Continuing Forward: Senate Leaders Release an AI Policy Roadmap

The US Senate’s Bipartisan AI Policy Roadmap is a highly anticipated document expected to shape the future of artificial intelligence (AI) in the United States over the next decade. This comprehensive guide, which complements the AI research, investigations, and hearings conducted by Senate committees during the 118th Congress, identifies areas of consensus that could help policymakers establish the ground rules for AI use and development across various sectors.

From intellectual property reforms and substantial funding for AI research to sector-specific rules and transparent model testing, the roadmap addresses a wide range of AI-related issues. Despite the long-awaited arrival of the AI roadmap, Sen. Chuck Schumer (D-NY), the highest-ranking Democrat in the Senate and key architect of the high-level document, is expected to strongly defer to Senate committees to continue drafting individual bills impacting the future of AI policy in the United States.

The Senate’s bipartisan roadmap is the culmination of a series of nine forums held last year by the same group, during which they gathered diverse perspectives and information on AI technology. Topics of the forums included:

  1. Inaugural Forum
  2. Supporting US Innovation in AI
  3. AI and the Workforce
  4. High Impact Uses of AI
  5. Elections and Democracy
  6. Privacy and Liability
  7. Transparency, Explainability, Intellectual Property, and Copyright
  8. Safeguarding
  9. National Security

The wide range of views and concerns expressed by over 150 experts including developers, startups, hardware and software companies, civil rights groups, and academia during these forums helped policymakers develop a thorough and inclusive document that reveals the areas of consensus and disagreement. As the 118th Congress continues, it’s expected that Sen. Schumer will reach out to his counterparts in the US House of Representatives to determine the common areas of interest. Those bipartisan and bicameral conversations will ultimately help Congress establish the foundational rules for AI use and development, potentially shaping not only the future of AI in the United States but also influencing global AI policy.

The final text of this guiding document focuses on several high-level categories. Below, we highlight a handful of notable provisions:

Publicity Rights (Name, Image, and Likeness)

The roadmap encourages senators to consider whether there is a need for legislation that would protect against the unauthorized use of one’s name, image, likeness, and voice, as it relates to AI. While state laws have traditionally recognized the right of individuals to control the commercial use of their so-called “publicity rights,” federal recognition of those rights would mark a major shift in intellectual property law and make it easier for musicians, celebrities, politicians, and other prominent public figures to prevent or discourage the unauthorized use of their publicity rights in the context of AI.

Disclosure and Transparency Requirements

Noting that the “black box” nature of some AI systems can make it difficult to assess compliance with existing consumer protection and civil rights laws, the roadmap encourages lawmakers to ensure that regulators are able to access information directly relevant to enforcing those laws and, if necessary, place appropriate transparency and “explainability” requirements on “high risk” uses of AI. The working group does not offer a definition of “high risk” use cases, but suggests that systems implicating constitutional rights, public safety, or anti-discrimination laws could be forced to disclose information about their training data and factors that influence automated or algorithmic decision making. The roadmap also encourages the development of best practices for when AI users should disclose that their products utilize AI, and whether developers should be required to disclose information to the public about the data sets used to train their AI models.

The document also pushes senators to develop sector-specific rules for AI use in areas such as housing, health care, education, financial services, news and journalism, and content creation.

Increased Funding for AI Innovation

On the heels of the findings included in the National Security Commission on Artificial Intelligence’s (NSCAI) final report, the roadmap encourages Senate appropriators to provide at least $32 billion for AI research funding at federal agencies, including the US Department of Energy, the National Science Foundation, and the National Institute of Standards and Technology. This request for a substantial investment underscores the government’s commitment to advancing AI technology and seeks to position federal agencies as “AI ready.” The roadmap’s innovation agenda includes funding the CHIPS and Science Act, support for semiconductor research and development to create high-end microchips, modernizing the federal government’s information technology infrastructure, and developing in-house supercomputing and AI capacity in the US Department of Defense.

Investments in National Defense

Many members of Congress believe that creating a national framework for AI will also help the United States compete on the global stage with China. Senators who see this as the 21st century space race believe investments in the defense and intelligence community’s AI capabilities are necessary to push back against China’s head start in AI development and deployment. The working group’s national security priorities include leveraging AI’s potential to build a digital armed services workforce, enhancing and accelerating the security clearance application process, blocking large language models from leaking intelligence or reconstructing classified information, and pushing back on perceived “censorship, repression, and surveillance” by Russia and China.

Addressing AI in Political Ads

Looking ahead to the 2024 election cycle, the roadmap’s authors are already paying attention to the threats posed by AI-generated election ads. The working group encourages digital content providers to watermark any political ads made with AI and include disclaimers in any AI-generated election content. These guardrails also align with the provisions of several bipartisan election-related AI bills that passed out of the Senate Rules Committee the same day of the roadmap’s release.

Privacy and Legal Liability for AI Usage

The AI Working Group recommends the passage of a federal data privacy law to protect personal information. The AI Working Group notes that the legislation should address issues related to data minimization, data security, consumer data rights, consent and disclosure, and the role of data brokers. Support for these principles is reflected in numerous state privacy laws enacted since 2018, and in bipartisan, bicameral draft legislation (the American Privacy Rights Act) supported by Rep. McMorris Rogers (D-WA), and Sen. Maria Cantwell (D-WA).

As we await additional legislative activity later this year, it is clear that these guidelines will have far-reaching implications for the AI industry and society at large.

© 2024 ArentFox Schiff LLP
For more on AI Policy, visit the NLR Communications, Media & Internet section.

