Health Law Reporter Index-Summary

BACTERIA

– Legionella-contaminated public drinking fountain at university medical center (Ohio Ct. Cl.), 290

BAD DEBTS

BALANCE BILLING

BANKRUPTCY

– Disability bias claim not included as asset in petition (M.D. Tenn.), 709
– Financial difficulties, Natl. States Ins. Co. ordered into rehabilitation (Mo. Cir. Ct.), 503
– Fiscal intermediary, dismissal of suit by trustee for not issuing timely Notice of Program Reimbursement (10th Cir.), 1141
– Forum Health sale of assets to Youngstown Ohio Hosp. Co. (Bankr. N.D. Ohio), 1163
– Judicial estoppel bars retaliation claim abandoned by trustee (D.C. Cir.), 800
– Late proof of claim against hospital, constructive notice (E.D.N.Y.), 1270
– Provider class action settlement with Aetna does not bar contract breach suit by bankrupt physician group (11th Cir.), 718
– St. Mary's Hospital, Passaic, N.J., reorganization plan (Bankr. D.N.J.), 268

BCBS

See BLUE CROSS AND BLUE SHIELD PLANS (BCBS)

BILLING

– Balance billing

– – Cal., state law breach, emergency room costs (S.D. Cal.), 1747
– – Evidence, hospital claims against two different insurance companies (N.J. Super. Ct. App. Div.), 241
– – HMO subscribers, Fla. hospital-based noncontract provider barred (Fla. Dist. Ct.), 212

– False claims

See FALSE CLAIMS

– Lymphatic therapy clinic, whistleblower fails to provide Medicare billing fraud details (11th Cir.), 271
– Mistakes and errors targeted by FCA probes, AHA letter, 1272; further discussions with Justice Dep't, 1742
– One-day inpatient admissions, Philadelphia hospital system agrees to pay, 1098
– Out-of-network emergency services, HMOs need not pay maximum prices (Fla. Dist. Ct. App.), 309
– Outliers

See OUTLIER PAYMENTS

– Provider class action settlement with Aetna does not bar contract breach suit by bankrupt physician group (11th Cir.), 718
– St. Louis-area pain clinic and billing company agree to pay, spinal decompression qui tam suit (E.D. Mo.), 336

BIOTECHNOLOGY

See GENETICS AND BIOTECHNOLOGY

BLOOD AND BLOOD PRODUCTS

– Antitrust, producers of traditional blood reagents (E.D. Pa.), 1234
– Blood banks, postpartum hemorrhaging cause of mother's death, jury award against hospital (Minn. Dist. Ct.), 1529
– Bloodborne pathogens, HIV

See AIDS AND HIV

BLOODBORNE PATHOGENS

– Hepatitis

See HEPATITIS

– HIV

See AIDS AND HIV

– Standard, impact on small business, comments, 720

BLUE CROSS AND BLUE SHIELD PLANS (BCBS)

– Ala., Duract pain relief drug, third-party payers class certification (Ala.), 144
– Ark., out-of-network hospital's state law promissory estoppel claim preempted by ERISA (E.D. Ark.), 29
– California

– – Anthem 39 percent increase in premiums, Sebelius seeks public explanation, 213; rate hike postponed to allow state review, 242; request for rate increase withdrawn, 645; state audit of claims data, 681
– – Balance billing for emergency room costs, state law breach alleged (S.D. Cal.), 1747
– – Breach of contract and unfair trade practices, state law claims in rescission case (Cal. Ct. App.), 456
– – Fines for violations of prompt payment and fair pay laws, 1656
– – Los Angeles may proceed with unfair competition and false advertising claims for rescission (Cal. Super. Ct.), 308
– – Physician rankings, doctors sue Blue Shield of Cal. over online program (Cal. Super. Ct.), 1295
– – Rescission suit belongs in state court (N.D. Cal.), 242
– – Residential care for dependent's eating disorder, denial not abuse of discretion (N.D. Cal.), 383
– – State regulatory authority no bar to Los Angeles city attorney's claims against insurers (Cal. Ct. App.), 99
– – Stop-loss claims, Anthem agrees to pay hospitals, 1656

– Colorado

– – Anthem will pay $20M in premium credits after consumer complaints, 1323
– – Indian tribal plan may pursue state claims against administrator (10th Cir.), 500

– Conn., Anthem BCBS will not require hospitals to give it same discounts as state plan, 169; Conn. Atty. Gen. calls on HHS to look into “anticompetitive” practices, 333
– Ga., any willing provider law, plan cannot bar physician group from networks, insurance commissioner, 535
– IRS memorandum on BCBS special deduction, 579
– La., out-of-network care, beneficiary not entitled to 100 percent of costs (5th Cir.), 567
– Mass., medical necessity of inpatient substance abuse and mental health treatment, refusal to pay upheld (D. Mass.), 278
– Medical loss ratio, temporary relief for stock insurance companies, IRS, 1672
– Michigan

– – Acquisition of Physicians Health Plan of Mid-Mich. called off, 333
– – Autism treatment denial (E.D. Mich.), 1748
– – Medigap, Atty. Gen. challenges BCBS rate increase (Mich. Cir. Ct.), 1322; injunction, 1655
– – “Most favored nation,” anticompetitive effect of parity clauses (E.D. Mich.), 1449; Justice Dep't official discusses complaint, 1635; motion to dismiss filed, 1771
– – Negotiation of rates with hospitals, not acting as fiduciary (6th Cir.), 1746
– – Subsidiary's acquisition of 3 other insurance companies allowed, contribution questions (Mich. Ct. App.), 1782

– Mont. law on premiums duplicative, preempted (D. Mont.), 1172; premiums of similarly-situated individuals, ERISA §702, 1433
– New Jersey

– – Ambulatory surgical centers, Horizon BCBS agrees to pay to resolve out-of-network underpayment claims, 3 cases (D.N.J.), 1490
– – Underpayments alleged, physician and ambulatory surgical practice must pursue administrative appeals (D.N.J.), 1321

– N.Y., Empire BCBS, hospital's balance billing suit against insurers (N.J. Super. Ct. App. Div.), 241
– Pennsylvania

– – Chiropractors' ERISA claims allowed, RICO claims fail (N.D. Ill.), 747; ERISA claims against WellPoint dismissed, 1432
– – Formularies, Plavix as Tier 3 drug, insurer did not violate terms of plans (3d Cir.), 832

– Physicians' BCBS claims settlement bars suit (11th Cir.), 139
– Rhode Island

– – ERISA preempts suit against chiropractors (D.R.I.), 1560
– – Rate increases hearing urged, 280

– Tennessee

– – Autism applied behavior analysis therapy, class certification denied (E.D. Tenn.), 277
– – Pre-existing conditions, diverticulitis specifically excluded by rider (Tenn. Ct. App.), 1214

– Tex., BCBS Ass'n not liable for claims reimbursement practices of state affiliate (S.D. Tex.), 1464; summary judgment denied both parties, 1489

BUDGET, U.S.

See also specific agencies and departments
– Bipartisan deficit commission proposal fails, 135
– Deficit reduction panel, proposed recommendations to cut health care spending, 1594; proposal lacks necessary votes for adoption, 1701