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Court Orders Cigna to Pay Out-of-Network Surgical Claims

On June 1, 2016, the United States District Court for the Southern District of Texas ordered Cigna to pay nearly $13.7 million to Humble Surgical Hospital, LLC (“Humble”). Of the nearly $13.7 million, almost $11.4 million...more

@Work: Your HR and Employment Law Update - June 2016

With the Ohio Senate’s passage of House Bill 523 on May 25, 2016, Ohio is poised to become the nation’s 25th state to legalize medicinal marijuana. Although the proposed state law provides direction for employers, a new OSHA...more

Employment Practices Newsletter - June 2016

EEOC Issues Final Regulations on Wellness Programs - It seems to be a win-win when employers who provide employees with incentives to encourage healthy behavior. But employers that do so must contend with an alphabet...more

A Recent Illinois Decision Explains How to Deal with Medical Staff Claims

The Illinois Supreme Court released a decision on May 19, 2016 that provides useful guidance in defending and protecting a claim by a medical staff member against a hospital for improperly failing to appoint or reappoint or...more

New Restrictions on Physician Non-Competes in Connecticut

A new Connecticut law significantly restricts the use of physician non-compete agreements. Public Act No. 16-95 (the “Act”), signed into law by Governor Dannel Malloy on June 2, 2016, limits the allowable duration and...more

Employees and Employers

Following are two interesting and recent federal court rulings related to arbitration. Future Disputes are beyond Arbitral Authority Minnesota Nurses Association v. North Memorial Health Care After completing 30...more

Update Your Employee Termination Review Checklist

On March 8, 2016, the Oklahoma Supreme Court significantly expanded the reach of the infamous Burk public policy wrongful discharge tort claim in Moore v. Warr Acres Nursing Center, LLC, 2016 OK 28. Here’s the key takeaway...more

8th Cir. Rejects Dr.’s Grab-Bag Retaliation Suit

Dr. Alaa Elkharwily lost his job at Albert Lea Clinic, but he didn’t go quietly. He sued the clinic and eight related organizations and individuals alleging just about everything a terminated doctor can allege in Minnesota:...more

Supreme Court Decides Not to Decide on Latest Challenge to ACA Contraceptive Coverage

The Supreme Court in a unanimous opinion remanded Zubick v. Burwell — and the six cases consolidated with Zubick — back to the Courts of Appeals to rule on the contraceptive opt-out notice provisions. The Court directed the...more

Second Circuit Applies Stricter Rules for a Plan Administrator’s Noncompliance with Benefit Claims Regulations

In Depth - On April 12, 2016, the US Court of Appeals for the Second Circuit in Halo v. Yale Health Plan, 2016 WL 1426291 (2d Cir. Apr. 12, 2016), addressed various issues that could arise during a plan administrator’s...more

Surprising Result in Supreme Court Contraceptive Decision

The U.S. Supreme Court issued an unusual decision in the latest legal challenge to the Affordable Care Act (ACA) to reach the high court. In Zubik v. Burwell, the Court consolidated appeals filed by religious nonprofit...more

High Court Sidesteps Contraceptive Coverage Decision – For Now

The Supreme Court declined to rule on whether religiously affiliated nonprofits can be required to affirmatively “opt out” of providing contraceptive coverage to their employees, which would have triggered separate...more

Illinois Supreme Court Issue Long-Awaited Decision on Vesting of Retiree Health Care Benefits in Matthews v. Chicago Transit...

On May 5th, nearly a full year after it heard oral arguments in the case, the Illinois Supreme Court issued its decision in Matthews v. Chicago Transit Authority, et al., addressing the interplay between a public sector...more

Cummins Power Generation to Pay Over $87,000 to Resolve EEOC Disability Lawsuit

Company Fired Employee for Objecting to Overbroad Medical Releases for Fitness-for-Duty Examination, Federal Agency Charged - MINNEAPOLIS - A Minneapolis-based power company will pay $87,500 and furnish other relief to...more

NLRB Rejects General Employee Behavior Standards in Code of Conduct

The National Labor Relations Board continues its assault on employer handbooks and other policies it considers to impede employees’ rights to engage in protected concerted activity under Section 7 of the NLRA. Last month, the...more

Wrongful discharge – alive and well in Oklahoma

It’s been awhile since Oklahoma’s Supreme Court weighed in on the ability of fired employees to sue their employers for wrongful discharge. Now a vomiting nurse gets to take a shot at the nursing center that terminated his...more

So You’ve Filed Your 1095-C…Now What?

As companies complete their Section 6055 and 6056 reporting under the Affordable Care Act (ACA), now it’s time to be on the lookout for notices regarding ACA penalties....more

Rhode Island Trial Court Decision Could Spell Trouble for Employers Seeking to Enforce Restrictive Covenants Against Healthcare...

One of an employer’s first steps in a suit against a former employee to enforce a restrictive covenant is to seek a preliminary injunction to prevent the employee from continuing to violate his or her contractual obligations....more

What You Say in Your SPD About Claims Processing Makes a Difference

Employers who self fund their medical plans often have contracts with their third party administrators about claims processing. Some of those contracts provide that the claims processor has discretion to decide claims; others...more

Employee Benefit Plans and Data Security Issues

In recent weeks, much of the discussion around a recent Supreme Court case, Gobeille, has focused on ERISA preemption. But for fiduciaries of benefit plans the case can serve as a reminder of important duties that often go...more

Can the ACA Employer Health-Insurance Mandate Be Avoided by Reducing Employees’ Hours? McGuireWoods Healthcare Reform Guide:...

This is the 56th in a series of WorkCite articles concerning the Patient Protection and Affordable Care Act and its companion statute, the Health Care and Education Reconciliation Act of 2010 (referred to collectively as the...more

Supreme Court Seeks Meaning in Falsity and Fraud in the False Claims Act

Oral arguments were heard Tuesday, April 19th by the U.S. Supreme Court in one of the most significant False Claims Act (FCA) cases the Court has dealt with in decades on an issue with very real impact on whistleblower suits...more

Nursing Manager, Removed from Patient Case, Seeks Supreme Court Review in Discrimination Case

Petitioner to the Supreme Court claims that the Sixth Circuit engaged in a “separate but equal” rationale when it rejected her claim that her employer discriminated against her based on race after the employer allegedly...more

Employee Health Plans: Good News / Bad News – State Claims Reporting Laws Do Not Apply, but Recovery of Overpayments Made More...

Employee health plans recently received good and bad news from the Supreme Court. On the upside, the Court invalidated a State law that required self-insured employee health plans (and their third-party administrators) to...more

Bad COBRA Notices Can Cost You

Sun Trust Bank was sued in a class action challenging its COBRA notice. The plaintiffs who brought the lawsuit claimed that the COBRA notice was materially deficient in that it failed to provide the name and address of the...more

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