Payday: Terminated Employee Awarded $78,000 in EEOC Settlement

Employees returning to work following a hospitalization or illness can present legally nuanced issues, particularly if an employer is considering terminating an employee in close proximity to such a leave. A recent case settled by a company with the Equal Employment Opportunity Commission (EEOC) highlights some of the legal risks that can come into play.

According to an EEOC press release: “The EEOC charged in [a lawsuit] that, in February 2022, [a company] fired a long-tenured receptionist, despite having recognized the 78-year-old employee as one of its employees of the year in January 2022. The receptionist’s termination came shortly after a brief hospitalization. The EEOC alleged that upon the receptionist’s return to work, [the company’s] general manager asked her how long she planned to continue to work, whether she needed to work, and whether she would prefer to spend her time traveling and seeing family instead of working.

Although the receptionist expressed her desire to continue working, and despite having never previously raised substantial performance concerns to the receptionist, the general manager told the receptionist that [the company] had lost confidence in her ability to work, citing her recent hospitalization. The receptionist was fired the next day and replaced by substantially younger employees.”

The EEOC alleged that these actions violated the Americans with Disabilities Act (ADA) and the Age Discrimination in Employment Act (ADEA), noting the alleged statements about “losing confidence” in the employee due to a hospitalization could be viewed as disability discrimination (the ADA defines “disability” very broadly), and the fact the employee was over the age of 40 (i.e., in the protected age group) and replaced with a younger employee could give rise to an inference of age discrimination under the ADEA.

The company elected to settle the allegations. As part of the settlement, the company agreed to pay $78,000 to the terminated employee. In addition, it entered into a two-year consent decree that also requires it to “revise its ADEA and ADA policies, post a notice in the workplace informing employees of the settlement, and train all employees and supervisors on their rights and responsibilities under both the ADEA and the ADA. Moreover, the company agreed to provide the EEOC with periodic reports regarding any future complaints of age or disability discrimination including a description of each employee’s allegations and the company’s response.”

Accordingly, this case serves as an important reminder that employee terminations should be carefully evaluated with respect to legal risks under various employment laws. Vetting such risks on the front end may mitigate pain on the back end.

© 2024 BARNES & THORNBURG LLP

International Groups Call for DOJ Whistleblower Program to Incorporate Best Practices

The Department of Justice (DOJ) is in the midst of developing a whistleblower award program. According to Acting Assistant Attorney General Nicole M. Argentieri, “the whole point of the DAG’s 90-day ‘policy sprint’ is to gather information, consult with stakeholders, and design a thoughtful, well-informed program.”

Since the Deputy Attorney General Lisa Monaco announced the policy sprint on March 7, whistleblower advocates in the U.S., including Kohn, Kohn & Colapinto, have consulted with the DOJ, outlining key elements of other successful whistleblower programs which should be incorporated in the DOJ program.

On May 13, a coalition of anti-corruption organizations and law firms from over twenty countries sent a letter to the DOJ emphasizing that an effective DOJ whistleblower program could greatly aid international anti-corruption efforts.

“We, the undersigned organizations, believe that a U.S. Department of Justice whistleblower rewards program has the potential to be instrumental to each of our anti-corruption efforts,” write the organizations.

“However, without careful consideration for the unique risks of international whistleblowers and without the implementation of the best-practice protocols identified above, this program could be damaging for international whistleblowers, and their catalytic role in transnational anti-corruption efforts,” the letter continues.

In the letter, the organizations call on the DOJ to incorporate four proven best practices for whistleblower award programs. These best practices mirror those previously called for by Kohn, Kohn & Colapinto. Allison Herren Lee, former SEC Commissioner and currently Of Counsel at Kohn, Kohn & Colapinto, outlined these four elements in a recent article for the Harvard Law School Forum on Corporate Governance.

The four recommendations are:

1. Mandatory Awards of 10-30% of Proceeds Collected

2. Anonymous and Confidential Reporting Channels

3. Dedicated Whistleblower Office

4. Eligibility Requirements which Match the SEC Whistleblower Program

Geoff Schweller also contributed to this article.

Copyright Kohn, Kohn & Colapinto, LLP 2024. All Rights Reserved.
For more on the DOJ Whistleblower Program, visit the NLR Criminal Law / Business Crimes section.

CEQ Finalizes “Phase 2” Revisions to NEPA Implementing Regulations

The Council on Environmental Quality (“CEQ”) is tasked with issuing National Environmental Policy Act (“NEPA”) regulations to guide federal agencies in its implementation. In 2021, CEQ began a two-phase process to revise these regulations. “Phase 1” largely reversed several changes made to the regulations in 2020 under the prior Trump Administration, including key changes relating to defining “purpose and need” and the long-used concepts of direct, indirect, and cumulative effects. The new “Phase 2” revisions are more extensive. Some of the Phase 2 revisions codify in regulation amendments to NEPA made by the Fiscal Responsibility Act of 2023 (“FRA”) and intended to improve the efficiency of the NEPA process, such as establishing page limits for environmental documents and facilitating the use of categorical exclusions (“CEs”). The Phase 2 revisions also restore additional concepts or provisions from the 1978 regulations and case law interpreting those regulations, remove additional changes made in 2020 that CEQ now “considers imprudent,” and, for the first time, specifically require consideration of effects relevant to environmental justice and climate change. We highlight some of these changes below.

