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Paul Zimmerman

Showing 14 posts from July 2016.

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Samantha Craddock ©

NY Attorney General Tightens the Screws on Direct Marketing Industry

In a move that will no doubt have ripple effects across the direct marketing industry, the New York Attorney General has reached a settlement with two marketers regarding allegations of deceptive advertising practices. If this settlement is any indication, going forward, marketers must be careful to disclose the terms of their offers and let consumers confirm all details and final prices of any order before finalization. Now is the time for direct marketers to closely review advertising, ordering processes and customer service practices to ensure compliance with applicable laws. (Read More)

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Michael Brown ©

DOJ Seeks to Block Two Major Health Insurance Mergers

The United States Department of Justice (DOJ) is suing to block two proposed mergers between major health insurance companies, claiming that the deals violate antitrust laws and would lead to increased health care costs for patients. As noted in an earlier blog post, the merger of Aetna and Humana, as well as Anthem Inc.’s acquisition of Cigna Corp., has faced many regulatory and antitrust hurdles since being announced last year. Several key stakeholders, including California insurance Commissioner Dave Jones, have expressed concern that the aforementioned mega-deals will result in an anti-competitive insurance market. Now, the DOJ has announced that it is challenging both mergers on the grounds that they "would lead to higher health-insurance prices, reduced benefits, less innovation, and worse service for over a million Americans." (Read More)

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lightwise ©

Criminal Charges Brought in $1 Billion Alleged Medicare Fraud Scheme

If the June 2016 nationwide Medicare fraud takedown was not a sufficient indicator, today’s announcement that the U.S. Department of Justice (DOJ) has filed criminal charges against three Florida individuals alleging more than $1 billion in health care fraud, should make very clear that the federal government is cracking down on Medicare schemes.

The owner of more than 30 Miami-area skilled nursing and assisted living facilities, a hospital administrator and a physician’s assistant were charged with conspiracy, obstruction, money laundering and health care fraud involving numerous Miami-based health care providers. (Read More)

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Dmytro Zinkevych ©

CA Appellate Court Rules That Outside Counsel’s Fact Investigation is Privileged

On June 8, 2016, the First Appellate District of the California Court of Appeal, reversed a Sonoma County Superior Court, holding that an outside counsel’s investigative report was protected from discovery by the attorney-client privilege and the work product doctrine despite outside counsel’s agreement not to provide “legal advice” based on her findings.  City of Petaluma v. Superior Court (Cal. App. 1st Dist. June 8, 2016, ordered published June 30, Case No. A145437). The Court also held that the assertion of an avoidable consequences defense did not waive the attorney-client privilege or work product protection because the investigation was initiated after the plaintiff resigned from her position. (Read More)

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Kheng Ho Toh ©

MetLife and Federal Regulators Battle Over 'Systemically Important' Label

The definition and regulation of systemically important financial institutions (SIFI), including the extension of this designation to certain insurance companies, has bred contention amongst key stakeholders. As federal regulators look to ramp up oversight of large insurance companies (including the imposition of higher capital requirements and other risk management protocols), all eyes are on a significant appeal being heard in the D.C Circuit Court, with potentially massive financial and political implications. (Read More)

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studiom1 ©

A Different Route: Challenging Orange Book Patents Via Inter Partes Review

Since the passage of the America Invents Act (AIA) in 2012, and the corresponding implementation of the inter partes review (IPR) process, patent challengers have been utilizing the Patent Trial and Appeal Board (PTAB) as an alternative venue for patent adjudication. The IPR process permits anyone other than the patent owner to challenge a patent's validity for alleged obviousness or lack of novelty based on patents or printed publications. This has become an increasingly popular avenue for challenging “orange book” pharmaceutical patents, many of which are simultaneously at issue in Hatch-Waxman / Abbreviated New Drug Application (ANDA) litigation in the federal courts. (Read More)

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alexskopje ©

A Sign of the Times: Philadelphia Insures Against Police Liability Claims Ahead of the Democratic National Convention

Given the current climate of hard-fought elections, law enforcement backlash, and fervent nationwide protests, it is no surprise that the insurance industry is being called upon to mitigate the significant risk surrounding major political events. The 2016 Democratic National Convention will be held at the Wells Fargo Center in Philadelphia from July 25 through July 28, 2016, and the City of Philadelphia is preparing.  Following Benjamin Franklin’s wise words that an ounce of prevention is worth a pound of cure, the City has purchased a law enforcement liability insurance policy to protect against it or its police officers being sued over the performance of their duties during the Democratic National Convention. (Read More)

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Maksim Kabakou ©

Federal and SoCal Employment Law Update

Several significant, new employment laws have or will go into effect in 2016, and in order to ensure full compliance, employers should immediately review their policies, procedures, and handbooks. Below are just a few of the new laws, at both the Federal and Southern California regional levels, that will substantially impact employers. (Read More)

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nopporn suntornpasert ©

Warner Bros. Settles FTC Charges It Failed to Adequately Disclose Payments to Online Influencers

More and more brands are paying online “influencers” to engage with, positively review and market their products. However, a recent federal action reiterates the importance of clearly disclosing the sponsored nature of such content. The Federal Trade Commission (FTC) has reached a settlement with Warner Bros. Home Entertainment, Inc. with respect to charges that the company deceived consumers during a marketing campaign for the video game Middle Earth: Shadow of Mordor. Specifically, the complaint alleges that Warner Bros. failed to adequately disclose that it paid online “influencers” thousands of dollars to post positive gameplay videos on YouTube and social media. (Read More)

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Steve Woods ©

New Federal Proposal May Make Health-Related Travel Insurance an Excepted Benefit Under ACA

For companies selling travel insurance products, there is major news out of Washington D.C. The Obama administration is seeking to curb short-term, limited duration health policies, which includes insurance products now frequently sold within the travel insurance industry. However, the proposed new rule addresses travel insurance head-on, as it makes very clear that travel insurance products with limited health coverage are excepted benefits under the Affordable Care Act (ACA). (Read More)