Health Care

Twenty-Three Pietragallo Law Firm Lawyers Named PA Super Lawyers

June 2, 2014

PITTSBURGH and PHILADELPHIA, PA – William Pietragallo, II, founding partner of the law firm of Pietragallo Gordon Alfano Bosick & Raspanti, LLP was selected as a Pittsburgh Top 50 Lawyer by Super Lawyers 2014. Mr. Pietragallo was recognized for his work in Business Litigation. Marc S. Raspanti, name partner in the firm, was selected as a Philadelphia Top 100 Lawyer and a Top 100 Lawyer in Pennsylvania by Super Lawyers 2014. Mr. Raspanti was recognized for his work in the White Collar Criminal Defense Practice Area. These designations are awarded to lawyers who received the highest point totals in the Pennsylvania Super Lawyers 2014 nomination, research, and blue ribbon review process. Twenty-three attorneys in total were named by the publication as 2014 Pennsylvania Super Lawyers. In addition to Pietragallo and Raspanti, the following firm counsel were recognized by the publication as 2014 Pennsylvania Super Lawyers, Gaetan J. Alfano, Joseph J. Bosick, Mark Gordon, Christopher A. Iacono, Kathryn M. Kenyon, James W. Kraus, Daniel J. McGravey, Michael A. Morse, Shelly R. Pagac, Francis E. Pipak, Jr., Kevin E. Raphael, Douglas Rosenblum, Eric G. Soller, Clem C. Trischler, and Paul K. Vey. The following firm attorneys were recognized as 2014 Pennsylvania Super Lawyers Rising Stars, Ethan J. Barlieb, Sarah R. Lavelle, Leslie A. Mariotti, Alicia M. Passerin, John A. Schwab, and Peter S. Wolff. Selection as a Pennsylvania Super Lawyer is an honor reserved for only 5% of the Pennsylvania Bar. The arduous selection process encompasses a strict nomination, research, and review process. Read More

FCPA Compliance In The Healthcare Industry

June 1, 2014

This article was originally published in the June 2014 issue of New Jersey Lawyer Magazine, a publication of the New Jersey State Bar Association, and is reprinted here with permission. Related Information: FCPA Compliance in the Healthcare Industry Read More

PBI’s Health Law Institute

2014/03/13

Daniel J. McGravey and Sarah R. Lavelle will be presenting at PBI’s Health Law Institute on “Current Employment Issues and Developments Facing the Healthcare Provider Community” in Philadelphia, PA on March 13-14, 2014. Read More

Covered Entities Beware: OCR Will Be Increasing HIPAA Security Rule Audits And Enforcement Activities

January 29, 2014

A recent report by the Department of Health and Human Services (HHS) Office of Inspector General (OIG) found that the HHS Office for Civil Rights (OCR) has not met certain requirements critical to the oversight and enforcement of the Health Insurance Portability and Accountability Act of 1996 (HIPAA) Security Rule. The OIG report and recommendations will likely result in an increase in enforcement activity and OCR Security Rule audits of HIPAA Covered Entities. HIPAA required the HHS to develop national standards for the use and dissemination of health care information, including standards to protect electronic protected health information (ePHI). To satisfy that requirement, HHS published the HIPAA Security Rule, which describes the administrative, physical, and technical safeguards necessary to ensure the confidentiality, integrity, and availability of ePHI. The Health Information Technology for Economic and Clinical Health Act (HITECH) requires OCR to provide for periodic audits to ensure covered entities and their business associates comply with Security Rule requirements. According to the OIG report, although OCR made available guidance that promoted compliance with the Security Rule, it had not “assessed the risks, established priorities, or implemented controls for its HITECH requirement to provide for periodic audits.” Instead, OCR continued to follow the complaint-driven approach to Security Rule investigations. OIG found that because OCR did not perform the compliance audits mandated by HITECH, it had limited information about the status of Security Rule compliance at covered entities, and lacked the necessary information about which ePHI was vulnerable. Further, OIG found that while OCR had established an investigation process for responding to reported violations of the Security Rule, OCR’s Security Rule investigation files did not contain required documentation supporting key decisions made. According to the report, management had not implemented sufficient controls, including supervisory review and documentation retention, to ensure investigators follow investigation policies and procedures for properly initiating, processing, and closing investigations. Read More

Pietragallo Gordon Alfano Bosick & Raspanti, LLP named a Tier 1 Metro “Best Law Firm”

November 1, 2013

Pietragallo Gordon Alfano Bosick & Raspanti, LLP was recently named a Tier 1 Metro “Best Law Firm” in six practice areas by U.S. News – Best Lawyers® in 2014 for Pittsburgh and Philadelphia. The six practice areas are listed below: Commercial Litigation Labor & Employment Litigation Personal Injury Litigation – Defendants Workers’ Compensation Law – Employers Criminal Defense White Collar Health Care Law Firms included in the 2014 “Best Law Firms” list are recognized for professional excellence with persistently impressive ratings from clients and peers. Achieving a tiered ranking signals a unique combination of quality law prac­tice and breadth of legal expertise. The 2014 rankings are based on the highest number of participating firms and highest number of client ballots on record. To be eligible for a ranking, a firm must have a lawyer listed in The Best Lawyers in America©, which recognizes the top 4 percent of practicing attorneys in the US. Over 12,000 attorneys provided over 330,000 law firm assessments, and almost 7,000 clients provided close to 20,000 evaluations. In addition, to provide personal insight, a new Law Firm Leaders Survey was implemented in the decision-making process. Read More

