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Court Holds That Physician’s State Law Claim For Disability Benefits Is Preempted by ERISA: Hershan v. Unum Group Corporation

A federal court has held that a radiologist’s state law contract claim for certain disability insurance benefits arose under a welfare benefit plan governed by ERISA and was therefore preempted by ERISA. In Hershan v. Unum...more

Proposed Regulations for Summary of Benefits and Coverage Seek to Simplify Compliance

As part of Health Care Reform, employers and insurers are required to provide group health plan participants with a Summary of Benefits and Coverage (“SBC”) describing the important features of the group health plan option(s)...more

Employer Concerns Regarding the Spread of Measles and Other Infectious Diseases

Action Item: Based on the rising number of issues related to highly communicable diseases like measles, mumps, flu, and Ebola, employers should be proactive rather than reactive in preparing and implementing an infectious...more

Unanimous Supreme Court Decision Eliminates Presumption That Union Retiree Health Benefits Are Vested For Life

In M&G Polymers USA, LLC v. Tackett, the United States Supreme Court invalidated a judicial presumption - commonly referred to as the Yard-Man presumption - that union retiree health care benefits are vested for life in the...more

The 2016 Federal Budget: Targeting Independent Contractor Misclassification as Part of the “Fissured Workplace”

The President released his Fiscal Year 2016 Budget today, February 2, 2015. In furtherance of the President’s budget request, the Labor Department’s Wage and Hour Division provided a 32-page budget justification to Congress...more

Supreme Court Rejects Sixth Circuit's Approach to Retiree Medical Benefits

Ordinary contract principles govern disputes about collectively bargained retiree medical benefits. A Morgan Lewis team secured a major victory for employers when the U.S. Supreme Court, in M&G Polymers USA, LLC v....more

The GPMemorandum, Issue 189

In This Issue: - VICARIOUS LIABILITY - As Part Of Recent Actions, National Labor Relations Board Alleges Mcdonald’s Is A “Joint Employer” In Unfair Labor Complaints Filed Against Mcdonald’s Franchisees -...more

Supreme Court Rejects Analysis of Duration of Retiree Benefits As Contrary to Contract Law

On January 26, 2015, the Supreme Court of the United States resolved a long-standing dispute between the Sixth Circuit Court of Appeals and the remainder of the federal judiciary in a case concerning the extent to which...more

Supreme Court Rejects Yard-Man: Ordinary Contract Principles Apply When Interpreting Retiree Medical Promises

The Supreme Court has unanimously vacated a Sixth Circuit ruling that a collective bargaining agreement (CBA) vested retirees with lifetime medical benefits. M&G Polymers USA, LLC v. Tackett, No. 13-1010, 2015 U.S. LEXIS 759...more

Decision Alert: US Supreme Court Potentially Shifts the Balance in Healthcare Employee Benefits Litigation

Justice Clarence Thomas and a unanimous US Supreme Court decided to vacate a Sixth Circuit decision and hold that the federal courts cannot assume from silence in a union’s collective bargain agreement that retiree group...more

U.S. Supreme Court Rebukes Reliance on Yard-Man In Retiree Health Benefit Dispute

The U.S. Supreme Court ruled that the Sixth Circuit’s reliance on retiree-friendly inferences set forth in UAW v. Yard-Man are incompatible with ordinary principles of contract interpretation and should not be used when...more

Supreme Court Decides M & G Polymers USA, LLC v. Tackett

On January 26, 2015, the U.S. Supreme Court decided M & G Polymers USA, LLC v. Tackett, No. 13-1010, holding that ordinary principles of contract law govern the interpretation of pension and insurance provisions of...more

Traditional Contract Rules Determine Whether Retirees Are Entitled to Lifetime Healthcare Benefits

Yesterday, in a unanimous decision, the U.S. Supreme Court held that courts must apply ordinary rules of contract interpretation when determining whether retiree healthcare benefits vest for life pursuant to the terms of a...more

Health Law Alert: Medical Staff Bylaws can be an Enforceable Contract—Implications of the Recent Minnesota Supreme Court Decision

On Dec. 31, 2014, the Supreme Court of Minnesota issued its long-awaited decision in Medical Staff of Avera Marshall Regional Medical Center v. Avera Marshall. This case has drawn national attention, addressing the unanswered...more

Minn. Sup. Court: Med Staff Bylaws Are a Contract & Staff May Sue

On the last day of 2014 the Minnesota Supreme Court gave a hospital medical staff a double victory, ruling that (1) medical staff bylaws constitute a contract between the hospital and medical staff members and (2) the medical...more

Second Circuit: Class-Wide Reformation Is Appropriate Equitable Relief

In the latest chapter of the Amara saga, the Second Circuit recently affirmed the district court’s class-wide order to reform CIGNA’s cash balance plan, as a means to remedy what the district court previously found to be...more

Often Overlooked, but Effective, Provisions to Consider for your Benefit Plans

The Issue: When benefits under welfare plans – such as health plans and disability plans – are denied, litigation frequently results. In the context of “self-funded” plans (in contrast to “fully insured” plans, which are...more

Reimbursement Changes, Shift to Consumerism Discussed at Akerman Healthcare Briefing

Changing reimbursement models and a shift to consumerism were two of the hot topics discussed at Akerman LLP's recent Healthcare Briefing event titled "Financial and Corporate Implications of the Affordable Care Act: A Look...more

D.C. Circuit Upholds Contraceptive Coverage Mandate

Last week, a unanimous three-judge panel of the D.C. Circuit upheld the religious accommodation to the Affordable Care Act’s (“ACA”) contraceptive coverage mandate (Priests for Life v. HHS, D.C. Cir. No. 13-5368, Nov. 14,...more

Government turns up the heat with the False Claims Act – 5 action steps for healthcare providers

Forbes magazine has dubbed 2014 “The Year of the Whistleblower.” For healthcare providers, this designation has translated into millions of dollars in fines and penalties and the initiation of criminal investigations. ...more

The DOJ Increases Scrutiny of Whistleblower False Claims Act Suits

The Criminal Division of the Department of Justice (“DOJ”) recently announced that it will review all complaints filed under the qui tam provisions of the federal False Claims Act (“FCA”) to determine if a parallel criminal...more

Employment Law Reporter – November 2014: The Impact of Burwell v. Hobby Lobby

Has the Supreme Court “ventured into a minefield,” by its “decision of startling breadth,” as Justice Ruth Bader Ginsburg wrote in her dissent to Burwell v. Hobby Lobby? In Hobby Lobby, the Court held that the contraceptive...more

Is Your Facility Ready for Ebola?

Polsinelli presents Crisis Management: a multi-part series (culminating in a webinar on 11.20.2014) on what companies must know to stay ahead of external interruption that risks serious impact to their business concerns....more

Doctors and Lawyers and Such

When doctors and lawyers get sideways with their business partners, they might dispute whether one or more of them are really “employees.” In a recent case, an anesthesiologist alleged disability and sex discrimination. To...more

Business Interruption Insurance for Ebola – Managing Risk for Hospitals and Healthcare Providers

William Gallagher Associates, a Boston-based insurance broker, has announced the rollout of a new policy to cover Ebola-related losses at hospitals and other healthcare providers involved in primary care emergency treatment. ...more

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