The Phase 2 Final Rule will impact a broad range of projects needing federal authorizations or funding. Many of the efficiency measures included in the Final Rule implement changes that were enacted in the FRA. Although these changes could help address some long-standing issues in the NEPA process around delays and litigation, the effect of the proposed changes will be highly dependent on how the individual federal agencies carry out the changes through their own procedures and implementing regulations. Moreover, the Phase 2 Final Rule makes other important changes to the regulations that, rather than streamlining and improving efficiency, could increase burdens and challenges associated with NEPA compliance.

The Phase 2 Final Rule is scheduled to go into effect on July 1, 2024. However, industry groups and others already have signaled their frustration with these revisions, including several key members of Congress, led by Senator Joe Manchin, who have announced that they will seek to overturn the Phase 2 Final Rule using the Congressional Review Act.

Provisions Directed Towards Promoting Efficiency and Streamlining

Page Limits and Timelines. The Final Rule makes many small and some larger changes to promote efficiency and streamline the NEPA process. The Final Rule incorporates the FRA’s page limits of 75 pages for environmental assessments (“EAs”), 150 pages for environmental impact statements (“EISs”), and 300 pages for EISs of “extraordinary complexity.” It includes the FRA’s time limits for completion of NEPA documents, requiring completion of EAs within one year and EISs within two years, although it allows for an agency to extend this deadline, in consultation with any project applicant, to the extent necessary to complete the document. To further promote efficiency, the Final Rule also requires agencies to set deadlines and schedules appropriate to specific actions or types of actions.

Categorical Exclusions. The Final Rule also makes substantial changes to its regulations governing CEs that should facilitate agencies’ adoption of CEs as a tool to streamline NEPA compliance in certain circumstances, as allowed under the FRA. It sets forth a process for agencies to adopt and utilize other agencies’ CEs, as allowed under the FRA without having to amend their regulations. The Final Rule clarifies that agencies can establish CEs individually as well as jointly with other agencies. And it allows agencies to establish CEs through land use plans, decision documents supported by a programmatic EIS or EA, or similar planning or programmatic decisions, without having to go through a separate rulemaking process. According to CEQ, by expanding the means by which agencies can establish CEs, these changes will, among other things, encourage agencies to undertake programmatic and planning reviews, as well as promote and speed the process for establishing CEs.

Programmatic Reviews and Tiering. The Final Rule includes various revisions to codify best practices for the use of programmatic NEPA reviews and tiering, which CEQ acknowledges “are important tools to facilitate more efficient environmental reviews and project approvals.”

Provisions that Could Increase NEPA Compliance Burdens

While the Phase 2 Final Rule emphasizes efficiency, it includes a range of regulatory changes that could have the opposite effect, creating additional burdens and potentially perpetuating opportunities for contentious litigation.

Climate Change, Environmental Justice, and Tribal Resources. Reflected in a wide range of revisions to the regulations, the Phase 2 Final Rule aims to further advance the Biden Administration’s policy focus on climate change, environmental justice, and Tribal resources. Among other provisions, the Final Rule explicitly requires agencies to analyze “disproportionate and adverse human health and environmental effects on communities with environmental justice concerns” and climate change-related effects, including quantification of greenhouse gas emissions where feasible, in their NEPA reviews. Agencies also must review these effects, as well as effects on Tribal rights and resources, in identifying the environmentally preferable alternative or alternatives. Similarly, the Final Rule defines “extraordinary circumstances”—which agencies must consider in determining whether to apply a CE—to include potential substantial disproportionate and adverse effects on communities with environmental justice concerns, potential substantial climate change effects, and potential substantial effects on historic or cultural properties. Moreover, agencies now “should, where relevant and appropriate, incorporate mitigation measures” to address effects “that disproportionately and adversely affect communities with environmental justice concerns.” And the Final Rule directs agencies, where appropriate, to use projections when evaluating climate change-related effects, including relying on models to project a range of possible future outcomes, provided that they disclose relevant assumptions or limitations. While these codifications are new—particularly the regulation directing agencies to consider mitigation for impacts to environmental justice communities—most agencies have been including some environmental justice and greenhouse gas emission impacts in their NEPA reviews based upon federal governmentwide and agency policy and court precedent.

Major Federal Actions. Implementing changes in the FRA and further responding to changes made in the 2020 rule, the Final Rule revises the definition of “major federal action”—the trigger for environmental review under NEPA. The FRA, in addition to specifying that a major federal action requires “substantial Federal control and responsibility,” established several exclusions including for certain types of projects receiving loans, loan guarantees, or other types of federal financial assistance. In an effort to address some of the uncertainty raised by these exclusions, the revised regulations provide that major federal actions generally include “[p]roviding more than a minimal amount of financial assistance, . . . where the agency has the authority to deny in whole or in part the assistance due to environmental effects, has authority to impose conditions on the receipt of the financial assistance to address environmental effects, or otherwise has sufficient control and responsibility over the subsequent use of the financial assistance” or effects of the funded activity.

Alternatives. The Phase 2 Final Rule clarifies that agencies are not required to consider “every conceivable alternative to a proposed action” but rather only “a reasonable range of alternatives that will foster informed decision making.” Additionally, the revised regulations provide that agencies have the discretion, but are not required, to include reasonable alternatives not within the lead agency’s jurisdiction. CEQ continues to anticipate that this will occur relatively infrequently and notes that such alternatives still must be technically and economically feasible and meet the proposed action’s purpose and need. The Final Rule also requires that environmental documents (and not just records of decision) identify one or more environmentally preferable alternatives, which could be the proposed action, the no action alternative, or a reasonable alternative.

