SCOTUS Decides Implied Certification Issue in Key False Claims Act (Whistleblower) Case

In a decision that is poised to have resonating implications for health services providers, the Supreme Court of the United States explicitly endorsed the “implied false certification theory of liability” under the False Claims Act (FCA) in Universal Health Services, Inc. v.  U.S. ex rel. Escobar.  Under this theory of liability, any person who submits […]

Disclosure Of Student Mental Health Records: Teachable Moment From Oregon

This month’s column in the Albany County Bar Association Newsletter reviews the situation that unfolded earlier this year at the University of Oregon.  The university, which had been put on notice of a tort claim by a student in connection with an alleged sexual assault,  controversially obtained the treatment records of the same student from an on-campus […]

Regulatory Focus on Mental Health Parity Laws

This month’s article from the Albany County Bar Association Newsletter discusses the New York Attorney General’s recent settlement with Excellus, a Rochester-based health insurer, which resulted from an investigation into complaints from consumers that Excellus was improperly denying claims for mental health and substance abuse treatment.  The article also includes a brief overview of New […]

New York State Attorney General Cracks Down on Mental Health Parity Violations

This year, the New York State Attorney General reached settlements with three health insurance companies for claimed violations of Timothy’s Law.  EmblemHealth (“Emblem”) recently agreed to pay $1.2 million in civil penalties, take remedial action, and participate in restitution which may exceed $31 million.  MVP and Cigna each faced penalties earlier this year.  Timothy’s Law, […]

Emergency Rule Making: Implementation of 1.1% Medicaid Fee Reductions for Operating Rates of Continuing Day Treatment Programs

The New York State Office of Mental Health has introduced an emergency rule to implement the 1.1% Medicaid fee reduction for operating rates of continuing day treatment programs. The reduction in rates for these programs is part of a continuation of the 1.1% reduction in State Medicaid expenditures for mental health programs, and is consistent […]