Insurance | JD Supra

Justice Department Lawsuit Reveals Roadmap to Avoid False Claims Act Liability

by James Holloway | Ober|Kaler on 5/23/2013

Earlier this month, the Justice Department filed a lawsuit against Vitas Hospice Services, LLC, and related entities, alleging that Vitas fraudulently billed the Medicare program in violation of the False Claims Act (FCA)....more

A Recent Development in “Wage and Hour” Insurance

by Rachel Kronowitz, Jason Rubinstein | Gilbert LLP on 5/23/2013

In our August 1, 2012 blog entry titled “Insurance Coverage for Wage and Hour Litigation Claims,” we discussed the recent surge in wage and hour litigation and the potential for insurance coverage related to wage and hour...more

Insurance Coverage For Businesses Affected By The Oklahoma Tornado

by Koorosh Talieh | Perkins Coie on 5/23/2013

Many businesses in Oklahoma have been impacted by the devastating tornado that hit that state on May 20, 2013. Early estimates indicate the tornado caused upwards of $2 billion in damage....more

OIG's Special Advisory Bulletin on the Effect of Exclusion—Continuing the Focus on Individual Accountability

by George Breen, Jonah Retzinger, Carrie Valiant | Epstein Becker & Green, P.C. on 5/23/2013

On May 8, 2013, the U.S. Department of Health and Human Services' Office of Inspector General ("OIG") released an Updated Special Advisory Bulletin on the Effect of Exclusion from the Participation in Federal Health Care...more

Healthcare Law -- May 21, 2013

by Manatt, Phelps & Phillips, LLP on 5/22/2013

Clearing up the Rumors around Health Reform Delays: What Really Happened, What Won’t and Steps Employers and Insurers Can Take Now - Rumors are flying in health policy circles that the Obama Administration might delay...more

Exclusions: OIG Offers Relationship Counseling to Providers

by Summer Swallow | BakerHostetler on 5/22/2013

On May 8, 2013, the U.S. Department of Health and Human Services Office of Inspector General (OIG) issued an updated Special Advisory Bulletin on the Effect of Exclusion from Participation in Federal Health Care Programs...more

CMS Issues Final MLR Rule for Medicare Advantage and Part D Programs

by Roy M. Albert, Susan Berson | Mintz Levin - Health Law on 5/22/2013

Last week, CMS published a final rule implementing the ACA’s medical loss ratio (“MLR”) requirements that will apply to the Medicare Advantage (Part C) and prescription drug (Part D) programs beginning in contract year 2014. ...more

Groundhog Day for Tuomey: Jury Finds Hospital Violated Stark Law and False Claims Act

by Darby C. Allen, Donna S. Clark | BakerHostetler on 5/22/2013

On May 8, 2013, a jury in the Columbia Division of the U.S. District Court for the District of South Carolina returned a verdict finding that Tuomey Healthcare Systems, Inc. (Tuomey) violated the Stark Law and the federal...more

Do Liability Policies, Particularly Pollution Liability Insurance Policies, Exclude Coverage for All Injunctions? The Fifth...

by Robert S. Sanoff | Foley Hoag LLP - Environmental Law on 5/22/2013

The Fifth Circuit handed down an important decision last week, Louisiana Generating LLC v. Illinois Union Insurance Company, clarifying the scope of coverage under a Premises Pollution Liability Insurance Policy. The...more

U.S. Department Of Labor Issues Model Notices Of Health Insurance Options

by Michael N. Morea | Cole Schotz on 5/22/2013

By October 1, 2013, most employers will be required to provide their current employees and new hires with notices of health insurance options. The notice is required to, among other things, inform employees of the existence...more

Judicial Notice Doctrine Bolstered by Court of Appeal Decision

by Travis Wall | Barger & Wolen on 5/22/2013

A recent California decision should make it easier for insurers to attack allegations at the pleading stage in state court actions. ...more

The Employer's Playbook for ACA Compliance: Are You In The 2014 "Pay Or Play" Game?

by Dan S. Brandenburg, Sarah Lockwood Church, Joanne G. Jacobson, Paul Kasicky, Joni Landy, Kevin Wiggins | Saul Ewing LLP on 5/22/2013

For better or worse, the ACA or Health Care Reform is still with us. If you do not want to end up in the penalty box in 2014, you must know whether you are subject to the employer shared responsibility provisions of the ACA...more

