Admissibility of Insurance Coverage: Sauce for the Goose

When Kerrie Evans’s child was born with cystic fibrosis, she sued her nurse practitioner and doctor for failure to adequately inform her about prenatal testing for CF, making concerns about cost the centerpiece of her case. Her complaint stated that genetic counseling was covered by her insurance (to rebut …

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Recovery of Medical Bills: Once Is Enough

Strange as it sounds, Missouri state law allowed federal workers to recover medical bills twice: once under their federal health insurance plan and again from the person (or person’s insurer) responsible for their injuries.  The law prohibited the federal plan from recovering any part of its payment from …

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Masked Man Robs Government; Faces 10 Years

The mask itself didn’t raise any suspicions.  After all, the man wearing it—Richard Toussaint--was an anesthesiologist.  But like so many other masked men, he turned out to be a thief.  That’s why on March 4 he was convicted in a Texas federal court on seven counts of health care fraud totaling about $10 …

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Health Facilities May Be Insuring Doctors without Knowing It

A September 29 ruling by the New Jersey Supreme Court effectively makes a health facility liable for the professional negligence of a medical staff member who doesn’t have malpractice insurance or who has insurance that doesn’t cover the acts in question. Dr. Kaul performed a spinal fusion on Jim Jarrell at …

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Fitbit Agrees to Sign Business Associate Agreements and Take on HIPAA Compliance

Is your Fitbit data covered by HIPAA?  It depends upon where you got it (kind of).  If you go to the store and pick up a Fitbit on your own, the data it generates is governed by the user agreement that you click through (which I’m sure everyone read carefully).  If your health plan or employer, through its …

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Third Cir. Holds Hospitals May Sue Health Insurers Directly

Before September 11 the Third Circuit Court of Appeals had been out of step with its sister federal circuits when it came to the right of hospitals, physicians and other health providers to sue health insurers that failed to cover patient obligations. So back in 2014 when North Jersey Brain & Spine Center …

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