Mitigation. Although NEPA has long been understood to be a procedural, rather than substantive, requirement, the Phase 2 Final Rule includes several provisions intended to encourage agencies to mitigate the impacts of proposed actions and to ensure that mitigation measures that agencies rely on in making their environmental determinations are actually carried out. When an agency incorporates and relies upon mitigation measures—whether in its analysis of reasonably foreseeable effects or in a mitigated finding of no significant impact—the revised regulations require the agency to explain the enforceable mitigation requirements or commitments to be undertaken and the authority to enforce them (for example, permit conditions, agreements, or other measures), and to prepare a monitoring and compliance plan.

Development of New Information. While agencies generally historically have not been required to develop data that was not readily available, CEQ “now considers it vital to the NEPA process for agencies to undertake studies and analyses” that provide information “essential to a reasoned choice among alternatives,” provided the overall costs are not unreasonable, and includes provisions to that effect in the Final Rule.

Exhaustion, Judicial Review, and Remedies. The Phase 2 Final Rule removes several changes included in the 2020 rule relating to exhaustion, judicial review, and remedies that were intended to reduce NEPA-related litigation and project delays.

The Phase 2 revisions take effect on July 1, 2024, and apply to any NEPA process that commences after that date, although the Final Rule states that agencies may apply them to ongoing activities and environmental documents that commence prior to that date. In addition to following the CEQ regulations, agencies also have adopted agency-specific NEPA implementing procedures. Agencies must revise these procedures to incorporate changes necessitated by the Phase 2 Final Rule by July 1, 2025.

© 2024 Van Ness Feldman LLP
For more news on Environmental Regulation Implementations, visit the NLR Environmental, Energy & Resources section.

The New Retirement Security Rule: Updated Fiduciary Definition Under ERISA

On April 23, 2024, the U.S. Department of Labor (the “DOL”) promulgated a final rule, titled the “Retirement Security Rule” (the “Final Rule”), updating the definition of an “investment advice fiduciary” under the Employee Retirement Income Security Act of 1974, as amended (“ERISA”). In addition, the DOL issued final amendments to several prohibited transaction class exemptions (“PTEs”) available to investment advice fiduciaries, which together with the Final Rule seek to effectuate the DOL’s goal of requiring honest investment advice from investment advice fiduciaries to retirement investors. The updated fiduciary definition under the Final Rule and the amended PTEs will become effective on September 23, 2024, with a one-year phase-in period for certain conditions of the amended PTEs.

Fiduciary Definition

The framework for determining whether a person is an investment advice fiduciary has historically required that investment advice be provided to a retirement investor on a regular basis and pursuant to a mutual agreement, arrangement, or understanding that such advice will serve as a primary basis for investment decisions.

Under the Final Rule, a person will be an investment advice fiduciary for purposes of ERISA if (1) they make a recommendation of any securities transaction or other investment transaction or any investment strategy to a retirement investor for a fee or other compensation (direct or indirect), and (2) such recommendation arises in either one of the following contexts:

  • The person either directly or indirectly (e.g., through or together with any affiliate) makes professional investment recommendations to investors on a regular basis as part of their business, and the recommendation is made under circumstances that would indicate to a reasonable investor in like circumstances that the recommendation:
    • is based on review of the retirement investor’s particular needs or individual circumstances,
    • reflects the application of professional or expert judgment to the retirement investor’s particular needs or individual circumstances, and
    • may be relied on by the retirement investor as intended to advance the retirement investor’s best interest; or
  • the person represents or acknowledges that they are acting as a fiduciary under ERISA with respect to the recommendation.

For purposes of the Final Rule, a “retirement investor” is defined as a plan, plan fiduciary, plan participant or beneficiary, IRA, IRA owner or beneficiary, or IRA fiduciary. “Recommendations” means recommendations as to:

  • the advisability of acquiring, holding, disposing of, or exchanging securities or other investment property, investment strategy, or how securities or other investment property should be invested following a rollover, transfer, or distribution from a plan or IRA;
  • the management of securities or other investment property, including, among other things, recommendations on investment policies or strategies, portfolio composition, selection of other persons to provide investment advice or investment management services, selection of investment account arrangements, or voting of proxies appurtenant to securities; or
  • rollovers, transfers, or distributions of assets from a plan or IRA, including recommendations as to whether to engage in the transaction, the amount, the form and the destination of such a rollover, transfer or distribution.

Significant Changes

The investment advice fiduciary standard in the Final Rule has become narrower than initially anticipated:

  • The DOL clarified that with respect to a person who becomes an investment advice fiduciary due to their representing or acknowledging that they are acting as a fiduciary under ERISA with respect to a recommendation, fiduciary status would apply only with respect to that recommendation and not with respect to every future interaction with the same retirement investor regardless of the circumstances.
  • The Final Rule includes a paragraph specifically confirming that sales pitches and investment education can be provided without triggering ERISA fiduciary status. A key component of this consideration is whether a sales pitch is individualized to a retirement investor’s particular needs and circumstances.

Amendment to Exemption for Transactions Involving Investment Advice (PTE 2020-02)

PTE 2020-02 generally permits parties providing fiduciary investment advice to retirement investors to receive reasonable compensation in exchange for their services, which would otherwise be prohibited in the absence of an exemption. The final amendment to PTE 2020-02 broadens the exemption to cover additional transactions and revises certain conditions, including conditions relating to disclosure, recordkeeping, and ineligibility.

The amended PTE 2020-02 applies to covered transactions on or after September 23, 2024; however, there is a one-year phase-in period beginning on September 23, 2024. During this phase-in period, investment professionals may receive reasonable compensation if they comply with the Impartial Conduct Standards and the fiduciary acknowledgement requirement.

