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  • Affidavits from Subrogation Agents on Medical Expenses allowed in Texas

    Insurance carriers come into play when determining reasonableness In a recent decision by the Texas Supreme Court, Gunn v. McCoy , the Court allowed plaintiffs to file affidavits from subrogation agents for health insurance providers to prove reasonableness of medical expenses pursuant to Texas Civil Practices and Remedies Code § 18.001. On appeal, the defendant contended that the plaintiff’s ...
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  • False Claims Act and the Materiality Standard

    Supreme Court Seeks Solicitor General’s Views on Certiorari for FCA Materiality Standard FCA History It comes as a surprise to many that the False Claims Act (FCA), 31 U.S.C. §§ 3729 – 3733, stretches back to the Civil War. Originally enacted in 1863 to combat fraud against the Union Army by suppliers, the FCA was not changed significantly until 1986, at which point double damages were increased ...
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  • Dallas Attorney Defrauds Federal Government of Approximately $26 Million

    Workers’ Compensation Scheme targets the Department of Labor Tshombe Anderson, a Dallas-area attorney, was sentenced to 10 years in federal prison and ordered to pay approximately $26 million as restitution for a fraud scheme he ran. Anderson, along with his wife, sister, and niece, filed false claims for medical equipment with the Department of Labor’s Office of Workers’ Compensation Program. The ...
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  • The Liability of Self-Driving Vehicles

    On March 18, 2018, an Uber autonomous vehicle struck and killed a woman crossing a dark street in Tempe, Arizona. In early May 2018, a self-driving minivan of Waymo was involved in a crash in Chandler, Arizona. The first known fatality from an autonomous vehicle came in 2016 when one of Tesla’s autonomous vehicles failed to sense a tractor-trailer crossing the highway near Williston, Florida. In ...
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  • Physician In McAllen, Texas Convicted of Healthcare Fraud After Eighteen Years

    For 18 years, Jorge Zamora-Quezada, a physician based in McAllen, Texas, enjoyed a lavish lifestyle—flying in private jets, driving luxury vehicles, and purchasing high-end clothing—at the mercy of his patients who underwent numerous medical treatments upon false diagnosis. Zamora-Quezada and his co-conspirators traveled between the Rio Grande Valley and San Antonio conducting unwarranted ...
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  • Civil Procedure Rules Strike Again

    Insured Sees Claim Dismissed for Improper Joinder For many attorneys, the rules of civil procedure are like a minefield. There are hidden traps everywhere as they seek to move their case along. One wrong step and BOOM, your case could be dismissed. That is exactly what happened in a recent case out of Dallas in Caruth v. Chubb Lloyd’s Insurance Company of Texas , No. 3:17-CV-2748-G. (Full case ...
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  • Anti-SLAPP Statute Combats Conspiracy Claim

    SLAPPs (Strategic Lawsuits Against Public Participation) are often filed with the primary intent to censor, intimidate, or silence a defendant. By burdening the defendant with the costs of litigation, SLAPP suits seek to dissuade a defendant from exercising his or her First Amendment rights. To guard against the chilling effect of SLAPPs, 28 states, the District of Columbia, and Guam have enacted ...
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  • Murphy v. NCAA: A Win for the States

    The Tenth Amendment helps to define the principle of federalism, the relationship between the federal government and the states. It provides that if the U.S. Constitution does not delegate a power to the federal government, or take that power away from the states, then that power is reserved for the states or for the people themselves. The Supreme Court has rarely declared laws unconstitutional ...
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  • Punitive Damages Slashed for Medical Supplies Manufacturer

    Sell at any cost. This seems to be the motto of Kimberly-Clark Corporation and Halyard Health Inc., as they pushed their defective MICROCOOL* Surgical Gowns to the medical community. A quick glance at their website will reveal that the gowns are designed to be fluid, microbial, flame, lint and abrasion resistant, but a Los Angeles jury did not agree. The jury delivered a whopping $454 million ...
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  • Washington Court Holds Individual Insurance Adjusters Can Be Liable for Acting in Bad Faith

    A Washington court of appeals recently held “that an individual employee insurance adjuster can be liable for bad faith and a violation of the CPA,” according to Keodalah et al. v. Allstate Ins. Co., et al. , No. 75731-8-I (Wash. Ct. App. Mar. 26, 2018). The issue needed to be settled as there was a split among federal judges about whether non-insurer entities were exempt from bad faith and CPA ...
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  • Arbitration is King: $50M RICO Suit Sent to Arbitration

    The Federal Arbitration Act (FAA) has been challenged numerous times since its inception, but the Supreme Court continuously upholds arbitration clauses because arbitration helps keep the court system moving and can keep costs down by avoiding costly litigation. Arbitration presents a powerful tool when used correctly. However, arbitration is a double-edged sword that can potentially cut the other ...
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  • Beware Statute of Limitations Dates for Every Aspect of a Suit

    The statute of limitations can present issues for attorneys and clients when they begin to get close to that end-date. For a personal injury suit in Texas, a plaintiff must bring suit within two years from the date the cause of action accrues. Accordingly, the plaintiff not only must bring suit within that two-year window, but also must use due diligence to serve the defendant with service of ...
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  • Attorney Sanctioned for Use of Pre-Trial “Push Poll” Survey

    Pre-trial surveys are a tactic used by attorneys sometimes to gauge public awareness of an issue or to get a read on a community. These types of pre-trial activities can draw heavy scrutiny from the court and opposing counsel as they may believe that the attorney conducting the survey is attempting to sway public opinion on the matter. Surveys like these must be neutral and used for informative ...
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  • California Continues to Chip Away at the Duty to Defend in Insurance Cases

    The opioid epidemic still presents a large problem for lawmakers and health care providers as opioid use continues to hurt communities and destroy lives. It is estimated that 116 people die every day from overdoses linked to opioid usage, according to an article by the U.S. Department of Health and Human Services. This issue affects millions of people as around 2.1 million people suffer from an ...
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  • Cedra Pharmacy Claims Insurer, UnitedHealth, Pushing Them Out of Markets in RICO Suit

    In a RICO suit filed in the Southern District of Texas in December 2017, Cedra Pharmacy is claiming that UnitedHealth Group is excluding its new locations in California and Texas from its pharmacy benefits manager (PBM) network, Catamaran/OptumRX, in an attempt to lower competition in the specialty-drug market. Specifically, Cedra claims that the Defendants are engaging in “a pattern of economic ...
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