Nine Pietragallo Lawyers Selected as 2014 Best Lawyers in America

August 15, 2013

Nine lawyers from Pietragallo Gordon Alfano Bosick & Raspanti, LLP were recently selected by their peers for inclusion in The Best Lawyers in America® 2014 (Copyright 2013 by Woodward/White, Inc., of Aiken, S.C.).  The attorneys who received this distinguished honor are listed below: William Pietragallo, II (Bet-the-Company Litigation, Commercial Litigation, Personal Injury Litigation- Defendants) Mark Gordon (Workers’ Compensation Law- Employers) Gaetan J. Alfano (Commercial Litigation) Marc S. Raspanti (Health Care Law) Alan G. Towner (Copyright Law, Litigation-Intellectual Property, Litigation- Patent, Patent Law, Trademark Law) Joseph D. Mancano (Criminal Defense: White-Collar) Paul K. Vey (Medical Malpractice Law- Defendants) Clem C. Trischler (Commercial Litigation, Product Liability Litigation- Defendants) Francis E. Pipak, Jr. (Workers’ Compensation Law- Employers) Since its inception in 1983, Best Lawyers has become universally regarded as the definitive guide to legal excellence. Because Best Lawyers is based on an exhaustive peer-review survey in which more than 41,000 leading attorneys cast almost 3.9 million votes on the legal abilities of other lawyers in their practice areas, and because lawyers are not required or allowed to pay a fee to be listed, inclusion in Best Lawyers is considered a singular honor. Corporate Counsel magazine has called Best Lawyers “the most respected referral list of attorneys in practice.” It is important to note that the lawyers listed in Best Lawyers have no say in deciding which practice areas they are included in. They are voted into practice areas entirely as a result of the votes they receive from their peers. The subspecialties listed after their names are based on information from a variety of sources. Read More

Will Pennsylvania adopt the “Any Willing Provider” Law?

May 17, 2013

A California jury recently awarded a doctor $3.8 million compensatory damages after they determined that Anthem Blue Cross (“Blue Cross”) violated his right to a fair procedure after denying his application into its provider network.  The case settled before the punitive damage claim was presented to the jury.  See, Nordella v. Anthem Blue Cross, No. BC 444364 (Cal. Super. Ct. filed Dec. 15, 2010) California law requires a fair procedure when a health insurer “possesses power so substantial that the exclusion significantly impairs the ability of an ordinary, competent physician to practice medicine or a medical specialty in a particular geographic area, thereby affecting an important, substantial economic interest.”  In this case, Blue Cross contended that Nordella lacked board certification in Blue Cross’ approved specialties.  Nordella averred that Blue Cross denied his application in retaliation for his outspoken advocacy in favor of patient care and against health insurers’ overzealous denial of coverage for services deemed “not medically necessary.” This case highlights the importance of establishing and implementing objective standards for consideration of providers; and of memorializing the reasons supporting the decision to deny or terminate a provider’s network membership.  Although Nordella may be confined to California, Pennsylvania health insurers should take heed of its lessons. Indeed, Pennsylvania State House Representative Anthony M. DeLuca intends on re-introducing HB1965 of 2011 (“Any Willing Provider”) to “ensure that private practitioners and facilities remain ‘in network’ if they are qualified and willing to accept the terms of the contract.” Time will tell if Pennsylvania adopts the “Any Willing Provider” law, affording providers with legal remedies should insurers refuse access to their networks or terminate provider participation. Medical providers should always understand the credentialing process that may be due and owing to them, i.e. notice, an opportunity to be heard and a fair and impartial tribunal.  Read More

The U.S. Supreme Court Limits State’s Recovery Of Medicaid Expenses In Personal Injury Actions

April 18, 2013

The U.S. Supreme Court recently struck down a North Carolina law that allowed state officials to seize one-third of a medical malpractice settlement paid to a Medicaid recipient. In the case, Wos v. EMA, North Carolina claimed over $900,000 of a legal settlement won by the parents of a 13-year-old girl born with serious injuries that left her unable to live or work independently.  The case settled for $2.8 million; however, the settlement did not indicate what part of the $2.8 million was meant to cover EMA’s medical expenses, which were paid, in part, by Medicaid.  North Carolina claimed over $900,000 of that amount under a state law that allows it to recover one-third of any legal verdict or settlement as a reimbursement for the state’s Medicaid costs.  EMA’s family sued North Carolina, arguing that the amount was disproportionately large and violated the federal Medicaid law, which limits a state’s recovery to medical expenses. The federal Medicaid Act requires states to recoup their medical expenses from beneficiaries’ tort winnings.  It does not specify what percentage of tort winnings should be allocated as medical expenses if the verdict or settlement is silent on that point. The U.S. District Court for the Western District of North Carolina found the state’s method for determining its reimbursement was reasonable, but in 2012 the Fourth U.S. Circuit Court of Appeal in Richmond, Virginia disagreed.  The Supreme Court upheld the Fourth Circuit’s ruling in a 6-3 opinion, holding that North Carolina’s law conflicted with the federal law’s requirement that a state not claim more than what it paid for medical expenses, known as the anti-lien provision. Eleven states supported North Carolina in an amicus brief, arguing that the federal Medicaid law was an agreement between the federal government and the states, and did not provide Medicaid beneficiaries with a legal claim.  Read More

Off-Label Use of Medical Devices

March 16, 2013

James W. Kraus and Martin T. Durkin, two veteran health care attorneys from the law firm of Pietragallo Gordon Alfano Bosick & Raspanti LLP will review the federal government’s intensified regulation of the practice of medicine and how it affects your medical practice, including off-label use of medical devices. Some of the latest civil and criminal cases will be reviewed, providing real world examples of health care providers caught in the cross-fire between quality of care and cost containment measures. The course will conclude with an open dialogue between the participants and the attorneys regarding the legal issues discussed. Read More

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