Escobar’s Materiality Standard Shields Organizations from the Risk in Risk Adjustment Payments

Posted on April 4, 2018Categories Fraud & Abuse

Finance Director for UnitedHealth Group brought qui tam suit against UnitedHealth Group, Inc. alleging that the organization upcoded risk adjustment data resulting in increased payments (more than $1.14 billion) to UnitedHealth Group. The Department of Justice (DOJ) intervened in the case, yet UnitedHealth Group was successful in getting the primary False Claims Act Claims dismissed by arguing that the Centers for Medicare & Medicaid Services (CMS) would not have refused to make the adjustment payments had they known of the errors in the risk adjustment. The Escobar materiality standard helps clarify threshold level of risk to Managed Care Providers in attesting to their risk adjustment payments; the falsities must have had an impact on the respective payment.
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The Balancing Act: Exclusive Ownership Rights and Digital Content Sharing

Posted on April 3, 2018Categories The Marketplace

The Internet has given millions of people the capability to share information with each other with just the click of a button. People have grown accustomed to learning about current events, researching, and gathering information all through digital news sources. Unfortunately, the ease of the Internet has also created complications with regulating how users share that information. As technology rapidly advances, the legal limitations concerning intellectual property rights have become blurred, resulting in different interpretations of the Copyright Act of 1976. This has complicated user compliance and created difficult questions for the courts to answer based largely on law that was created before many of the capabilities of the Internet existed. There is a need for consistency and balance in this area of the law so that copyright owners are afforded adequate protection and the Internet can continue to serve as an information gathering, content sharing platform without fostering infringement.
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What Google’s Genericide Win Means for the Future of Trademark Law

Posted on April 3, 2018Categories The Marketplace

In 2014, in the District Court of Arizona, a judge ruled that “Google” was not a generic term and was eligible to receive trademark protection in Elliott v. Google. On appeal, the Ninth Circuit affirmed the district court’s ruling. In 2011, Forbes estimated that the “Google” trademark was worth $113 Billion; the trademark is worth more now in 2018 and the company’s trademark is likely its most valuable asset. The suit first ensued when Elliott purchased over 700 domain names with the word “Google” and after the company had successfully won a name dispute, Elliott filed to cancel “Google” trademarks. Elliott claimed that Google was a generic term and should not receive trademark protection. The Ninth Circuit’s ruling in this case will most definitely affect companies and entrepreneurs of all sizes, perhaps giving companies more protection than they were afforded in the past; what some are calling an unintended consequence.
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Trump Administration Deregulates Housing

Posted on April 3, 2018Categories Uncategorized

As President Donald Trump continues to deliver on his promise to deregulate, the Department of Housing and Urban Development (HUD) has been instrumental in reversing Obama-era regulations.  President Trump, who made his fortune in real estate development, has a checkered past when it comes to fair housing and discrimination.  Now his administration is working to cut funding to HUD and unwind many fair housing and discrimination rules.  Administration proponents say this is a necessary step to fix a broken and corrupt bureaucracy, while many advocates have expressed concern over the government scaling back enforcement of fair housing laws.  Any reform effort should seek to balance concerns about bureaucracy with the vital missions of fair discrimination-free housing, inclusive communities, and civil rights.  
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Dodging Pitfalls on the Path to Success: Entrepreneurs and E-Commerce

Posted on March 28, 2018Categories The Marketplace

The number of Americans who purchase goods online is steadily rising.  Recent data published by the U.S. Department of Commerce stated that retail e-commerce had increased by 16.2 percent in 2Q 2017 from 2Q 2016.  The report also stated that as a whole retail e-commerce had risen from 3.5 percent of total quarterly retail sales in 2008 to 9 percent as of 2Q 2017.  In hard numbers, 2Q 2017 e-commerce generated 111.5 billion dollars in sales.  Showing strong growth in under 10 years, these staggering numbers indicate that e-commerce has started to creep up on the traditional brick and mortar (BM) style of retail which has so long dominated the retail landscape.  One can only look at the financial data and stock charts of traditional BM stores as well as the REITs that own the malls and land these stores call home to see there has been some effect with this shift.
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How Would a New Bipartisan Bill that Encourages the DEA to Increase Opioid Quotas Affect Drug Manufacturer Efforts to Remain Compliant?

Posted on March 28, 2018Categories Drugs & Devices

After years in an opioid crisis, the United States now faces an opioid epidemic that has left the government and public desperate for relief and a workable solution. A group of senators hopes to be part of the solution with the introduction of a bipartisan bill that aims to better enable the DEA to establish opioid quotas. Despite already-present struggles to effectively manage its quota system and policies, the DEA would be given significantly more responsibility under this bill. Drug manufacturers, directly responsible for following DEA, FDA, and OIG regulations to hopefully resolve the epidemic, will need to grow their compliance efforts and create responsive solutions to remain both profitable and compliant.
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New Senate Dealings Prepare to Ease Banking Regulations Under the Dodd-Frank Act

Posted on March 26, 2018Categories Finance & Banking

New discussions in the U.S. Senate indicate a likely repeal of 2010’s controversial Dodd-Frank Act. Designed in response to the 2008 economic crisis, the Dodd-Frank Act implemented regulations on banks and lending agencies to provide greater financial stability and consumer protection. The fundamental purpose of Dodd-Frank was to increase oversight and transparency among financial institutions. However, the Dodd-Frank Act has been the target of much criticism, most notably that its imposed regulations stifle the growth of smaller institutions. As of March 2018, Senate discussions indicate an intent to lay the foundations to remove this regulation.
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TAX TALK SERIES: IRS Clarifies Post-TCJA Confusion on Home Equity Interest

Posted on March 23, 2018Categories Uncategorized

On December 20, 2017, Congress passed the Tax Cuts and Jobs Act (“TCJA”) designed to decrease the taxable rate for corporations and individuals, and significantly limited allowable deductions. Since this change to the Tax Code was one of the largest since the Reagan era, the Internal Revenue Service will need to publish many regulations and advisories in the coming months to better clarify provisions of the TCJA. This multi-part series will explore prominent IRS regulations and advisories as they relate to the TCJA, and what these regulations and advisories mean for both individual and corporate taxpayers. 
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Financing a Funeral: FTC Protection Against Providers

Posted on March 21, 2018Categories Fraud & Abuse, The Marketplace

One of the most difficult things many of us will experience in our lifetime is the death of a loved one. Whether unexpected or a drawn out farewell, it is a situation no one can be full prepared to handle. In this moment of extreme vulnerability, most people begin the process of planning a funeral. Society has placed an incredible amount of faith in funeral directors to make sure the wishes of our loved ones are met and insure a memorable service for the living. However, this is not always the case.
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