Required Disclosure and Fiduciary Acknowledgement

The amended PTE 2020-02 requires investment advisers to provide a written acknowledgement that the institution and the investment professional are providing fiduciary advice and are fiduciaries under ERISA. Furthermore, the amended PTE 2020-02 requires investment advisers to make certain additional disclosures regarding fees, scope of services, and conflicts of interest.

Impartial Conduct Standard

The amended PTE 2020-02 replaces the “best interest standard” for determining impartial conduct with the “Care Obligation” and the “Loyalty Obligation,” which, according to the DOL, are more consistent with the Securities and Exchange Commission’s Regulation Best Interest. Under the Care Obligation, advice must reflect the care, skill, prudence, and diligence under the circumstances then prevailing that a prudent person acting in a like capacity and familiar with such matters would use in the conduct of an enterprise of a like character and with like aims, based on the investment objectives, risk tolerance, financial circumstances, and needs of the retirement investor. Under the Loyalty Obligation, the investment professional must not place the financial or other interests of the professional, their affiliate or related entity, or other party ahead of the interests of the retirement investor or subordinate the retirement investor’s interests to those of the professional, their affiliate, or related entity.

Policies and Procedures

Each investment adviser must establish, maintain, and enforce written policies and procedures prudently designed to ensure that the investment adviser and its investment professionals comply with the Impartial Conduct Standards and other exemption conditions. The policies must mitigate conflict of interests.

Specifically, investment advisers may not use quotas, appraisals, bonuses, special awards, differential compensation, or other similar actions in a manner that is intended, or that a reasonable person would conclude are likely, to result in recommendations that do not meet the Care Obligation or Loyalty Obligation. The investment adviser must provide their complete policies and procedures to the DOL within 30 days of a request.

Additionally, the investment adviser must continue to conduct a retrospective review at least annually that is reasonably designed to detect and prevent violations of and achieve compliance with the conditions of this exemption. The investment adviser must maintain records demonstrating compliance with PTE 2020-02 for a period of six years after the covered transaction.

Penalties

The amended PTE 2020-02 broadens the disqualification provisions to include convictions of certain affiliated entities and foreign convictions. Previously, an investment adviser or an investment professional was ineligible only upon a conviction for “crimes arising out of such person’s provision of investment advice” to retirement investors. Under the amended PTE 2020-02, however, a relevant conviction or final judgment that occurs on or after September 23, 2024, with respect to an entity in the same controlled group as an investment adviser would result in such investment adviser’s becoming ineligible to rely on PTE 2020-02 for a 10-year period.

The DOL’s Retirement Security Rule has broad implications for financial institutions, including investment advisers.

COPYRIGHT © 2024, STARK & STARK
For more on the Retirement Security Rule, visit the NLR Labor & Employment section.

Poor Oversight: Healthcare Company & Owner to Pay $1 Million for Care Plan Oversight Service Billing Fraud

The United States announced that Chicago-based healthcare company Apollo Health Inc. (Apollo), and its owner, Brian J. Weinstein, will pay $1 million to resolve False Claims Act allegations. The claims state that Apollo, under the direction of Weinstein, submitted bills to Medicare for services that were never performed. The case was brought by two whistleblowers who will be rewarded for their efforts.

From December 2014 through March 2017, Apollo allegedly submitted Medicare claims for care plan oversight services (CPO) that did not occur. CPOs detail a physician’s duties to supervise a patient receiving complex medical care. Weinstein allegedly directed Apollo to submit 12,592 CPO service claims for over two dozen providers employed by Apollo, despite Weinstein’s knowledge that no services had been rendered to Medicare patients, and no CPO services were documented in medical records.
Medicare fraud undermines the trust and integrity of the healthcare system, resulting in significant financial burdens on taxpayers. When individuals or organizations engage in fraudulent activities, such as billing for services not rendered or submitting false claims, they siphon funds from Medicare’s intended beneficiaries. Medicare fraud diminishes the resources available for legitimate healthcare services for truly ill Medicare beneficiaries.
The settlement resolves claims brought by two whistleblowers, also known as relators, under the qui tam provisions of the False Claims Act. Javar Jones and Louis Curet, the relators in the case, will receive 20% of the settlement amount for bringing the fraudulent activity to the United States’ attention. Whistleblowers who report fraud against the government via a qui tam lawsuit can earn a 15-25% share of the government’s recovery.

© 2024 by Tycko & Zavareei LLP
For more news on Whistleblower Settlements, visit the Criminal Law / Business Crimes section.

Fourth Circuit Holds Firm Against Expansion of Religion-Based Defenses to Discrimination (US)

What happened in the interim that ended this beloved educator’s decorated teaching career? In 2014, shortly after North Carolina recognized same-sex marriage, Mr. Billard posted on his personal Facebook page that he and his partner of fourteen years were engaged to be married.

Lonnie Billard was a well-loved and decorated drama and English teacher at Charlotte Catholic High School (CCHS) in Mecklenburg County, North Carolina. He was named Teacher of the Year in 2012 after serving the Catholic high school’s students for eleven years.

Two years later, CCHS told Mr. Billard he was not welcome back as a teacher.

CCHS has never denied why it fired Mr. Billard: his plans to marry violated the Mecklenburg Diocese’s policy against teachers engaging in conduct contrary to the moral teachings of the Catholic faith. Mr. Billard filed a charge with the Equal Employment Opportunity Commission (EEOC) alleging sex discrimination in employment. The EEOC issued a notice of right to sue. Mr. Billard sued in federal court. He won and was awarded stipulated damages.

