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Section 1557 of the ACA: The Legal Side of Health Equity

This week marks the end of National Minority Health Month and its 2016 theme of “Accelerating Health Equity for the Nation.” This month, the HHS Office of Minority Health’s goal was to “raise awareness of the health...more

Insurance Policy Definitions Essential to Wage-and-Hour Claim Coverage

As discussed in the first installment of our three-part series on insurance protection against wage-and-hour claims, policyholders have looked to two types of traditional insurance for protection against employment...more

Life and Annuity Series: Cost-of-Insurance Charge Litigation

Plaintiffs' lawyers have been challenging cost-of-insurance (COI) charges for years, with mixed results. The following outline reviews the most recent flurry of cases. ...more

The Supreme Court - March 2016 #6

The Supreme Court of the United States issued one decision on March 30, 2016: - Luis v. United States, No. 14-419: Petitioner Sila Luis was charged with various health care related crimes. Pursuant to a federal...more

Health Care Discrimination Litigation Gets a New Set of Teeth under the ACA: 2015 Litigation Review and Preview of 2016

Discrimination in health care was prohibited before the Affordable Care Act, but on a limited basis. Protected classes did not include sex; prohibitions excluded private physicians accepting Medicare Part B; and, most...more

Office Love Affairs: How to Prevent Scandal

Are things starting to get a little steamy around the office? Perhaps two employees have started to take long glances at each other from across the conference room, text each other like crazy, or maybe they have been known to...more

Health and Welfare Plans: Big Compliance Burdens, Big Penalty Exposures

Health and welfare have been around for a long time, and they are ubiquitous. Employees have come to expect medical, dental, life, and other insurance as part of their benefits packages. Employers offer coverage in order to...more

Senate Bill Would Strengthen Mandate That People With Disabilities Be Integrated in the Community

Senator Charles Schumer (D-NY) recently introduced the Disability Integration Act of 2015 (DIA) in the U.S. Senate. If passed, the bill would require states and health insurers to provide services to people with disabilities...more

Summary of California Appellate Decisions - January 2016

Insurance Coverage; Vandalism and Malicious Mischief Exclusion - Hung Van Ong v. Fire Insurance Exchange (2015) 235 Cal.App.4th 901, 185 Cal.Rptr.3d 524 - Facts: The insured had a vacant apartment building....more

FTC's Big Data Report Provides Road Map for Insurers Using Big Data

On January 6, the Federal Trade Commission ("FTC") released a report entitled "Big Data: A Tool for Inclusion or Exclusion? Understanding the Issues" ("Report") that follows the FTC's September 15, 2014 workshop on "the...more

Health Care Coverage for California Employers After Obergefell v. Hodges

After the U.S. Supreme Court’s landmark marriage-equality decision this summer (Obergefell v. Hodges), we now have full equality between same-sex and opposite-sex spouses under federal and state law. That decision affects...more

HHS Releases Far-Reaching Proposed Rule to Prohibit Discrimination by “Covered Entities” Pursuant to Section 1557 of the...

On September 8, 2015, the U.S. Department of Health and Human Services (“HHS”) published a proposed rule titled “Nondiscrimination in Health Programs and Activities” (“Proposed Rule”)[1] to implement the nondiscrimination...more

Regulators make whistleblowing rules

FCA and PRA have published their feedback, rules and policy documents on whistleblowing. The rules complement the senior manager regime (SMR) and reforms of remuneration rules. The new rules affect...more

HHS Proposes Rules for Nondiscrimination in Health Care

On September 8, 2015, the U.S. Department of Health and Human Services (“HHS”) proposed new regulations implementing Section 1557 of the Patient Protection and Affordable Care Act (“ACA”). Section 1557 prohibits...more

Nondiscrimination in Health Programs and Activities: Proposed Rules from HHS

...So, why did HHS need over five years to propose the set of rules published September 8? Here are a few highlights. For brevity’s sake, we omit foreign language service requirements, disability accommodation, compliance...more

California Employment Law Notes - September 2015

Newly Enacted California Statutes - The Word "Alien" Is Stricken From The California Labor Code - Section 1725 of the California Labor Code defines "alien" as "any person who is not a born or fully naturalized...more

The Future of Healthcare Discrimination Litigation-Section 1557 of the ACA

This article was originally published by American Health Lawyers Association. Copyright 2015, American Health Lawyers Association, Washington, DC. Reprint permission granted. It is no secret that the Affordable Care Act...more

Not-So-Sudden Impact: Insurers Face A New Breed Of Claim Under the Fair Housing Act (Part 3 of 3)

This is the final article of a three-part series about two recent decisions by federal courts in Connecticut and California: Viens v. America Empire Surplus Lines Ins. Co., No. 3:14cv952 (D. Conn. June 23, 2015), and Jones v....more

Not-So-Sudden Impact: Insurers Face A New Breed Of Claim Under the Fair Housing Act (Part 2 of 3)

This is the second article of a three-part series about two recent decisions by federal courts in Connecticut and California: Viens v. America Empire Surplus Lines Ins. Co., No. 3:14cv952 (D. Conn. June 23, 2015), and Jones...more

Wal-Mart Accused of Gender-Discrimination Because of Anti-Gay Insurance Policies

In Cote v. Wal-Mart Stores, Wal-Mart is facing the possibility of a class action suit from a former employee who claims that the company’s denial of healthcare benefits to her same-sex spouse amounts to sex discrimination....more

Not-So-Sudden Impact: Insurers Face A New Breed Of Claim Under the Fair Housing Act (Part 1 of 3)

Late in June, in Texas Dept. of Housing v. Inclusive Communities, No. 13–1371 (U.S. June 25, 2015), the U.S. Supreme Court ended years of debate by embracing a “disparate impact” claim against a housing authority under the...more

The Supreme Court Addresses Federal Health Care Subsidies and Same-Sex Marriage

Two recent Supreme Court decisions have implications for employee benefit plan sponsors: King v. Burwell, decided June 25, 2015, and Obergefell v. Hodges, decided June 26, 2015....more

What does "will be insured" actually mean?

Balancing obligations to provide health and life insurance benefits to retirees with other legitimate business needs can be tricky. Although retirees depend on the benefits, employers may need to modify benefit plans for...more

Virginia Federal Court Sustains Late Notice Disclaimer

In its recent decision in E Dillon & Co. v. Travelers Cas. & Sur. Co. of America, 2015 U.S. Dist. LEXIS 76295 (W.D. Va. June 12, 2015), the United States District Court for the Western District of Virginia, applying Virginia...more

Two key legislative developments impact wellness plans, non-qualified deferred compensation plans

Employer-sponsored “wellness programs” have been a growing trend for years. Many employers have established having some form of such a program to help employees become more aware of their physical well-being. The idea of an...more

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