Doctrine of primary jurisdiction, not exhaustion of remedies, warrants staying litigation to obtain a decision on issues within an agency’s expertise. Read more
Dr. Willie Goffney is a surgical oncologist who has provided services to Medicare patients since 1991. In 2005, Dr. Goffney stopped receiving reimbursement payments for his Medicare claims, Read more
The California Medical Association (CMA) is a nonprofit, professional organization that advocates on behalf of its physician members, including Aetna in-network physicians. CMA sued Aetna under the Unfair Competition Law (UCL) (Bus. & Prof. Code, § 17200), seeking to enjoin it from inhibiting in-network physicians from referring their patients to out-of-network providers. The CMA alleged that Aetna’s policy unlawfully interfered with its members’ ability to exercise independent medical judgment and violated various California statutes. Read more
Dr. Peter Redko designated Dr. Thomas Chang as his standard of care expert witness in a disciplinary proceeding before the Podiatric Medical Board. Read more
The Patient Protection and Affordable Care Act (ACA) requires employers to provide women with “preventive care and screenings” without cost sharing, and requires the Heath Resources and Services Administration (HRSA) to issue comprehensive guidelines defining such services. These requirements have been the subject of continuous litigation. Read more