013, the U.S. Supreme Court handed down a decision that addressed a “reverse payment” settlement agreement between a brand-name pharmaceutical company and multiple generic drug companies. The Supreme Court held that a settlement agreement in which a patentee pays an accused infringer not to enter the market – even if the agreement allows market entry before the patent term expires – is not presumptively lawful and is still subject to antitrust scrutiny.

IP: Obamacare’s Constitutional Impact on Patents [InsideCounsel]

A variety of patent issues arise from the act’s Biologics Price Competition and Innovation Act.

Hospitals Prevail in Effort to Include Pennsylvania GA Days in the Medicare DSH Calculation [Health Law Alert]

Two of Mercy Health System’s hospitals (Nazareth Hospital and the former St. Agnes Medical Center) successfully challenged, before Judge Ludwig of the U.S. District Court for the Eastern District of Pennsylvania, the Secretary of Health and Human Services’ exclusion of days of care provided to Pennsylvania’s General Assistance (GA) patients in fiscal year 2002 from the formula used to determine the hospitals’ Medicare disproportionate share hospital (DSH) payments (Nazareth Hosp. v. Sebelius, E.D. Pa. No. 2:10-cv-03513-EL, April 8, 2013). The exclusion resulted in lower Medicare DSH payments.

Highlights of the Omnibus HIPAA/HITECH Final Rule [Cozen O'Connor Whitepaper]

On January 25, 2013, the Office of Civil Rights (OCR) of the Department of Health & Human Services (HHS) published the long-awaited omnibus final regulation governing health data privacy, security and enforcement (Omnibus Rule). The Omnibus Rule is a group of regulations that finalizes four sets of proposed or interim final rules, including changes to the Health Insurance Portability and Accountability Act (HIPAA) Privacy and Security Rules mandated by the Health Information Technology for Economic and Clinical Health (HITECH) Act and proposed in 2010; changes to the interim final breach notification rule; modifications to the interim final enforcement rule; and implementation of changes to the Genetic Information Nondiscrimination Act of 2008 (GINA). The Omnibus Rule goes into effect on March 26, 2013, and compliance is required by September 23, 2013. As expected, the Omnibus Rule did not finalize the May 31, 2011 proposed regulation regarding accounting for disclosures.

Implementing the Affordable Care Act: Countdown to 2014 (Tax Implications) [ACA Alert]

Under the Affordable Care Act, a number of significant tax increases go into effect in 2013 and other tax provisions will be implemented during the next several years.

Seventh Circuit Rules that Medical Necessity Trumps State-Imposed Cap on "Optional" Medicaid Coverage [Health Law Alert]

Seventh Circuit Rules that Medical Necessity Trumps State-Imposed Cap on "Optional" Medicaid Coverage - Health Law Alert - In a class action lawsuit, the U.S. Court of Appeals for the 7th Circuit recently affirmed a lower court decision granting a preliminary injunction that prevented the state of Indiana from enforcing a $1,000 annual cap on Medicaid coverage for medically necessary dental services, and concluded the cap most likely violated rights granted to Medicaid beneficiaries under federal law. Bontrager v. Indiana Family and Social Services Administration, 2012 U.S. App. LEXIS 20157 (September 26, 2012).

Supreme Court Rules on Affordable Health Care Act: Upholds Individual Mandate and Limits Scope of Medicaid Expansion [Health Law Alert]

Supreme Court Rules on Affordable Health Care Act: Upholds Individual Mandate and Limits Scope of Medicaid Expansion - Health Law Alert - In a heavily anticipated landmark ruling, the Supreme Court has upheld the constitutionality of the so-called “individual mandate” of the Affordable Care Act – i.e., the requirement that those not insured privately, through their employer or through a governmental program, must either purchase minimum essential health insurance coverage or pay a “penalty” for failing to do so.

Federal Court Sends Mixed Message on Hospital's Right to Payment for Out-of-Network Services [Health Law Alert]

Federal Court Sends Mixed Message on Hospital's Right to Payment for Out-of-Network Services - Health Law Alert - Hospitals seeking reimbursement from a Medicaid managed care organization (MCO) for non-contracted services, and without the benefit of a single case agreement, need a legal basis to compel payment by the MCO.

CMS Issues Proposed Rule on Reporting and Returning Medicare Overpayments [Health Law Alert!]

CMS Issues Proposed Rule on Reporting and Returning Medicare Overpayments - Health Law Alert! - On February 16, 2012, the Centers for Medicare & Medicaid Services (CMS) issued a widely anticipated proposed rule (the proposed rule) implementing the statutory requirement of Section 6402(a) of the Affordable Care Act (the ACA) that providers and
suppliers report and return overpayments from Medicare and Medicaid.

