The Center for Medicare and Medicaid Innovation (“Innovation Center”) has extended certain deadlines for its new bundled payment program known as the “Bundled Payments for Care Improvement” initiative (the “Bundled Payments Program”), which was first announced on August 23, 2011.

A bundled payment approach combines payment for hospital, physician, and other provider services into a

Before considering arrangements involving the provision of durable medical equipment, prosthetics, orthotics, and supplies (“DMEPOS”) as part of their practice, healthcare providers must be mindful of not only the Stark Law and Anti-kickback Statute, but also of the CMS standards applicable to DMEPOS suppliers.[1] These standards are contained in 42 CFR § 424.57(c), and all

Palm Beach Grading, Inc., a general contractor on the Moody River Project in Florida, contended that the work performed by one of its subcontractors, A-1 Underground Services, Inc., on a sewer system pipe was defective. Palm Beach hired another subcontractor, RDMC, Inc., to repair the work. As a result, Palm Beach incurred $256,208.01 in

The Centers for Medicare & Medicaid Services (“CMS”) announced today that it is seeking applications from providers to participate in its Bundled Payments for Care Improvement (“BPCI”) initiative (more information about this program can be found at http://innovations.cms.gov/documents/pdf/Fact-Sheet-Bundled-Payment-FINAL82311.pdf). This is a program developed pursuant to the Affordable Care Act to accomplish the goals of

The New York Court of Appeals’ nine significant insurance law rulings last term displayed no discernible theme, evidenced no apparent trend, and reflected no obvious insurance law philosophy. Policyholders were victorious in some of the cases and insurance companies in others – and creditors in another.

The principal cases involved statutory construction, [1] policy construction,

Please click the link below to view New York Places Burden On Design Defect Defendant To Show the Infeasibility of An Alternative Design On Summary Judgment. Adobe Reader is required to view the bulletin. If Adobe Reader is not installed on your PC, click here to download and install.

New York Places Burden On Design

The New York State Department of Health (“DOH”) recently announced that it has extended from September 1 to October 3, 2011 the filing deadline for submission of applications by interested organizations seeking to participate in the new Health Home program being established by Medicaid.  Under the health home program, DOH will provide reimbursement to

More than a decade ago, in Lunney v. Prodigy Servs. Co.,[1] the New York Court of Appeals declined, as premature, a request to decide whether to adopt a broad interpretation of immunity for Internet service providers (“ISPs”) under Section 230[2] of the federal Communications Decency Act (“CDA”).[3]

In the intervening years, Internet use has exploded

No Coverage Where Building Insured As Two-Family Dwelling Had Three Apartments

An insurance company that issued an insurance policy to owners of a building asserted that they were not entitled to defense or indemnity for a personal injury action because the owners represented that the building was a two-family dwelling but the

After extensive litigation and negotiations, the Passaic Valley Sewerage Commission (“PVSC”) and Spectraserv, Inc., entered into a settlement agreement providing for the transfer of assets and other consideration from PVSC to Spectraserv. The settlement included the entry of a consent order resolving notices of violation that PVSC had issued to Spectraserv; PVSC’s agreement to

After Konica Minolta Business Solutions fired an African-American salesman who had been working at the Konica facility in Tinley Park, near Chicago, the salesman filed a charge of discrimination with the Equal Opportunity Employment Commission (EEOC) that stated:

Since the beginning of my employment, my Branch Manager has subjected me to different terms and conditions

Insurance fraud is not just a New York problem, it is a national problem. While this column generally focuses on trends in New York, it can be helpful on occasion to review conduct from across the country. Such a national review reveals that insurance carriers are taking an aggressive stance against insurance fraud and are

Exclusion Did Not Bar Coverage For Wrongful Death Claim By Noninsured Father Following Daughter’s Death

A girl drowned at her grandparents’ home, where she lived. The girl’s father, who did not live with the grandparents, obtained a wrongful death judgment and filed a direct action against the grandparents’ homeowner’s insurer. The Court of

An individual who lived in New York claimed that he was injured while working in New York on a project lasting five or six days for his employer, a New Jersey corporation with its sole office in New Jersey. The individual filed a claim in New York for workers’ compensation benefits. Travelers Indemnity Company, the

Real estate developers obtained insurance for the construction and sale of homes they were building, primarily against claims of defective construction. The developers received $10 million of coverage on each of two projects and paid the insurer an “advance premium” of approximately $1.3 million. Due to the deteriorating real estate and credit markets, however,