CMS Prevails in DSH Challenge Involving Waiver-Expansion Days

by Thomas W. Coons | Ober|Kaler on 5/22/2013

Over the years, CMS and its contractors have wrestled with how days approved under a Medicaid demonstration project should be counted, if at all, for purposes of the Medicare disproportionate share hospital (DSH) calculation....more

CMS Updates Manual to Reflect Ambulance Fee Schedule Reduction for Non-Emergency BLS Transports of Patients With ESRD

by King & Spalding on 5/22/2013

On May 10, 2013, CMS issued a transmittal clarifying the requirement in Section 637 of the American Taxpayer Relief Act of 2012 (ATRA) that ambulance payments for non-emergency basic life support (BLS) transports for end...more

Historical Tort System Claim Values Cannot Be Reduced By "Nuisance" Settlements and "Implicit Defense Costs" To Determine Present...

by Timothy Durken on 5/22/2013

Delaware Bankruptcy Judge Judith Fitzgerald in the bankruptcies of Specialty Products Holding Corp. (a/k/a RPM, Inc.) and Bondex International, Inc. rejected the Debtors’ “novel” claim estimation approach that reduced from...more

Act Now Advisory: Important Affordable Care Act Deadline: Employee Notices of the Health Insurance Marketplace (Exchange) Due by...

by Michelle Capezza, Gretchen Harders | Epstein Becker & Green, P.C. on 5/22/2013

On May 8, 2013, the Employee Benefits Security Administration of the U.S. Department of Labor ("DOL") issued Technical Release No. 2013-02 ("Release") providing important guidance under the Patient Protection and Affordable...more

A Whiter Shade of Pale -- Building a Private Label Investment Program with Private Placement Life Insurance and Annuities

by Gerald Nowotny on 5/22/2013

Overview - Poor John Paulsen! Now that's an oxymoron! He has to be the most radioactive man on the Planet when it comes to tax planning. Everything he touches in business seems to be couched in subversive tax planning...more

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Insurance Updates

Justice Department Lawsuit Reveals Roadmap to Avoid False Claims Act Liability

A Recent Development in “Wage and Hour” Insurance

Insurance Coverage For Businesses Affected By The Oklahoma Tornado

OIG's Special Advisory Bulletin on the Effect of Exclusion—Continuing the Focus on Individual Accountability

Healthcare Law -- May 21, 2013

Exclusions: OIG Offers Relationship Counseling to Providers

CMS Issues Final MLR Rule for Medicare Advantage and Part D Programs

Groundhog Day for Tuomey: Jury Finds Hospital Violated Stark Law and False Claims Act

Do Liability Policies, Particularly Pollution Liability Insurance Policies, Exclude Coverage for All Injunctions? The Fifth...

U.S. Department Of Labor Issues Model Notices Of Health Insurance Options

Judicial Notice Doctrine Bolstered by Court of Appeal Decision

The Employer's Playbook for ACA Compliance: Are You In The 2014 "Pay Or Play" Game?

CMS Prevails in DSH Challenge Involving Waiver-Expansion Days

CMS Updates Manual to Reflect Ambulance Fee Schedule Reduction for Non-Emergency BLS Transports of Patients With ESRD

Historical Tort System Claim Values Cannot Be Reduced By "Nuisance" Settlements and "Implicit Defense Costs" To Determine Present...

Act Now Advisory: Important Affordable Care Act Deadline: Employee Notices of the Health Insurance Marketplace (Exchange) Due by...

A Whiter Shade of Pale -- Building a Private Label Investment Program with Private Placement Life Insurance and Annuities

Minnesota Policyholder Scores Victory on “Insured Contract” Coverage for Direct Liability Indemnification

Weekly Law Resume - May 16, 2013: Insurance Coverage – Duty to Defend – Vacant Property

Retired County Employees Can Amend Their Complaint In An Attempt To Prove Existence Of A Contract for Health Benefits

Can an Intervening Insurance Company Sue for Breach of Contract?

CFPB settles RESPA enforcement action involving affiliated business arrangements

Proper Disclosure and Documentation the Focal Point in New HIPAA and Medicare Rules

Eighth Circuit Addresses Business Risk Exclusions

ERISA Litigation Alert: Check Your Plan Subrogation and Reimbursement Language to Eliminate “Contractual Gaps”

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