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Law Firm News

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Kegler, Brown, Hill & Ritter Co., LPA.

Shuster Named to Jury Instructions Editorial Board
Congratulations to Michele Shuster, on her appointment to the Ohio State Bar Association's (OSBA) Jury Instructions Editorial Board. The board was formed in 2001, and is charged with drafting comprehensive jury instructions to be available on Casemaker, OSBA's computer-assisted legal research tool, for use by Ohio's lawyers and judges. The board and members of its Jury Instructions committee focus on topics for which there are no instructions, or where the Ohio Jury Instruction's current version is outdated or needs attention. The committee selects and prioritizes the topics for instructions; subcommittees draft and edit the instructions, usually via listserv; and the Editorial Board review, edits and approves the instructions for publication on Casemaker. Michele joined the committee in 2004, and will now expand her role as a new member of the Editorial Board.

For more information, contact Kegler Brown Marketing.

02-07-2006

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Hooper, Lundy & Bookman, Inc.

PacifiCare's Managed Care Practices
Dear Clients and Friends:

Many of our hospital clients are experiencing specific types of payment problems with PacifiCare that we wish to bring to your attention. In light of the issues described below, we encourage you to review your accounts receivable and contracts.

Medical Bill Review
PacifiCare has recently instituted a program – called Medical Bill Review -- to disallow and deny certain charges in order to reduce the claim below the stop loss threshold or to reduce the stop loss payment. Rather than amend its contracts with providers, PacifiCare has unilaterally changed the manner in which claims are reimbursed under its hospital contracts. Like other health plans, PacifiCare is improperly attempting to apply Medicare guidelines to deny these charges. We have been successful in having these charges paid in numerous arbitrations.

Implants
It has come to our attention that PacifiCare is denying payment for certain types of implants by improperly applying a narrow definition as to what constitutes an implant. Many hospital contracts do not define what items constitute an implant. PacifiCare's definition of what constitutes an implant is much narrower than the UB-92 Manual definition of an implant. We believe it is improper for PacifiCare to unilaterally adopt a narrow definition of implants without defining that term in the contract. Our firm has been successful in litigating this issue in a number of arbitrations.

Most Favored Nation Provisions
In many new contracts, PacifiCare and United Healthcare ("UHC") are requiring hospitals to ensure that the rates PacifiCare/UHC negotiates with the hospital are as low as the lowest rates in the hospital's contracts with other health plans. PacifiCare/UHC is also insisting that the hospital agree that a third party auditor review all of the hospital's contracts and claims to ensure that PacifiCare/UHC is receiving the lowest rates. We believe that this practice is improper for a number of reasons:

First, such a practice may require the hospital to breach the confidentiality provisions of its contracts with other health plans. PacifiCare certainly would not want its contract rates to be disclosed to other health plans.
Second, there may be HIPAA issues if PacifiCare's auditor were to review claims relating to other health plans.
Third, the practice may be anti-competitive or otherwise constitute unfair business practices. PacifiCare certainly would not disclose the rates it pays other hospitals, or agree to a provision that states that it will pay the hospital the highest rate it pays other hospitals in the area.
Fourth, the rates that hospitals negotiate with different health plans depend in large part on volume and utilization of services.

02-07-2006

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Hangley Aronchick Segal & Pudlin

Wendy Beetlestone Appointed to Philadelphia University Board of Trustees
Philadelphia, PA – February 7, 2006 – Wendy Beetlestone, a litigation shareholder at Hangley Aronchick Segal & Pudlin, was recently elected to the Philadelphia University Board of Trustees. The Board of Trustees plays a key role in helping to shape the future of the University for its students who benefit from the educational experience the university provides.

Ms. Beetlestone concentrates her practice in commercial litigation and has developed a practice serving education clients. Prior to joining Hangley Aronchick Segal & Pudlin, she was the general counsel of the School District of Philadelphia. In addition to serving on Philadelphia University’s board, Ms. Beetlestone is on the Philadelphia Bar Foundation Board of Trustees and the Board of Directors of the Mann Center for the Performing Arts.

Hangley Aronchick Segal & Pudlin, a 50-lawyer firm, has offices in Philadelphia and Harrisburg, Pennsylvania and Cherry Hill, New Jersey. The firm’s practice includes litigation, bankruptcy, corporate and business law, real estate, and tax and estates. For more information on Hangley Aronchick Segal & Pudlin visit our web site at www.hangley.com.


02-07-2006

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Stites & Harbison PLLC

Stites & Harbison celebrates Black History Month
Stites & Harbison celebrates Black History Month by sponsoring Black History Moments on WLKY-TV (in conjunction with New Directions Housing Corporation). The vignettes recognize the achievements of African-American leaders in science, the arts, athletics and government.

The following historical African-Americans are profiled in the series:

* Lorraine Hansberry (Playwright)

* Sojourner Truth (Activist)

* Elijah J. McCoy (Inventor)

* Arthur Ashe (Athlete)

* Wilma Rudolph (Athlete)

* Marian Anderson (Singer)

* Frederick Douglass (Orator)

* Matthew A. Henson (Explorer)

The vignettes can be seen on WLKY-TV at the following approximate times:

* 02/01/07 Thu 11:16:37 PM (11 O'Clock News)

