Philippe Charest-Beaudry

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The Supreme Court has handed down a judgment that marks a tremendous victory for Theratechnologies and public corporations in general. This important decision is a reminder of the continuous disclosure requirements of corporations and clearly defines the burden to be met by investors seeking authorization to bring a class action under the secondary market liability regime of the Securities Act (the “SA“). This new liability regime was adopted to facilitate actions brought by shareholders…
On February 27, 2014, the D.C. Department of Insurance, Securities, and Banking (DISB) released a bulletin reminding insurers that medically necessary treatment for gender dysphoria, including gender reassignment surgeries, is a mandated benefit in the District of Columbia.  This is not the case in every state and serves as a reminder for health insurance plans required by federal law to offer “essential health benefits” (EHBs) that state law continues to play the primary role in…
On February 7, 2014, the Centers for Medicare and Medicaid Services (CMS) issued a memorandum that adds to the growing library of federal guidance on the permissibility of and limitations for health care providers and other entities paying the premiums of patients covered by qualified health plans (QHPs) in the health insurance exchanges or marketplaces.  The guidance significantly limits the types of third party premium payment arrangements that CMS would find to be acceptable. In…
Introduced on June 4, 2013, Ohio S.B. 140 proposes to make some of the most significant changes to Ohio’s insurance laws since perhaps the Ohio Healthcare Simplification Act (H.B. 125) in 2008.  If passed, the bill will impact everything from insurer’s filing and disclosure obligations, reinsurance options, online and other automated transactions, risk management programs and intra-holding company system transactions.  The bill will also significantly expand the authority of the Superintendent of the Ohio Department…
“[T]his is managed care,” observed the U.S. District Court for the Northern District of California in its June 3rd order granting Sutter Health’s motion to dismiss an antitrust suit.  In so concluding, the court was merely echoing the same observation that Sutter Health repeated throughout its motion to dismiss. While the case, Sidibe v. Sutter Health et al. (subscription required), is most certainly an antitrust suit about a health system in a strong bargaining position…
The Centers for Medicare and Medicaid Services (“CMS”) has historically used its authority to immediately terminate Part D plan sponsors only sparingly.  In fact, it has done so only once.  However, when it chooses to exercise this authority, plan sponsors should not count on courts to come to their aid.  In Fox Insurance Co., Inc. v. Centers for Medicare and Medicaid Services, the Ninth Circuit displayed a strong deference to CMS in its first…
In January of 2005, the Centers for Medicare and Medicaid Services (“CMS”) finalized its regulation permitting Medicare Part D plans to establish networks of “preferred” and “non-preferred pharmacies,” meaning that the plans may offer lower cost-sharing to enrolled Medicare beneficiaries who receive items or services from a preferred pharmacy.  70 Fed. Reg. 4194 (Jan. 28, 2005).  This rule was highly contested by pharmacies and their associations leading up to the final rule and has remained…
On Wednesday, March 20, 2013, armed with a publicly circulated legal opinion and a complaint  filed in the Court of Common Pleas of Allegheny County, the City of Pittsburgh initiated its challenge to the payroll tax exemption claimed by the University of Pittsburgh Medical Center (“UPMC”), which claims the exemption on the basis of its status as an “institution of purely public charity,” or “IPPC,” under Pennsylvania law.  At stake for the parties are millions…
On March 22, 2013, a new Ohio law will go into effect that seeks to clarify who must notify a patient that his or her physician’s employment has been terminated.  Under Ohio Revised Code Section 4731.228, the “health care entity” that employs a physician is now responsible for notifying the physician’s patients that the physician’s employment has been terminated.  This new law will trump the Ohio State Medical Board’s current rules that places the responsibility…
On August 13, 2012, in Rivell v. Private Health Care Systems Inc., the U.S. District Court for the Southern District of Georgia dismissed the plaintiffs’ claims arising from the rental of a health care provider network by a preferred provider organization (“PPO”) to a discount medical plan (“DMP”) as time barred for two plaintiffs and for lack of standing for a third plaintiff.  However, the case still invites provider networks and health plans to…