State Courts

California bans balance billing

Anne Zieger — Thu, 16 Oct 2008 09:28:34 -0400

Capping years of debate, a new law just went into effect in California banning balance billing, a landmark measure that may further shift the balance of power in the direction of health plans. Several legal challenges regarding balance billing are going before state courts soon, but in the meantime, some hospitals are panicking about how to make ends meet when insurers underpay them.

Among the key backers of the bill was the state's Department of Managed Health Care, which argued that under existing state laws, consumers were having their credit ruined because they didn't pay the hospital's bill, or were paying out of pocket because they didn't know that they weren't responsible for that payment.

Many doctors and hospitals, however, are claiming that this law is unfair. They claim that the Department of Managed Health Care should be acting more quickly against the insurance companies when they underpay or make late payments, instead of going after the doctors themselves, who are just trying to get the money they need to keep in business.

To learn more about this law and the court battles:
- read this L.A. Times piece

ALSO NOTED: S&P to rate non-profit hospitals' IT investments; Pharmas winning legal battle over pre-emption; and much more...

Wed, 14 May 2008 06:59:50 -0400

> Ratings firm Standard & Poor's has announced that it plans to track not-for-profit hospitals' IT investments and factor them in significantly in how they rate the hospitals' financial health. FierceHealthFinance

> It looks like pharmaceutical companies may be winning one of their key arguments--that since they're regulated by the FDA, plaintiffs are pre-empted from suing in state courts. Let's see what the Supremes think. FiercePharma

> Think your electronic medical record system is just for patient care? Think again, say policy makers and researchers. FierceHealthIT

> Stem cell researchers who managed to engineer a human embryo are now facing criticism that their work is a big step toward designing babies. FierceBioResearcher

And Finally... What includes Harry Truman's 1948 Democratic National Convention speech, Michael Jackson's "Thriller" and Fiorello LaGuardia reading comics? Article

Pharmas may be able to drag suits to federal court

Mon, 07 Apr 2008 06:59:58 -0400

Increasingly, consumers who feel that they've been injured by drugs are taking their case to state courts. Their adversaries, the pharmaceutical companies, have long contended that the cases had no place in state proceedings, at least in the case of drugs that had been approved by the FDA, suggesting that federal law should govern such cases. For decades, courts disagreed with the pharmas, but of late, things are turning around. Some observers say that if state courts don't put pressure on the pharmas, they'll have little incentive to disclose post-approval adverse drug effects--but the FDA disagrees.

Now, it seems that the Supreme Court may have the final word. Recently, the Court ruled that many states' suits against medical device makers are pre-empted by federal law. They'll soon rule on a similar case that could make pre-emption the standard for drug cases, too. This could have a dramatic effect on actions such as the flood of state suits against Johnson & Johnson, which has been sued by more than 3,000 women and their families, all claiming that its FDA-approved Ortho Evra patch caused harm by delivering much more estrogen than expected.

To learn more about this trend:
- read this New York Times piece

Related Articles:
CT attorney general sues FDA over OxyContin. Report
Supreme Court makes it harder to sue device makers. Report