Federal Court Holds That Voluntary Refund Programs Can Defeat Class Certification Under Rule 23(b)(3)’s Superiority Requirement

By Lisa Baird on 19 November 2010 Posted in Class Actions, Product Liability

This post was written by James C. Martin and Colin E. Wrabley. Class action defense litigators should be aware of a recent federal district court decision that endorsed and accepted a creative option for defeating class certification—the defendant’s implementation of a voluntary refund and replacement program providing a comparable remedy to what the putative class … Continue Reading

Medicare Secondary Payer (MSP) Mandatory Insurer Reporting: MMSEA section 111–Delay Announced for Liability Insurance (Including Self Insurance) Mandatory Reporters

By Lisa Baird on 16 November 2010 Posted in Health Care, Medicare & Medicaid, Reimbursement

In an "Alert" dated November 9, 2010, the Centers for Medicare and Medicaid Services (CMS) has published a revised implementation timeline applicable to liability insurance (including self-insurance) "responsible reporting entities" (RREs) under Section 111 of the Medicare, Medicaid and SCHIP Extension Action of 2007 (MMSEA). Specifically, the obligation to report "total payment obligation to claimant" (TPOC) amounts subject to the reporting requirement has been extended from the first calendar quarter of 2011 to the first calendar quarter of 2012. Moreover, under the revised implementation timeline, only TPOC amounts established on or after October 1, 2011 (instead of October 1, 2010) must be reported. Earlier reporting (i.e., reporting prior to the first calendar quarter of 2012), and reporting of TPOC amounts established prior to October 1, 2011 is now optional. CMS has also delayed the staggered phase-out of its interim threshold dollar amounts for TPOC amounts that liability insurance (including self-insurance) and workers' compensation RREs must report by one year.… Continue Reading

New Guidance on the OIG’s Ability To Exclude Owners, Officers and Managing Employees; Related FDA Statements on Pharmaceutical Executives

By Elizabeth B. Carder-Thompson, Katie Pawlitz and Paul W. Pitts on 1 November 2010 Posted in Fraud & Abuse, Health Care, Regulatory Developments

On October 20, 2010, the Office of Inspector General (OIG) of the Department of Health and Human Services issued significant new guidance for implementing its permissive exclusion authority under section 1128(b)(15) of the Social Security Act. Section 1128(b)(15) specifically authorizes the OIG to exclude an owner, officer or managing employee of a sanctioned entity, i.e., health care provider, supplier, or manufacturer, from participation in federal health care programs. The OIG's new guidance sets out non-binding factors that the OIG intends to consider in deciding whether to impose exclusion on owners, officers and managing employees.… Continue Reading