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Is Ranking Physicians a Fair Practice?
New York Attorney General Andrew M. Cuomo recently spearheaded a statewide New York investigation into health insurers' use of physician-ranking programs. The investigation, which has made inquiries to insurers including United Healthcare, Aetna, CIGNA Healthcare, Empire Blue Cross Blue Shield, Preferred Care and HIP Health Plan of NewYork/GHI, has now produced a settlement with CIGNA.
Although the investigation is specific to New York, the issues raised are national in scope and worth serious consideration, since health insurers nationwide are increasingly utilizing physician-ranking systems. The primary concern raised in this investigation is that such physician-ranking systems are concerned more with the insurer and/or the employer saving money than with providing insureds open and unbiased information regarding quality of care by a provider. This can possibly be deceiving to consumers and lead to health care choices by consumers for the cheapest, but not necessarily best quality, health care.
The DOJ's Corporate Enforcement Policy: One Year Later
The DOJ's Criminal Division issued three declinations since the issuance of the revised CEP a year ago. Review of these cases gives insight into DOJ's implementation of the new policy in practice.
The DOJ's New Parameters for Evaluating Corporate Compliance Programs
The parameters set forth in the DOJ's memorandum have implications not only for the government's evaluation of compliance programs in the context of criminal charging decisions, but also for how defense counsel structure their conference-room advocacy seeking declinations or lesser sanctions in both criminal and civil investigations.
Use of Deferred Prosecution Agreements In White Collar Investigations
This article discusses the practical and policy reasons for the use of DPAs and NPAs in white-collar criminal investigations, and considers the NDAA's new reporting provision and its relationship with other efforts to enhance transparency in DOJ decision-making.
Bankruptcy Sales: Finding a Diamond In the Rough
There is no efficient market for the sale of bankruptcy assets. Inefficient markets yield a transactional drag, potentially dampening the ability of debtors and trustees to maximize value for creditors. This article identifies ways in which investors may more easily discover bankruptcy asset sales.
A Lawyer's System for Active Reading
Active reading comprises many daily tasks lawyers engage in, including highlighting, annotating, note taking, comparing and searching texts. It demands more than flipping or turning pages.