If that were the end of the story, although a frustrating one for Mr. Billard and his husband, the case would hardly be newsworthy. Why the case warrants attention is the defense that CCHS did not assert, and why.

The ‘Ministerial Exception’

Throughout the second half of the twentieth century, a judicially crafted concept known as the “ministerial exception” emerged among federal appellate courts: Religious institutions may discriminate in their treatment of certain employees, notwithstanding Title VII, provided that the employee plays a vital ministerial employment role or is involved in ecclesiastical matters. Indeed, ministerial exception is a misnomer because the exception is not limited to those employees holding titles of independent religious significance (e.g., priest, pastor, rabbi, imam), but also applies to employees holding important positions within churches and other religious institutions. The Supreme Court recognized the ministerial exception in Hosanna-Tabor Evangelical Lutheran Church & Sch. v. EEOC, 565 U.S. 171 (2012). Although the Court refused to answer directly the question of who is and is not a minister, it found on the facts of the case before it that a “called teacher” with the title of “Minister of Religion, Commissioned” fit the bill.

Hosanna-Tabor was binding law when Mr. Billard filed suit in 2017. CCHS’s obvious defense to Mr. Billard’s allegations of sex discrimination was that he, as a Catholic school teacher engaged to teach his students in accordance with diocesan mission, fell within the ministerial exception, but in an unusual turn of events, CCHS waived this argument. In fact, CCHS stipulated with Mr. Billard that it would not argue that his job duties qualified him for the ministerial exception. Why? CCHS claims that it waived the ministerial exception defense because it wanted to avoid the burden of discovery around the issue of whether Mr. Billard’s role was sufficiently ministerial. (More on that below.) Since CCHS waived the best defense available to it and unequivocally admitted why it fired Mr. Billard, it’s no wonder he prevailed.

The Appeal

On appeal, CCHS propounded four affirmative defenses it had advanced without success at the trial court level – none of which included the ministerial exception. First, CCHS asserted two First Amendment-based defenses: the “church autonomy” doctrine and freedom of association. The trial and appellate courts quickly disposed of both theories, concluding that CCHS’s “church autonomy” argument was another way of trying to dress up the ministerial exception and, as to freedom of association, the courts found “no precedent for privileging a right of expressive association over anti-discrimination laws.” CCHS also asserted a statutory defense under the Religious Freedom Restoration Act (RFRA), but the courts made quick work of this too, finding that the RFRA does not apply to suits between private parties.

But CCHS’s fourth and final argument, and by far its most controversial, was that the trial court should have exonerated it under Title VII’s religious exemption. This notion, which is different than the First Amendment-inspired ministerial exception and derives from the plain text of Title VII, exempts certain religious organizations from Title VII’s non-discrimination strictures “with respect to the employment of individuals of a particular religion.” 42 U.S.C. § 2000e-1(a). For instance, a Baptist church may favor hiring a Baptist minister or liturgical worship leader over a Methodist or Lutheran candidate, regardless of their respective qualifications. But the religious exemption has only ever been applied as a defense to claims of religious discrimination. Seeking to overturn decades of precedent, CCHS argued in Billard for an unprecedented expansion of the exemption, one that would permit religious organizations to discriminate even on the basis of sex, race or national origin as long as religious belief motivated the employment decision. At oral argument before the Fourth Circuit Court of Appeals, CCHS conceded that its proffered interpretation of the religious exemption would permit discrimination against not only the relatively small number of employees of religious institutions with a claim to ministerial status, but also the hundreds of thousands of groundskeepers, custodians, bus drivers, musicians and administrative personnel that work for such institutions but whose duties are non-ecclesiastical.

An interpretation like that for which CCHS called would seriously erode protections against discrimination. For instance, under CCHS’s interpretation of the religious exemption, if a religious employer asserted as a principle of its faith that women should not work outside the home, it should be permitted to discriminate on the basis of sex. Likewise, under CCHS’s reading of the exemption, a religious employer asserting a faith-based reason for preferring one race over another would be exempt from Title VII consequences. And, to close the loop, if a religious employer held as a religious tenet that being gay or marrying one’s gay partner was a moral lapse, then it should be permitted to discriminate on the basis of sexual orientation.

The Fourth Circuit balked at CCHS’s statutorily ungrounded argument for an expansion of the religious employer exemption. The text of Title VII is ambiguous and exempts religious organizations “with respect to the employment of individuals of a particular religion”; it does not protect discrimination against individuals because of religion. The appellate court was also unimpressed by CCHS’s attempt to force a determination on these grounds by earlier waiving the ministerial exception. Therefore, the Fourth Circuit set aside the parties’ waiver and found sua sponte (meaning on the Court’s own initiative), that CCHS was not liable for discrimination for terminating Mr. Billard because he was, notwithstanding his secular teaching subjects, “a messenger of CCHS’s faith.”

The Fourth Circuit explained that it was constrained to reach this outcome based on developing jurisprudence interpreting the ministerial exception. In the years since Mr. Billard filed suit, the Supreme Court expanded on Hosanna Tabor in Our Lady of Guadalupe Sch. v. Morrissey-Berru, finding in 2020 that two secular subject teachers at religious schools were nonetheless ministers within the ministerial exception as they were entrusted with educating and forming students in the school’s faith. (Notably, CCHS was represented by The Becket Fund for Religious Liberty. The Becket Fund was also lead counsel in Our Lady of Guadalupe, a fact which raises a few questions about the plausibility of CCHS’s explanation for waiving the ministerial exception. The Becket Fund claims to be a “leader[ ] in the fight for religious liberty … at home and abroad,” and has fought against COVID-19 mandates, contraception care and LGBT and unmarried parent foster and adoption rights.)