On First Anniversary, a Look at Challenges to Health Care [The Legal Intelligencer]

On First Anniversary, a Look at Challenges to Health Care - The Legal Intelligencer - On its one-year anniversary, the sweeping health care reform law — referred to as the "Affordable Care Act" (ACA) if you like it, and "Obamacare" if you don't — is embroiled in litigation. Its fate, like that of the 2000 presidential election, is likely to be determined by the Supreme Court.

Adverse Incident Reports: How Many Is Too Many? [Life Sciences Alert]

Adverse Incident Reports: How Many Is Too Many? - Life Sciences Alert - On January 10, 2011, the U.S. Supreme Court heard argument in the matter Siracusano v. Matrixx Initiatives, Inc., 585 F.3d 1167 (9th Cir. 2009), and suggested that some major changes may be in store for pharmaceutical companies which could forever alter how they handle adverse reports.

CMS Voluntary Self-Referral Disclosure Protocol: The Good, The Bad, and The Ugly [Health Law Alert!]

CMS Voluntary Self-Referral Disclosure Protocol: The Good, The Bad, and The Ugly - Health Law Alert! - On September 23, the Centers for Medicare & Medicaid Services (CMS) released the much anticipated Medicare self-referral disclosure protocol (SRDP). CMS was required to establish the SRDP by Section 6409 of the Affordable Care Act (ACA), which obligated the Secretary of Health and Human Services to inform providers and suppliers how to self-disclose actual or potential violations of the Stark law.

CMS Delays Section 111 Reporting for Liability Insurers [Health Law Alert!]

CMS Delays Section 111 Reporting for Liability Insurers - Health Law Alert! - the Centers for Medicare & Medicaid Services (CMS) announced a one-year delay in the implementation of certain reporting obligations under Section 111 of the Medicare, Medicaid, and SCHIP Extension Act of 2007 for claims involving liability insurers (including self-insured entities). Claims involving workers’ compensation and no-fault insurance, however, must be reported as scheduled in the first calendar quarter of 2011. The net result is a two-tiered implementation timeline.

The Difficulty in Certifying a Class Action Against Drug Companies [Life Sciences Alert!]

The Difficulty in Certifying a Class Action Against Drug Companies - Life Sciences Alert! - Three cases decided over the past few months demonstrate the difficulty with certifying class actions by third-party payors (TPPs) against drug companies.

Investigational Devices and the Defenses that Protect Them [Cozen O'Connor Paper]

Investigational Devices and the Defenses that Protect Them - Cozen O'Connor Paper -

Stark Realities of Health Care Reform [Health Law Alert!]

Stark Realities of Health Care Reform - Health Law Alert! - Our Health Law Alert of April 26, 2010 summarized recent amendments to the Anti-Kickback Statute (“AKS”) concerning “reverse” federal false claims act (“FCA”) and the implications of the requirement of Section 6402 of the Patient Protection and Affordable Care Act of 2010, Pub. L. No. 111-148 (the “PPACA”) to report and refund “overpayments” by Medicare and Medicaid within sixty (60) days of “identification.” An “overpayment” is defined to

Providers Beware: Health Care Reforms Make Failing to Promptly Refund Overpayments—Including Those Attributable to Identified Stark Violations—Potential False Claims Act Violations [Health Law Alert!]

Providers Beware: Health Care Reforms Make Failing to Promptly Refund Overpayments—Including Those Attributable to Identified Stark Violations—Potential False Claims Act Violations - Health Law Alert! - By linking the retention of program overpayments and potential liability under the False Claims Act (FCA), the Patient Protection and Affordable Care Act of 2010 (PPACA) has dramatically expanded the scope of exposure for health care providers under the FCA. Potential overpayments to providers—including but not limited to such things as garden variety duplicate payments to discoveries of Medicare payments for designated health services (DHS) provided on referrals from

Medicare Secondary Payer Update - CMS Delays Reporting Deadlines [Health Law Alert!]

Medicare Secondary Payer Update - CMS Delays Reporting Deadlines - Health Law Alert! - In December 2007, Congress amended the Medicare Secondary Payer law (MSP) through Section 111 of the Medicare, Medicaid and SCHIP Extension Act (MMSEA). The amendment imposes mandatory reporting obligations on Responsible Reporting Entities (RREs), including liability, self-insured, no-fault and workers’ compensation insurers (collectively referred to as “non-Group Health Plans” or “Non-GHPs”) regarding settlements with Medicare beneficiaries.

