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Congress

The Sicker, The Better: Cigna Orchestrates Fraudulent Scheme to Defraud Government

Cigna Corporation (Cigna)–a global juggernaut in the insurance arena–faces a health care fraud lawsuit brought by the government under the federal False Claims Act (the FCA). By allegedly exaggerating patients’ illnesses to boost its own risk scores, Cigna secured inflated payments from the Medicare Advantage reimbursement system.

Congress Should Revisit the Federal Vacancies Reform Act

In 1998, Congress passed legislation to address vacancies created when a high-ranking official of an executive branch agency leaves their position. The Federal Vacancies Reform Act (FVRA) establishes a time limit of 210 days from the date of a vacancy for which a person may serve in an acting capacity in a position that is otherwise nominated by the President, with advice and consent of the Senate. The FVRA allows acting officials to serve beyond that time if there is a first or second nomination pending in the Senate for the vacancy. However, certain agencies have supplemental succession plans within their enabling statues that may supersede or complicate the FVRA.

Judge Scrutinizes Wells Fargo and FINRA Over Arbitration Selection Process

Throughout the history of the financial services industry, broker-dealers and investment advisory firms have typically required harmed investors to dispute matters through arbitration rather than the court system. Arbitration disputes between broker-dealers and former clients are generally kept confidential and decided by a purportedly impartial three-person panel; the panels are hand-selected by the parties from a randomly generated list of arbitrators employed by the Financial Industry Regulatory Authority (FINRA). FINRA utilizes a computer algorithm, the Neutral List Selection System (NLSS), which creates a list of potential arbitrators to review the matter based on the type of case. However, a recent court decision overturning a 2019 FINRA arbitration award in favor of Wells Fargo has flooded the financial services industry with widespread allegations of fraud and misconduct. In addition to vacating the arbitration award, Fulton County Superior Court Judge Belinda Edward criticized FINRA’s arbitration selection procedures as well as Wells Fargo for their role in altering the process. Wells Fargo is set to appeal the decision while FINRA now faces immense regulatory pressure to address its failure to facilitate a fair arbitration selection process.

2022: U.S. Privacy Chaos, Continued?

Conversation surrounding the hodgepodge of state data privacy legislation in the U.S. has long been a subject of frustration within the U.S. and abroad. 2021 saw a drastic uptick in awareness and a need for meaningful comprehensive consumer privacy laws. With both data privacy and cybersecurity repeatedly making front page news over the last year, and even becoming high priority within the Biden Administration, it has become one of the few issues on which people across the political spectrum can agree. But will 2022 be the year that comprehensive federal privacy legislation becomes a reality? Don’t count on it.

Big Tech vs the American Innovation and Choice Online Act

Amazon, Apple, Facebook, and Google are dominating the headlines with record-breaking profits and dismissals of antitrust lawsuits; however, that may not last long with new antitrust bills gaining traction in Congress. In fact, when the Senate Judiciary Committee voted 16 – 6 to advance a major antitrust bill on January 20, 2022, the American Innovation and Choice Online Act, the tech companies stock prices dipped. Currently, with bipartisan support, the bill is on a path to pass the Senate.

Investor Choice Act Approved by House Committee

For several years, broker-dealers and investment advisory firms have typically required harmed investors to dispute matters through arbitration rather than the court system. However, the House of Representatives’ Financial Services Committee has approved a bill aimed at prohibiting mandatory arbitration commonly imposed by broker-dealers and investment advisory firms. H.R. 2620, known as The Investor Choice Act, restricts investment advisors and broker-dealers from including pre-dispute binding arbitration clauses in their client agreements. The Investor Choice Act addresses “long-standing and deeply unfair practices of forcing customers to resolve their claims through arbitration instead of as part of a class action,” according to Maxine Waters, Chairwoman of the Financial Services Committee.

Prescribing Online with COVID-19

COVID-19 has rapidly changed the healthcare field unlike anything has before. With the continued spread, healthcare providers have started to adopt telehealth as a way to access patients and continue to provide quality care, without breaking their self-isolation. One avenue that has long been closed off for physicians has been online prescribing, but COVID-19 appears to be changing even that.

The Future of Online Prescribing

Telehealth allows for the delivery and facilitation of medical services through technology. It is rapidly evolving as the tech industry grows. Ten years after the passage of the Ryan Haight Act, the Drug Enforcement Agency (DEA) has still not taken any action to assist physicians in their usage of telehealth. Recently, Congress finally stepped in and passed a bill that requires the DEA to take action within the next year. But, the question still remains whether the DEA will finally act, or continue their history of avoidance?

What Does a Federal Government Shutdown Mean for Compliance?

For the first time since 2013, on Saturday, January 20th, 2018, the U.S. government ran out of money when Congress failed to pass a spending bill to fund the federal government. Much of the federal government’s operations have ground to a halt due to the lack of funding. Because Congress is seemingly at an impasse over immigration policy, the shutdown may last several days, if not weeks. In light of Loyola’s upcoming symposium exploring what happens when regulation is not enforced, it is interesting to consider how, in a similar vein, the shutdown affects compliance.

Congressional Repeal of Consumer Protection Rule Creates Bar to Class-Action Suits Against Banks

In July of 2017, the Consumer Financial Protection Bureau (“CFPB”) Director, Richard Cordray, implemented a rule regulating the ability of banks to prohibit class-action lawsuits from being placed within the fine print of their consumer contracts. By the end of July, the House of Representatives voted to repeal the rule under the Congressional Review Act, which allows lawmakers to overturn any recently issued regulation by an executive agency. The Senate subsequently voted to repeal the rule after a 50-51 vote, where Mike Pence cast his vote to break the 50-50 tie. On November 1st, 2017, President Trump signed the bill repealing the regulation.