The appellate court’s decision undoubtedly provides little comfort to Mr. Billard, who is now spending his retirement with his husband whom he married in May 2015. But even though the Fourth Circuit reversed judgment in his favor and instructed the trial court to enter judgment in CCHS’s favor on the grounds that the ministerial exception protected the school, it at least rejected CCHS’s request for unfettered license to discriminate on any basis so long as it articulated a faith-based motive for doing so. As CCHS proved victorious and therefore lacks grounds to appeal to the Supreme Court, for now, religious employers remain insulated from civil interference with decisions about the appointment and removal of persons in positions of theological significance—even high school drama teachers—but may not use purported religious beliefs to justify discrimination on other grounds.

© Copyright 2024 Squire Patton Boggs (US) LLP
For more news on Religious-based Discrimination Defenses, visit the NLR Civil Rights section.

Death, Taxes, and Crypto Reporting – The Three Things You Cannot Escape

The IRS released a draft of Form 1099-DA “Digital Asset Proceeds from Broker Transactions” in April which will require anyone defined as a “broker” to report certain information related to the sale of digital assets. The new reporting requirements will be effective for transactions occurring in 2025 and beyond. The release of Form 1099-DA follows a change in the tax law.

In 2021, Congress amended code section 6045 to define “broker” to include any “person who (for consideration) is responsible for regularly providing any service effectuating transfers of digital assets on behalf of another person.” This is an expansion of the definition of a “broker.” The language ‘any service effectuating transfers of digital assets’ is oftentimes construed by many in the tax practitioner community as a catch-all term, in which the government could use to determine many people involved in digital asset platforms aa “brokers.”

The IRS proposed new regulations in August 2023 to further define and clarify the new reporting requirements. Under the proposed regulations, Form 1099-DA reporting would be required even for noncustodial transactions including facilitative services if the provider is in a “position to know” the identity of the seller and the nature of the transaction giving rise to gross proceeds. With apparently no discernible limits, facilitative services include “services that directly or indirectly effectuate a sale of digital assets.” Position to know means “the ability” to “request” a user’s identifying information and to determine whether a transaction gives rise to gross proceeds. Under these proposed regulations and the expanded definition of “broker,” a significant number of transactions that previously did not require 1099 reporting will now require reporting. There has been pushback against these proposed regulations, but the IRS appears determined to move forward with these additional reporting requirements.

Copyright ©2024 Nelson Mullins Riley & Scarborough LLP
For more news on Taxes and Crypto Reporting, visit the NLR Tax section.

The Psychology Behind Distracted Driving: Understanding the Urge to Multitask

There was a time when modern devices like smartphones, GPS devices, and infotainment systems in cars didn’t exist, but drivers still had to contend with other distractions. These included children in the back seat, beautiful scenery, and daydreaming, which are also leading causes of car accidents.

All forms of distractions are dangerous to some extent. But there may be nothing you can do to help in some cases, for example, getting lost in thought while at the wheel.

Activities like talking on the phone, texting, messing with the infotainment system, watching a video clip, etc., call for multitasking and are 100 percent avoidable, especially considering the dangers they pose. But it may not be as easy as it sounds, as it is part of human nature to want to multitask.

What Is Multitasking?

Psychology describes multitasking as the act of handling more than one task at a time. The complexity of multitasking and its effect on the brain depends on the types of activities a person is engaging in at once.

For example, it doesn’t take a lot in terms of brain faculties to listen to music while driving, so such a thing isn’t much of a big deal. However, being in a conference meeting while driving is difficult, as both activities require much more attention, making the chances of getting into a car accident much higher.

How Does Multitasking Affect the Brain?

People handle multitasking differently, but it doesn’t make it safe for anyone while at the wheel. The science behind how the brain functions shows that the human brain can handle one task at a time, so it’s right to say there is nothing like multitasking as far as the brain goes.

What looks like multitasking is actually the brain switching between different tasks at a relatively high speed, but it can only focus on one task at any given millisecond. Eventually, the switching back and forth affects focus, accuracy, and a person’s effectiveness.

The Psychology of Distracted Driving

Distracted driving at face value is a choice. However, if you dig deeper, you will realize it takes much more than making a choice to keep off because it also has something to do with most drivers’ psychology. Technology, especially communication technologies like social media, are built to be attention-grabbing, and the more time you stay on there, the more perceived satisfaction you get.

There is always the allure of knowing what has happened in the past few minutes, how your post is doing, who’s liking it, and stuff like that. This allure and the dopamine hits individuals get from the likes and comments make staying away a battle against the mind.

There is also social pressure, and this is especially true for younger drivers. Since everyone talks of doing it, or how good they are at it, the habit seems less and less risky.

Drives can be boring and too monotonous. For people who love mind-stimulating activities, their minds always crave something exciting that only a device can offer.

You Can Avoid Driving Distracted

It won’t be easy to break a bad habit. But understanding that multitasking is a myth and that it’s only a matter of time till you make a terrible mistake should make you want to think twice about it.

It is a matter of life and death, so the question is not if you like keeping off your devices but if you want to save lives. Be intentional, even when it means putting distractions out of reach until you reach your destination.

Buckfire & Buckfire, P.C. 2024
For more news on Avoiding Distracted Driving, visit the NLR Utilities & Transport section.