Highmark, Inc. Challenges PA. Insurance Department Investigation [Health Law Alert!]

Highmark, Inc. Challenges PA. Insurance Department Investigation - Health Law Alert! - Highmark, Inc. has filed a lawsuit in the Commonwealth Court of Pennsylvania challenging the legality of an ongoing Pennsylvania Insurance Department investigation involving potential anticompetitive conduct and/or unfair trade practices by Pennsylvania’s Blue Cross and Blue Shield companies.

Under New Rules, Plans Offering Mental Health and Substance Use Disorder Benefits Must Ensure Parity in Member Costs and Access to Care [Health Law Alert!]

Under New Rules, Plans Offering Mental Health and Substance Use Disorder Benefits Must Ensure Parity in Member Costs and Access to Care - Health Law Alert! - On February 2, 2010, the Centers for Medicare &
Medicaid Services, the Internal Revenue Service,
and the Department of Labor’s Employee Benefits
Security Administration published long-awaited regulations implementing the Mental Health Parity and Addiction Equity Act of 2008 (the “MHPAEA”).1 The MHPAEA followed the Mental Health Parity Act of 1996, which had previously mandated parity in aggregate lifetime and annual dollar limits between mental health benefits and medical/surgical benefits.

A New Era in HIPAA Enforcement: Connecticut Attorney General Files First HITECH Act Suit [Health Law Alert!]

A New Era in HIPAA Enforcement: Connecticut Attorney General Files First HITECH Act Suit - Health Law Alert! - Connecticut Attorney General Richard Blumenthal has filed a lawsuit against Health Net of Connecticut, Inc. for violations of the Health Insurance Portability and Accountability Act (“HIPAA”) following Health Net’s loss of protected health information (“PHI”) and other personally identifiable information.

New Jersey Enforces Limits on Overpayment Recoveries [Health Law Alert!]

New Jersey Enforces Limits on Overpayment Recoveries - Health Law Alert! - The New Jersey Commissioner of Banking and Insurance
issues Enforcement Notice requiring Insurer to cease and
desist from attempting to recoup overpayments based on
improper extrapolations and to reimburse providers for
amounts improperly obtained.

Recent Pennsylvania Decision Requires Disclosure of Medicaid Managed Care Rates [Health Law Alert!]

Recent Pennsylvania Decision Requires Disclosure of Medicaid Managed Care Rates - Health Law Alert! - Commonwealth Court holds that provider agreements with
Medicaid managed care plans, including the negotiated
payment rates contained in those agreements, are subject to
disclosure under the Pennsylvania Right to Know Law.

New Medicare Secondary Payer Requirement: Mandatory Reporting for Liability, No-Fault and Workers Compensation Insurers [Health Law Alert!]

New Medicare Secondary Payer Requirement: Mandatory Reporting for Liability, No-Fault and Workers Compensation Insurers - Health Law Alert! - The Medicare Secondary Payer law (“MSP”) is again “in the news” for liability (including self-insured), no-fault, and workers compensation insurers. In December 2007, Congress amended the MSP law through Section 111 of the Medicare, Medicaid, and SCHIP Extension Act to impose mandatory reporting requirements on liability, no-fault, and workers’ compensation insurers (collectively referred to as “non-Group
Health Plans” or “Non-GHPs”)

The American Recovery and Reinvestment Act of 2009: Sweeping Changes to HIPAA Put Business Associates in the Spotlight [Health Law Alert!]

The American Recovery and Reinvestment Act of 2009: Sweeping Changes to HIPAA Put Business Associates in the Spotlight - Health Law Alert! - On February 17, 2009, President Obama signed into law the Health Information Technology for Economic and Clinical Health Act (“HITECH” or the “Act”), as part of the American Recovery and Reinvestment Act of 2009. The Act made
sweeping changes to the Health Insurance Portability and Accountability Act of 1996 (“HIPAA”) and the Privacy and Security Rules promulgated under HIPAA. This Alert focuses
primarily on Subtitle D of HITECH, which includes important

New Codey Legislation to Provide Certainty After a Year of Limbo [Health Law Alert!]

New Codey Legislation to Provide Certainty After a Year of Limbo - Health Law Alert! - On February 5, 2009, the New Jersey legislature
adopted Assembly Bill No. A1933 (the “Bill”), which
amends the New Jersey Health Care Practitioner
Self-Referral Law (commonly referred to as the “Codey Law”).
The Senate adopted an identical bill (S. 787) on December 15,
2008. The Bill currently awaits Governor Corzine’s signature.

FTC Delays Enforcement of Red Flags Rule [Health Law Alert!]

