In an increasingly intense and unforgiving regulatory environment, all healthcare organizations — from small physician practice groups to large health systems — must closely scrutinize areas where they may be vulnerable to fraud and abuse allegations. Corporate compliance programs are useful in this effort, but only if they are well-constructed and aggressively implemented, not merely

Alan Rutkin article entitled, “Insight – A Lesson in Cyber,” has been published in the November 2016 issue of Best’s Review magazine.

Click here to read the article.

Best’s Review:  November 2016. Copyrighted A.M. Best Company, Inc. 2016.  All Rights Reserved, Reprinted with Permission.

A federal district court in Alabama has ruled that a grocery store was not entitled to coverage of a lawsuit brought by credit unions alleging that they had been damaged when the store’s computer network was hacked.

The Case

Three credit unions sued Camp’s Grocery, Inc., which operated a grocery store in Hokes Bluff, Alabama,

The U.S. Court of Appeals for the Fifth Circuit has affirmed a decision by the U.S. District Court for the Western District of Texas that the owner of a refinery was not covered under its parent company’s insurance policy where the refinery owner was not listed as an insured and it could not demonstrate that

The U.S. Court of Appeals for the Third Circuit has affirmed a decision by the U.S. District Court for the Middle District of Pennsylvania granting summary judgment in favor of an insurance carrier in a bad faith case.

The Case

A man working for Stephen Bodnar died when a trench they were digging collapsed.

Danielle

The U.S. Court of Appeals for the Ninth Circuit has affirmed a decision by the U.S. District Court for the Northern District of California that an insurer was not obligated to defend its insureds in an action brought by a vineyard owner against them.

The Case

The owner of a vineyard sued Jack Neal &

The U.S. Court of Appeals for the Fifth Circuit has ruled that an insurance company was not required to cover its insured’s loss under the computer fraud provision of a crime protection insurance policy where the only computer use was an email to the insured asking it to change a vendor’s bank account information.

The

Since its enactment six years ago, the Patient Protection and Affordable Care Act (the “ACA”) has faced numerous challenges from Republicans attempting to repeal the law. Though previous efforts, through both legislation and litigation, have been unsuccessful, the election of Donald Trump and a Republican-controlled Congress likely portends at least a partial repeal of the

New York State Medicaid providers who claim, order or receive at least $500,000 in any consecutive 12-month period from the Medicaid Program are required to implement a compliance program aimed at detecting and preventing Medicaid fraud, waste and abuse. This requirement also applies to third party billing companies that bill or receive the threshold amount

For providers contemplating a business arrangement with a potential referral source for items or services reimbursable under a federal health care program, fitting that arrangement within a recognized safe harbor under the Anti-Kickback Statute (“AKS”) is the “holy grail,” for it ensures that the arrangement will be immunized against civil and criminal enforcement actions.  And

The U.S. Copyright Office (the “Office”) has recently issued an exemption to the Digital Millennium Copyright Act (the “Act”), which prohibits users from hacking their own digital devices. Pursuant to 17 U.S.C. § 702, the Office is authorized to promulgate rules and regulations regarding copyright policies and other intellectual property issues. The Act was first

The Federal Trade Commission recently issued a new guidance for businesses on responding to a data breach. The guidance, which is also available in video format on the FTC’s website here, sets forth the concrete steps that any business should take in the event that personal information has been hacked, stolen, or inadvertently exposed.

The

The New York Supreme Court, New York County (Justice Ostrager), recently issued a decision, Centre Lane Partners, LLC et al. v. Skadden, Arps, Slate, Meagher & Flom LLP et al., addressing New York’s borrowing statute in the context of legal malpractice claims.

New York’s borrowing statute, CPLR 202, provides that:

an action based upon a

The federal False Claims Act (FCA)1 is a powerful tool in the fight against fraud involving federal health insurance programs such as Medicare and Medicaid. Indeed, one of the greatest areas of FCA success is in the health-care industry. From 1987 to 2015, the federal government recovered more than $31.1 billion in health-care-related FCA actions.2

United States immigration laws permit a foreign national to enter and work in the United States in an international cultural exchange program that is approved by the Department of Homeland Security.  If the foreign national and the program qualify, the foreign national will be classified as a Q-1 cultural exchange visitor.

To qualify for the