How to Recover Attorneys’ Fees in a Schedule A Trademark Case in the Northern District of Illinois

In recent years, a substantial number of “Schedule A” trademark infringement cases have been filed in the Northern District of Illinois. In such a case, the trademark owner may file a trademark infringement complaint against a number of defendants, with the complaint identifying the defendants as “The Individuals, Corporations, Limited Liability Companies, Partnerships and Unincorporated Associations Identified on Schedule A hereto.” [See, e.g., Opulent Complaint]

The trademark owner may file Schedule A separately from the complaint with a request to the Court that the schedule be placed under seal. Sometimes, trademark owners file the entire complaint under seal. After filing sealed pleadings that shield the defendants’ identities, the trademark owner may then file ex parte motions for temporary restraining orders (“TROs”) against the secretly-named defendants. Because the proceedings are ex parte, the alleged infringer is not given notice of the proceedings or an opportunity to appear. If the Court grants the TRO, the trademark owner may then present the TRO to online marketplaces with a demand that the marketplaces immediately stop selling the allegedly infringing goods. The result may be that an alleged infringer may find all of its activity frozen by the online marketplace, including a freeze on the alleged infringer’s cash held with the online marketplace. This may create cashflow problems for the alleged infringer and prevent the alleged infringer from making future sales. Because its identity is sealed by the court, an alleged infringer may first learn of the TRO after its accounts are frozen.

Schedule A cases appear to be concentrated in the Northern District of Illinois because judges in that district have been receptive to granting ex parte relief. See, A. Anteau, “The Northern District of Illinois v. the Internet: How Chicago Became the Center of Schedule A Trademark Infringement Litigation”; Law.Com, December 19, 2023. At least two judges in that district even provide templates for TROs, preliminary injunctions and default judgments in Schedule A cases. See Northern District of Illinois (uscourts.gov); Northern District of Illinois (uscourts.gov). The justification for the ex parte nature of these proceedings is that it, if notice was required, online counterfeiters (frequently from China) could hide their assets or move their counterfeit products to new sites as soon as an infringement case was filed.

Notwithstanding the foregoing, remedies and relief do exist if an entity is the subject of a wrongfully obtained ex parte TRO. Recently, Ya Ya Creations, a defendant in a Schedule A trademark case, obtained an attorneys’ fees award against a plaintiff that failed to conduct a proper investigation before naming two Ya Ya-affiliated entities as alleged infringers in a case filed in the Northern District of Illinois. [Award of Fees] The dispute began in August 2021, when the plaintiff filed a lawsuit against Ya Ya for trademark infringement and a variety of other causes of action in the Eastern District of Texas. The Texas court transferred the case to the Central District of California in April of 2022. Four months after the transfer, the plaintiff filed a very similar lawsuit against Ya Ya in the Middle District of Florida. On May 26, 2023, the Florida court transferred the case to the Central District of California, and then the CD California consolidated the cases due to the similarity of the facts and claims. On September 26, 2023, the plaintiff filed yet another lawsuit. This time, the plaintiff filed a Schedule A trademark infringement case against a number of defendants in the Northern District of Illinois. In the Schedule A case, the plaintiff named two entities affiliated with Ya Ya as alleged infringers.

Notwithstanding the litigation history between the parties, the plaintiff obtained an ex parte TRO against Ya Ya in the Northern District of Illinois. Ya Ya first learned about the TRO after the court issued it and after an online marketplace froze Ya Ya’s accounts.

Ya Ya’s first step in seeking redress was to file an emergency motion asking the court to dissolve the ex parte TRO. [Ya Ya Motion to Dissolve TRO] Ya Ya argued that, because the parties were actively litigating against each other in California, the plaintiff had no basis to seek ex parte relief against Ya Ya or its affiliated entities without notifying Ya Ya of the proceedings. Ya Ya also argued that the plaintiff’s ex parte TRO was a transparent attempt to gain a litigation advantage in the California cases to either leverage a settlement, force Ya Ya into a position where it could not even pay its lawyers to mount a defense, or force Ya Ya to file for bankruptcy. In response to Ya Ya’s motion to dismiss, the plaintiff agreed to dismiss all of its claims against the Ya Ya-affiliated entities.

Ya Ya’s next step was to file a motion for recovery of the attorneys’ fees it expended in the Northern District of Illinois proceedings. [Ya Ya Request for Reimbursement of Attorneys’ Fees]. In response, the plaintiff argued that it was not obligated to pay Ya Ya’s attorneys’ fees, because it did not know the entities it named in the Northern District of Illinois lawsuit were affiliated with Ya Ya. But the court rejected that argument. The court concluded that, pursuant to Federal Rule of Civil Procedure 11, a court may award attorneys’ fees incurred while defending an ex parte TRO when (1) the TRO caused “needless delay” and unnecessarily “increased the cost of litigation,” or (2) the TRO was obtained by pleadings that were not “well grounded in fact” or made after “reasonable inquiry.” The Court determined that plaintiff could have avoided increasing the costs of litigation if it had conducted a reasonable inquiry to determine if the two entities were affiliated with Ya Ya, but it failed to do so. As a result, the Court awarded Plaintiff to pay Ya-Ya almost $100,000 in attorneys’ fees.

Trademark litigators should be aware that judges in the Northern District of Illinois have been receptive to granting ex parte TROs in trademark cases. If you represent a client that is the subject of an improperly granted ex parte TRO, be prepared to move quickly to dissolve the TRO and consider whether you have a basis to move for an award of attorneys’ fees.

Copyright © 2024, Sheppard Mullin Richter & Hampton LLP.
For more news on Recovering Trademark Infringement Attorney’s Fees, visit the NLR Intellectual Property section.