FTC Delays Enforcement of Red Flags Rule - Health Law Alert! -

HHS' First Resolution Agreement for Alleged HIPAA Violations and What it Means for You [Health Law Alert!]

HHS' First Resolution Agreement for Alleged HIPAA Violations and What it Means for You - Health Law Alert! - The Department of Health and Human Services
(“HHS”) has entered into its first resolution
agreement with a covered entity to settle alleged
violations of the Health Insurance Portability and Accountability Act’s (“HIPAA”) privacy and security rules.1 According to HHS, the resolution agreement with Providence Health & Services (“Providence”), a Seattle-based not-for-profit health system, addresses a series

Supreme Court Weighs in on Scope of False Claims Act [Health Law Alert!]

Supreme Court Weighs in on Scope of False Claims Act - Health Law Alert! - A recent, unanimous decision of the U.S. Supreme Court appears significantly to reduce the
potential liability under the False Claims Act for claims health care providers file with private Medicare and Medicaid managed care organizations, as opposed to with the Medicare and Medicaid fee-for-service programs. Allison Engine Co. v. United States ex rel. Sanders, 553 U.S.___ (No. 07-214, June 9, 2008).

Update: Pennsylvania Hospitals to Pay For Medical Mistakes – Quality of Care At The Forefront [Health Law Alert!]

Update: Pennsylvania Hospitals to Pay For Medical Mistakes – Quality of Care At The Forefront - Health Law Alert! - Prevention of medical mistakes is a cause celebre, and states are beginning to jump
on the so-called “never event” bandwagon. Taking a highly proactive stance,
Governor Edward G. Rendell recently announced that Pennsylvania acute-care
general hospitals will not be reimbursed by the state Medicaid program for services
resulting from medical errors. On January 14, 2008, Pennsylvania became just the

Pending Changes to the Stark Law Phase III [Health Law Alert]

Pending Changes to the Stark Law Phase III - Health Law Alert - On September 5, 2007, the Centers for Medicare & Medicaid Services (CMS)
published its long-awaited Phase III regulations regarding the federal ban on
physician self-referrals, more commonly known as “Stark.” CMS claims that the
Phase III Stark regulations, effective on December 4, 2007, will reduce the
regulatory burden on the health care industry, “simplify” the rules and provide

Using Mental Health Records for Research [Compliance Today]

Using Mental Health Records for Research - Compliance Today - The Health Insurance Portability and Accountability Act’s Privacy Rule (the “Privacy Rule”) strikes a balance between restricting the unauthorized disclosure of medical records and permitting health care providers to operate effectively, including participation in research studies. Specifically, the Privacy Rule takes into account that getting patient authorization for a disclosure can be problematic for researchers who do not interact directly with

The Deficit Reduction Act of 2005 Imposes New Obligations On Medicaid Providers By January 1, 2007 [Health Law E-lert!]

The Deficit Reduction Act of 2005 Imposes New Obligations On Medicaid Providers By January 1, 2007 - Health Law E-lert! -

HIGHLIGHTS OF THE DEFICIT REDUCTION ACT OF 2005 [Health Law E-lert!]

HIGHLIGHTS OF THE DEFICIT REDUCTION ACT OF 2005 - Health Law E-lert! -

Top 5 Health Policy Predictions for 2019

Alex Campau, Principal & Director of Health Policy, shares her predictions about the key health policy trends she anticipates taking center stage in 2019 with Morning Consult.

Cozen O'Connor Lands Ex-White House Health Care Pro

Alex Campau, a member of Cozen O'Connor's Public Strategies group, spoke with Law360 about her experience at the White House.

White House Special Assistant to the President for Health Policy Alexandra Campau Returns to Cozen O’Connor Public Strategies

Campau is a major add to the Firm’s Government Relations Practice in Washington, D.C.

International Life Sciences Attorney Joins IP Department

Former LeClairRyan attorney Jeffrey N. Townes brings substantial experience in international life sciences IP to the firm's Washington, D.C., office.

Hospital megamergers may lower overhead, but at what cost?

Jonathan Grossman, a member of the firm's Antitrust Practice, was quoted in Modern Healthcare's article, "Hospital megamergers may lower overhead, but at what cost?"

Cozen O’Connor’s Melinda Rudolph named a 2017 "Women of Distinction" by the Philadelphia Business Journal

Melinda Rudolph, a member of Cozen O’Connor’s Corporate Practice Group, has been selected as a 2017 Women of Distinction by the Philadelphia Business Journal.

Cozen O’Connor Strengthens Life Sciences Offerings with New Addition to Corporate Practice Group

Cozen O’Connor is pleased to welcome Melinda Rudolph to the firm as a member. Rudolph joins the firm’s Corporate Practice Group and is resident in the Philadelphia office.