* 02/01/07 Thu 10:28:51 PM (SHARK - PRIMETIME)
* 02/02/07 Fri 6:47:30 PM (CBS Evening News)
* 02/02/07 Fri 11:52 PM (David Letterman)
* 02/03/07 Sat 4:40:30 PM (NCAA Basketball - Ohio State/Michigan State)
* 02/03/07 Sat 5:23:10 PM (NCAA Basketball - Ohio State/Michigan State)
* 02/03/07 Sat 5:58:25 PM (NCAA Basketball - Ohio State/Michigan State)
* 02/05/07 Mon 7:07:40 PM (Wheel of Fortune)
* 02/05/07 Mon 1:58:50 PM (Bold & The Beautiful)
* 02/05/07 Mon 11:25:43 PM (11 O'Clock News)
* 02/14/07 Wed 6:17:56 PM (Evening News)
* 02/15/07 Thu 1:28:25 PM (Access Hollywood)
* 02/16/07 Fri 10:08:04 AM (Martha Stewart)
* 02/17/07 Sat 6:09:53 AM (Morning News)
* 02/18/07 Sun 5:16:40 PM (NCAA B-Ball -Wisconsin/Ohio State)
* 02/18/07 Sun 6:48:15 AM (Morning News)
* 02/19/07 Mon 11:33:55 PM (11 O'Clock News)
* 02/19/07 Mon 12:46:35 PM (Noon News)
* 02/19/07 Mon 5:38:16 PM (Evening News)
* 02/20/07 Tue 12:59:25 PM (Noon News)
* 02/20/07 Tue 7:36:25 PM (Jeopardy)
* 02/21/07 Wed 12:38:26 PM (Noon News)
* 02/23/07 Fri 2:59:00 PM (Guiding Light)
* 02/24/07 Sat 6:57:20 AM (Morning News)
* 02/25/07 Sun 6:35:50 PM (NCAA B-Ball)
* 02/25/07 Sun 8:28:25 AM (Morning News)

02-06-2006

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Taft Stettinius & Hollister LLP.

MARCIA ANDREW ELECTED TO MIDDLETOWN
CINCINNATI, OH., Marcia Voorhis Andrew, a partner in the Litigation Department of Taft, Stettinius & Hollister LLP, has been elected to the Middletown School Board.

Andrew, a resident of Middletown, practices in general commercial litigation with an emphasis on franchise and distributor relationships, software performance and intellectual property disputes, and ERISA litigation. She received her undergraduate degree from Williams College and law degree from the University of Virginia School of Law, where she was Order of the Coif and served on the Articles Review Board of the Virginia Law Review.

Andrew served as chair of the firm’s Professional Women’s Resource Group (PWRG) for five years. She currently is a member of the Executive Committee of the Williams College Alumni Association of Greater Cincinnati.

Taft, Stettinius & Hollister LLP has offices in Cincinnati, Columbus, Cleveland, Dayton and Northern Kentucky. The firm provides a broad range of legal services to businesses and individuals, including litigation, corporate and business law, securities and municipal financing, tax and estate planning, labor and employment law, real estate and environmental, health care, intellectual property and unfair competition and antitrust law.

02-06-2006

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Nelson Mullins Riley & Scarborough LLP

Monica Wilson Joins Nelson Mullins as Librarian
COLUMBIA, S.C. – Monica Wilson has joined Nelson Mullins Riley & Scarborough LLP to serve as Manager of Library Services in the Firm’s Columbia office.

Ms. Wilson will manage all aspects of the Firm’s multi-office law libraries including acquisitions, budgets, personnel, and legal research. Specifically, she will oversee the supervising and training of library staff, developing and implementing of library services throughout the Firm, provide research assistance, supervise electronic and print collection development, and provide excellent customer service in research and reference services.


Ms. Wilson will also be responsible for implementing a new cataloguing program for the Library and a new information management program for the Firm. She will primarily work in the Firm’s Columbia office; however she will frequently visit other Nelson Mullins offices as needed.

Prior to joining Nelson Mullins Ms. Wilson served as a Reference Librarian, Library Director and Office Administrator at a law firm in Miami for 15 years. She brings to Nelson Mullins over 30 years of Library experience including 15 years of Research Law Library experience. She is a member of the American Law Libraries Association, Special Libraries Association and South Florida Law Libraries Association.

Ms. Wilson earned a bachelors degree in Liberal Arts from the University of West Indies, a Master of Liberal Studies at Pratt Institute, and a Masters of Business Administration from Nova Southeastern University.

Nelson Mullins, established in 1897, has more than 360 attorneys practicing from offices in Atlanta, Boston, Charleston, Charlotte, Columbia, Greenville, Myrtle Beach, Raleigh, Washington, D.C. and Winston-Salem. For more information on the Firm, go to www.nelsonmullins.com, or call (803) 255-9788 or (803) 255-9280.

02-06-2006

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LeClairRyan

Jim Guy Appointed Chair of Section Council, VBA Administrative Law
James Patrick Guy, II has been appointed to chair the Section Council of the Administrative Law Section of the Virginia Bar Association.

Mr. Guy is a partner in the LeClair Ryan law firm in its Government Relations & Regulated Industries Group.

The VBA’s Administrative Law Section, founded in 1991, serves attorneys who practice before, or serve as counsel to, the Commonwealth's administrative agencies. Its mission is to promote professional advocacy before such agencies through educational programs and publications. Each year the Section and VBA staff publish a summary of legislation passed by the General Assembly relating to administrative practice. Each Fall, the Section and the Administrative Law Advisory Committee of the Virginia Code Commission sponsor the Annual Administrative Law Conference. www.vba.org/section/admin.htm.

The Virginia Bar Association is a voluntary organization of Virginia lawyers committed to serving the public and the legal profession by promoting the highest standards of integrity, professionalism and excellence in the legal profession; working to improve the law and the administration of justice; and advancing collegial relations among lawyers. www.vba.org

02-06-2006

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