Governor Cuomo recently announced his 2014-15 executive budget for New York State. The new budget contains some relevant legislative changes for healthcare within the State, including a pilot program for private business to partner with academic medical centers to own or operate hospitals, an expansion of office-based surgery (“OBS”), and expansion of urgent care services. 

Long wait times and difficulty for a patient to get convenient doctor’s appointments have long been issues for patients seeking medical treatment.  The expansion of individuals with health insurance due to the Affordable Care Act will cause the issue to grow as more individuals have access to health care services they previously did not.  With

On Friday, January 24th, Judge B. Lynn Winmill blocked the acquisition of Saltzer Medical Group (“Saltzer”) by St. Luke’s Health System (“St. Luke’s”) in Idaho.  The District Court Judge held that the merger violated antitrust laws, and allowing the merger to remain in place would give St. Luke’s greater bargaining leverage with health plans and

Health care compliance attorneys are frequently asked to “rate” the risks around various existing or proposed business arrangements involving medical professionals.  Could a given arrangement be viewed as a violation of the Stark Self-Referral Law (“Stark”) or Anti-Kickback Statute (“AKS”)?  Are there compelling, or at least plausible, arguments for why the arrangement should instead be

New York Court of Appeals Vacates K2, Rejecting “Automatic Indemnity” Where Insurer Breaches Duty to Defend

In K2 Investment Group, LLC v. American Guarantee & Liability Ins. Co., the insurer breached its duty to defend, and a default judgment was entered against its insured. The New York Court of Appeals has vacated its controversial June

The U.S. Court of Appeals for the Eleventh Circuit, affirming a district court decision, has ruled that a homeowner’s insurance carrier was not obligated to defend or indemnify its insured for claims that he got into a fight with a golfer, struck him with his golf club, and injured him.  

The Case 

While golfing with

The U.S. Court of Appeals for the Third Circuit, affirming a district court’s decision, has ruled that an insurance company was not required to defend or indemnify its insureds for claims that they had sent out unsolicited facsimile advertisements in violation of the federal Telephone Consumer Protection Act (“TCPA”). 

The Case

After an insured corporation

A federal district court in Minnesota has ruled that a policy’s trademark infringement exclusion barred coverage for an action against the insured, rejecting the insured’s argument that the suit was one for covered “slogan infringement.”  

The Case 

The insured company was sued for (1) unfair competition under the Lanham Act, (2) unfair business practices under

An appellate court in Wisconsin, affirming a trial court’s decision, has ruled that “septage” was “unambiguously” a pollutant within the meaning of various insurance policies’ pollution exclusions. 

The Case 

A lawsuit against the insureds alleged that they had contaminated well water by over-spraying septage – a combination of water, urine, feces, and chemicals – and

The Nebraska Supreme Court has affirmed a trial court’s decision that exclusions in a homeowner’s insurance policy and in a personal umbrella insurance policy barred coverage for claims against the homeowner that his son had sexually assaulted a minor, ruling that a severability clause in the policies did not change the exclusions’ “plain language” or

The plaintiff in this case sued Raytheon Company on June 13, 2013 for breach of contract because it had discontinued paying long term disability benefits to him in November 2000. The plaintiff, who had been terminated by Raytheon in July 2002, sought $3.8 million in damages.

Raytheon moved to dismiss, arguing that the plaintiff’s action

AMERICAN BAR ASSOCIATION – MASS TORTS & DEVELOPMENTS

In a December 17, 2013, decision, the New York Court of Appeals refused to adopt an independent equitable cause of action for medical monitoring by a four-to-two vote in Caronia v. Philip Morris USA, Inc., No. 227 (N.Y. Dec. 17, 2013). The decision resolved a split among

The Public Health and Health Planning Council (the “Council”) voted on January 7th to approve its report on ambulatory services (the “Report,” viewable here), completing an initial step in the process of expanding and reforming ambulatory service clinics in New York.1

The Report seeks to regulate various classes of ambulatory service centers in the State.

The legal issues governing insurance fraud that are discussed in this column typically focus on New York law or on federal law and its application to New York cases. The world of insurance fraud is quite extensive, however, as illustrated by recent insurance frauds alleged or uncovered from across the country – including some unusual,

On December 18, 2013, New York Governor Andrew Cuomo signed into law the Non-Profit Revitalization Act of 2013 (the “Act”), the full text of which is available here.  The Act, which takes effect on July 1, 2014, represents the first extensive overhaul of New York’s nonprofit laws in over four decades.  The Act is intended