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CareFirst Suffers Cyberattack, Data Breach of 1.1 Million Customers’ Information

BREAKING NEWS: Health insurer CareFirst BlueCross BlueShield disclosed today that hackers gained access to one of its databases, exposing personally identifiable information for approximately 1.1 million people....more

Insurance Recovery Law - May 2015 #2

Recent Lawsuit Underscores Critical Lessons for Purchasers of Cyber Insurance - Why it matters: Columbia Casualty Company v. Cottage Health Systems was filed on May 7, 2015, in the Central District of California. Cottage...more

Recent Lawsuit Underscores Critical Lessons for Purchasers of Cyber Insurance

Columbia Casualty Company v. Cottage Health Systems, No. 2:15-cv-03432, was filed on May 7, 2015 in the Central District of California. Cottage Health is one of the first cases nationwide—if not the first case—in which the...more

DOL’s Proposal To Expand Fiduciary Definition Would Bring Many Service Providers Into Scope

As we previously reported, the US Department of Labor (DOL) released its reproposed rule “Definition of the Term ‘Fiduciary’; Conflict of Interest Rule—Investment Advice” on April 14. The initial deadline for comments on the...more

ERISA (3rd Circuit): Even a Voluntary Settlement Can Mean “Some Success on the Merits” When Awarding Attorney Fees?

You know that a court has discretion to award attorney fees under ERISA if a party shows “some degree of success on the merits.” But how do you define “success”? A new third circuit case reminds one of that old Milton...more

Manatt on Health Reform: Weekly Highlights - May 2015 #3

Washington and Iowa report surges in insurer participation in Marketplaces for 2016; Maine considers legislation to maintain premium subsidies regardless of King v. Burwell. KING V. BURWELL ACTIVITY: Maine:...more

CNA Denies Cyber Insurance Claim

Key takeaway: The insurance applications and underwriting questionnaires prepared in connection with cyber insurance do matter. Cyber security, and cyber insurance, have dominated the industry headlines for several...more

Early Termination of Annuities Not Permitted

Since investing can be a risky business with investments dropping in value from time to time, investors seeking steady income with minimal risk are sometimes attracted to an annuity’s guaranteed-income feature. A recent case...more

Compensation and Benefits Insights – April 2015 #3

Employers and plan sponsors must comply with numerous filing and notice deadlines for their retirement and health and welfare plans. Failure to comply with these deadlines can result in costly penalties. To avoid such...more

Surprise Bills Laws Enacted in California and New York

What Do They Mean for Providers? - Both California and New York have recently enacted so-called “Surprise Bills Laws” that require out-of-network providers to give notice to patients that a particular item or service...more

Arizona Court: Argument that All Business Income Loss Caused by a Wildfire is Covered is “Off Base”

Several weeks ago in White Mt. Communities Hosp., Inc. v. Hartford Cas. Ins. Co., 2015 WL 1755372, 2015 U.S. Dist. LEXIS 50900 (D. Ariz., Apr. 17, 2015), an Arizona federal court underscored that business interruption losses...more

4th Cir. Sides with Surgeon in Disability Policy Dispute

On May 5 the Fourth Circuit reversed a District Court decision upholding Lloyd’s of London’s rescission of a Maryland surgeon’s disability policies. Lloyd’s had rescinded the policies because the surgeon gave false answers...more

Medigap Insurer's Contract with Preferred Hospital Network Approved (Yet Again)

On April 22, 2015, the Department of Health and Human Services, Office of Inspector General (OIG) issued Advisory Opinion 15-05 [PDF], approving a Medigap insurer’s proposed contract with a preferred hospital network. The...more

Iowa Supreme Court Affirms Ruling for Health Insurer in Antitrust Dispute

In late February, the Iowa Supreme Court affirmed a lower court ruling in Mueller v. Wellmark, ending a seven year battle over whether the health insurer’s agreement with employers operating “self-funded” insurance plans to...more

Insurance Antitrust Legal News: Volume 4, Number 3

Auto Insurers Again Seek Dismissal of In Re Auto Body Shop Antitrust Litigation - In early March, the auto insurer defendants in the In re Auto Body Shop Antitrust Litigation renewed their motions seeking the dismissal...more

Maryland Legislative Update

On April 13, 2015 after the release of the traditional sine die balloons and streamers, the first General Assembly of the newly elected Governor Lawrence J. Hogan, Jr. concluded with much success. With bills awaiting...more

Manatt on Health Reform: Weekly Highlights - May 2015

This week Montana became the 30th state to expand Medicaid, and the battle over Medicaid expansion and uncompensated care reached a breaking point in Florida. Meanwhile, as the King v Burwell decision looms, Congress and...more

Wellness Programs and the EEOC, Part One

On May 29, 2013, the U.S. Department of Labor, the U.S. Department of the Treasury, and the U.S. Department for Health and Human Services finalized rules regarding wellness programs offered in conjunction with group health...more

NC Legislative Update for May 2015

This Week - “Crossover” - the date by which a bill must pass out of the chamber in which it originated to remain eligible for the 2015-16 session - expired on Thursday. Throughout the week, lawmakers cumulatively...more

All or Nothing: Federal Court Decides Exclusion from ‘Some’ Patients Insufficient for Refusal to Deal Claim

A federal district court in the Eighth Circuit dismissed claims brought against a physician-hospital organization and an insurer alleging that the defendants violated federal antitrust laws by refusing to deal with certain...more

Manatt on Medicaid: Montana Governor Signs Act to Expand Medicaid

On April 29, 2015, Montana Governor Steve Bullock signed Senate Bill 405, referred to as the Montana Health and Economic Livelihood Partnership Act (HELP Act), which expands Medicaid to cover an estimated 70,000 new adults....more

The Soon-to-be Reality of Medicare Part B Reimbursements for Biosimilars

As the country’s largest health insurer, Medicare has immense influence on the health care market. In the wake of the recent approval of Sandoz’s Zarxio (filgrastim-sndz), the first FDA-approved biosimilar, last month the...more

Health Care Update - April 2015 #3

In This Issue: - House E&C Proceeds with Cures Initiative this Week - Congress Continues Budget Considerations; Health Care Playing Leading Role - Implementation of the Affordable Care Act - Other Federal...more

HHS Settlement: Dumpster-Diving Leads to Settlement for Improper Disposal of Documents Containing Protected Health Information

The U.S. Department of Health and Human Services Office for Civil Rights (HHS) recently announced that it has reached an agreement with a small pharmacy to resolve potential HIPAA violations. The settlement arose from the...more

HIPAA Rules and Procedures in the Event of a Data Breach, Part One

As discussed in my prior post, recent massive data breaches at major retailers and health insurance providers paint a bleak picture of modern data and emphasize the importance of strong security safeguards and plans for...more

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