Beginning on May 1st, qualified Medicare beneficiaries will have the opportunity to enroll in the New Medicare Drug Discount Card Program, which was established by the enactment of the Medicare Prescription Drug, Improvement, and Modernization Act ("MMA") of 2003 (Pub. L. 108-173). Federal regulations governing the administration of the new programs were published in the Federal Register on Dec. 15, 2003 (68 FR 69840).In addition to discounts on prescriptions, the MMA established a Transitional

The Tyler Court of Appeals recently held that, under the plain language of the Texas statute, the medical peer review committee privilege is not applicable to the personnel files of nursing and administrative personnel.

In Aetna v. Davila, together with CIGNA vs. Calad, the United States Supreme Court reached a unanimous landmark decision that a state law cause of action for wrongful denial of benefits, such as one brought under the Texas Health Care Liability Act (commonly referred to as "S.B.386" passed by the Texas legislature in 1997), is completely pre-empted by ERISA and removable to federal court.

Recently, the Internal Revenue Service ("IRS") announced an initiative to monitor tax-exempt health care organizations to ensure compliance with section 4958 of the Internal Revenue Code of 1986, as amended, regarding excess benefit transactions. Specifically, the IRS is looking at compensatory arrangements between a tax-exempt health care organization and a disqualified person to determine if an excess benefit transaction has occurred. A disqualified person includes any person in a position to

Four years ago, in <I>Epilepsy Foundation of Northeast Ohio</I>, the National Labor Relations Board (the "Board") ruled that employers must permit non-unionized workers to have a co-worker present during an investigatory interview that could result in discipline. Although this right had existed in unionized settings since 1975, it did not exist in non-unionized workplaces.

In the proposed IPPS rule published on May 18 (69 Fed. Reg. 28196, 28266), CMS proposed a wage index adjustment based on commuting patterns of hospital employees, pursuant to the direction of Congress in Section 505 of the Medicare Prescription Drug, Improvement and Modernization Act of 2003 ("MMA").

On May 17, 2012, in In re Baxter International, Inc., the Federal Circuit affirmed the decision by the Board of Patent Appeals and Interferences (in an ex parte reexamination context) that certain claims of Baxter’s ’434 patent were obvious under 35 U.S.C. § 103(a)

On March 19, 2004, CMS issued guidance on the specialty hospital moratorium included in the Medicare Prescription Drug, Improvement and Modernization Act of 2003 (the "MMA"). The moratorium applies to the Stark Law whole hospital exception for physician self-referrals to "new" specialty hospitals. Existing specialty hospitals and specialty hospitals that are "under development" as of November 18, 2003, however, are excepted from the moratorium.

On Friday, June 25, 2004, the Centers for Medicare & Medicaid Services ("CMS") proposed numerous changes to its regulations governing the appeals process for Medicare reimbursement determinations, which are typically heard by CMS's Provider Reimbursement Review Board ("PRRB"). See 69 Fed. Reg. 35,716.