Business Law Health Law Committee

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

District courts lack jurisdiction to award a Medicare provider injunctive relief until administrative remedies are exhausted. 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

Medical staff credentialing recommendations cannot support a physician’s action against a hospital, a separate legal entity. 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

Keith Burchell consented to undergo a surgical procedure to remove a mass in his scrotum for testing. During the surgery, Dr. Gary Barker discovered the mass was much larger than expected. Believing the mass was malignant, Dr. Barker decided to remove it entirely. Dr. Barker did not first consult Burchell (who was under general anesthesia) or Burchell’s medical proxy (who was present but unknown to Dr. Barker) before performing the more extensive surgery. Burchell suffered serious side effects from this surgery. Read more

“Virtual Presence” by Real-Time Livestreaming Satisfies the Contemporaneous Presence Requirement for a Bystander NIED Claim Read more

Unlicensed companies may manage licensed skilled nursing facilities via an approved management agreement. Read more