Elderly Health Care Costs to Grow by 25.8% in 10 Years

Stephen Bowers, a member of Cozen O’Connor’s Employee Benefits Practice Group, discusses the rising cost of health care for the elderly in HR Dive.

Chris Raphaely Discusses SMARTER Act in Modern Healthcare

Chris Raphaely discusses a house-passed bill that may impact hospital decisions on mergers in Modern Healthcare.

Kyle Vos Strache and George Bibikos Named 2015 Lawyers on the Fast Track

Two Cozen O'Connor attorneys are among those recognized by The Legal Intelligencer as Lawyers on the Fast Track.

Christopher Raphaely Discusses Moving to a Law Firm from In-House

Christopher Raphaely discusses the challenges faced when moving from an in-house position to private practice with The Legal Intelligencer.

Cozen O’Connor Welcomes Health Care Attorney Marc Auerbach to Growing Miami Office

Cozen O’Connor is pleased to announce that Marc H. Auerbach has joined the firm as a member of the Health Care Practice, resident in the Miami office.

Greg Fliszar Quoted in Healthline on the Increase of Health Data Theft

Greg Fliszar, of the firm's health law practice, is quoted on the topic of breaches of medical data, and how the number of affected patients is on the rise.

Gregory Fliszar Discusses Health Insurer Hacking Attack

In early February, U.S. health insurer Anthem announced that it has been the victim of a huge hacking attack, with possibly millions of people’s personal information compromised. What lessons can health care risk managers take from this breach? HRMR investigates.

Mark Gallant Discusses Medicaid in Bloomberg Businessweek

In an article titled ''Why the Supreme Court's Medicaid Decision Matters,'' Mark Gallant, co-chair of the firm's Health Care Group, comments on Medicaid providers and how a recent Supreme Court hearing could affect issues at the state and federal level.

Cozen O’Connor Welcomes Schultz Back to Firm as Head of Government Law and Regulatory Affairs Practice

Cozen O’Connor is pleased to welcome James D. Schultz back to the firm as a member and chair of the newly formed Government Law and Regulatory Affairs Practice. Since 2011, Schultz has served in the Governor’s Office of General Counsel. He was appointed as First Executive Deputy General Counsel in 2011 and in 2012 was appointed by Governor Tom Corbett to head that office as General Counsel of the Commonwealth of Pennsylvania.

Christopher Raphaely Discusses Issues Facing Health Care Industry with Philadelphia Business Journal

Raphaely discusses the Affordable Care Act, ACOs and other issues facing in house counsel working in the health care industry.

Jefferson Health System Legal Counsel, Raphaely, Joins Cozen O’Connor as Co-Chair of Health Care Practice Group

Cozen O’Connor continues to strengthen its focus on health care with the recent hiring of R. Christopher Raphaely, who will serve as co-chair of the firm’s Health Care Practice Group. Previously deputy general counsel for the Jefferson Health System, and general counsel to the system’s accountable care organization and captive professional liability insurance companies, Raphaely will be resident in the Philadelphia office.

Mark Gallant Prevails in Third Circuit ERISA Dispute

Mark Gallant, chair of the Health Care Group, was recently mentioned in a Law360 article about his victory on behalf of CardioNet and LifeWatch Services in the 3rd Circuit.

Mark Gallant Discusses How Cardiac Telemetry Manufacturers, CardioNet Inc. and LifeWatch Services Inc., Were Misguided by PA Federal Judge in Law360

In an article titled “Cigna Coverage Row Shouldn’t Be Arbitrated, 3rd Circ. Told,” Mark Gallant (Health Care, Philadelphia) discusses how a Pennsylvania federal judge wrongly forced two cardiac telemetry manufacturers to arbitrate their claims that Cigna Health Corp. violated federal pension laws and unfair competition laws when it decided to stop covering the devices. Mark, who’s representing CardioNet Inc. and LifeWatch Services Inc., told a three-judge panel that claims his clients brought against the insurer under the Employee Retirement Income Security Act and for trade disparagement did not fall under the terms of a provision in the contract the companies inked with Cigna requiring that the parties arbitrate any disputes over interpretations of the deal or any alleged breaches.​

Mark Gallant Quoted in Law360

Mark Gallant, Chair of the Health Care Practice Group, was mentioned in a Law360 article titled, "PA Charity Patients Can Be Nixed From DSH, 3rd. Circ. Told." The article explains how Mark is arguing on behalf of Nazareth Hospital and St. Agnes Medical Center.