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Health Law
Suit Filed Against Feds Over CMS Risk Adjustment Formula
On July 29, 2016, Minuteman Health Inc. filed suit in Massachusetts against the federal government, naming, as defendants, the US Department of Health and Human Services, the Centers for Medicare and Medicaid Services (CMS) and the heads of both agencies. The suit alleges that the risk adjustment formula used to calculate which insurance companies have […]
- September 12, 2016
- By Allen & Gooch
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Professional Liability
Louisiana Courts Address Legal Malpractice Intentional Tort
In the wake of the Louisiana Supreme Court’s ruling in Lomont v Bennett, 172 So.3d 620 (La. 2015), courts across Louisiana are addressing the intentional tort provision(s) of La. R. S. 9:5605 in legal malpractice actions. Two recent Louisiana Federal Court cases touch on intentional tort/fraud. Lawyer’s agreement to settle malpractice claim with client […]
- September 7, 2016
- By Allen & Gooch
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Health Law
Access to Better Care Act to Reduce Deductibles for Managing Chronic Illness
The Access to Better Care Act of 2016, H.R. 5652, is currently sitting in the Congressional Ways and Means Committee. Introduced by Representatives Diane Black (R-TN) and Earl Blumenauer (D-OR) on July 7, 2016, with bi-partisan and industry support, this bill seeks to change insurance coverage related to care of chronic disease. The bill seeks […]
- August 15, 2016
- By Allen & Gooch
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Workers' Compensation
Are Franchisee’s Entitled to Workers’ Compensation Benefits?
Who is entitled to Workers’ Compensation Benefits? The Workers’ Compensation Act provides an exclusive remedy for an employee against his employer or co-employee where the terms of the statute are met. The compromise allows the injured employee to recover benefits pursuant to the statute, but the employer (and/or co-employee) will be immune from […]
- July 25, 2016
- By Allen & Gooch
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Professional Liability
FINRA Complaints – 5 Steps to Responding
5 Steps For Financial Professionals to Take When Facing FINRA Complaint With the rise of BrokerCheck, it is more important than ever that brokers and financial advisors maintain a clean record. Complaints by clients can show up on BrokerCheck and create a shadow on the financial professional’s integrity, making it significantly more difficult to market […]
- July 20, 2016
- By Allen & Gooch
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Maritime Casualty
Admiralty Jurisdiction When Damage Occurs on Land
Admiralty Jurisdiction My last post referenced the two-part test to determine if a claim falls under a federal court’s admiralty jurisdiction: (1) did the incident occur on navigable waters? and (2) was the incident substantially related to a traditional maritime activity? However, a claim can be an admiralty claim even if the damage/injury occurs on […]
- July 18, 2016
- By Allen & Gooch
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Civil Procedure
Fair Credit Reporting Act – Plaintiffs Need More Than Mere Allegation
The United States Supreme Court recently decided Spokeo, Inc v. Robins, which stated that a plaintiff has to prove an actual “injury in fact” occurred from a violation of the Fair Credit Reporting Act, rather than merely alleging that a party has violated the Act. 578 U.S. ____ (2016) 2016 WL 2842447. In reversing the […]
- June 6, 2016
- By Allen & Gooch
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Insurance & Casualty Litigation
Invalid UM Selection Form May Supersede Previous Forms
A recently decided First Circuit Case has held that an insurer may not “pick and choose” which UM Selection Form to enforce. In the particular case, the insurer first argued that a 2009 UM Selection Form precluded recovery under a UM Policy. It was ultimately determined that issues of fact remained as to whether UM […]
- May 11, 2016
- By Allen & Gooch
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General Liability
Discoverability of Accident Reports
In a previous blog articles, 10 Items to Preserve After an Accident in a Company Vehicle and Best Practices for Documenting Slip and Fall Accidents, I discussed the importance of preserving information after an accident and creating accident reports. However, it is important to note that your reports may be discoverable by the adverse party. […]
- May 9, 2016
- By Allen & Gooch
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Insurance & Casualty Litigation
Spotting and Successfully Defending Claims Against Malingerers
Patients who malinger, or exaggerate illness, can be a problem for health and claims management professionals. Malingering is defined by the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition-Text Revision (DSM-IV-TR) as the intentional production of false or grossly exaggerated physical or psychological symptoms, motivated by external incentives such as avoiding work or military duty; […]
- May 4, 2016
- By Allen & Gooch
