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The Ninth Circuit Weighs in on ERISA’s Plan Document and Summary Plan Description Requirements: Mull v. Motion Picture Ind. Health...

Mull v. Motion Picture Ind. Health Plan educates employers on the basics of the requirements of the Employee Retirement Income Security Act (ERISA) governing plan documents and summary plan descriptions. The lessons are...more

Recent 11th Circuit Decision Is a Victory for Health Care Providers Challenging Insurer Reimbursement Decisions and a Reminder of...

by K&L Gates LLP on

The existence and scope of assignments of benefits from patients to health care providers continues to be critically important to a provider’s ability to challenge an insurer’s reimbursement decision under the Employee...more

Massachusetts Employers Face $200 Million Increase in Health Care Costs under MassHealth Amendments

On August 1, Massachusetts Governor Charlie Baker signed into law H. 3822, “An Act Further Regulating Employer Contributions to Health Care” (the “Act”). The purpose of the Act is to shore up the finances of the...more

New Guidance on Coverage for Eating Disorders

by Tucker Arensberg, P.C. on

The Departments of Labor, Treasury, and Health and Human Services recently released a frequently asked question (“FAQ”) regarding the implementation of the Paul Wellstone and Pete Domenici Mental Health Parity and Addiction...more

Health Alert (Australia) 14 August 2017

by DLA Piper on

In This Issue: - Judgments; Legislation; and Reports. - Excerpts from Judgments: 10 August 2017 - Inquest into the Death of Stephen Herczeg 57/2016 (1808/2016) - The said Court finds that Stephen Herczeg aged 72...more

ACA Reform – What Comes Next?

by Holland & Knight LLP on

The chances that Congress will continue trying to repeal or replace the Affordable Care Act (ACA) have significantly reduced, as the Senate is determined to instead proceed with a tax cut or tax reform....more

Failure To Hold Back Settlement Funds Subject To A Medical Lien Can Expose An Insurer To Treble Damages

by Ellis & Winters LLP on

A court’s decision to impose liability for committing an unfair or deceptive trade practice in a particular case may have wide-ranging implications—even when the amount in dispute in the matter itself is relatively...more

Torts & Insurance Cases from the 4th Circuit Court of Appeals - May 2017

by Nexsen Pruet, PLLC on

Each month, Nexsen Pruet attorney Marc Manos, a member of the SC Bar Torts and Insurance Practice Section Council, sheds light on a few recent cases from the Fourth Circuit Court of Appeals, focused in the area of Torts &...more

Senate Rejects Proposals to Repeal and Replace Affordable Care Act

by McDermott Will & Emery on

Senate Republicans failed to pass legislation to repeal and replace the Affordable Care Act last week. After voting to proceed with debate on the American Health Care Act, which was passed by the House in May, the Senate...more

Healthcare Legislation Outlook and Update

by Holland & Knight LLP on

Below is a summary of recent U.S. Senate action on healthcare legislation and our outlook regarding coming issues and possible actions. Holland & Knight's Healthcare & Life Sciences Team will follow up as developments...more

Health Care Reform Weekly Roundup – Issue 8

Below is a summary of significant health care reform developments over the past two weeks. GOP Repeal and Replace Efforts Stalled. After releasing a revised version of the Better Care Reconciliation Act (BCRA) on July 13,...more

Third Circuit Rules That Johnson Controls Did Not Promise Lifetime Health Benefits

The Third Circuit rejected a claim for lifetime health insurance benefits filed by retired employees of Johnson Controls, finding that the clear and unambiguous language of the CBAs and group insurance booklets did not...more

Health Care Weekly Preview from ML Strategies – July 2017 #4

Following the dramatic conclusion of the failed vote on the repeal of the Affordable Care Act (ACA), it appears the Senate will pivot to other issues, namely the National Defense Authorization Act (NDAA). However, the...more

Senate Fails to Advance Health Care Reform Bill; Next Steps Remain Uncertain

by Baker Ober Health Law on

After a late-night defeat, it appears that Senate Republicans' years-long push to repeal the Affordable Care Act (ACA) has stalled following deep divisions between moderate and conservative members over the goals and various...more

ACA Brief: Path to Repeal—Skinny Repeal Falls in Short Order

This ACA Brief is the sixth in a series of installments that will closely track congressional and administrative actions relating to ACA provisions that impact large employer-sponsored health plans. Early Friday morning,...more

Post-Repeal and Replace: What’s a Sponsor to Do?

by Epstein Becker & Green on

In the wake of the demise of recent Affordable Care Act “repeal and replace” efforts, both “skinny” and full boat, health care financial sponsors may wonder how they should be thinking about opportunities and threats related...more

Double Whammy for United Healthcare: Two False Claims Act Cases in Two Weeks

by Michael Volkov on

The False Claims Act is the government’s weapon of choice in fighting healthcare fraud. In the beginning of the Obama Administration, Congress amended the False Claims Act and enacted a wish list from DOJ prosecutors. ...more

After GOP fails to repeal Obamacare, what’s next for U.S. health care?

As the late, sultry diva Peggy Lee used to croon: Is that all there is? The Republicans in Washington, after seven years of trying and dozens of faux earlier votes, have failed to repeal and replace the Affordable Care...more

Witnesses at Congressional Hearing on 340B Urge Congress To Give HRSA Broader Regulatory Authority

On July 18, 2017, just days after CMS went public with its proposal to reduce Medicare Part B reimbursement to certain 340B covered entities, Congress held its first hearing on 340B Program Oversight since March 2015. A...more

Health Care Weekly Preview from ML Strategies – July 2017 #3

We head into the last week of July with the Findings of the Senate Parliamentarian in hand, who ruled late Friday that several provisions in the Better Care Reconciliation Act (BCRA) released on June 26th would be subject to...more

As Trumpcare founders, GOP offers harsh paths for government on health

The Republicans haven’t waved a white flag—yet. They may never formally surrender. But the GOP’s seven-year, take-no-prisoners campaign to repeal and replace the Affordable Care Act, aka Obamacare, has foundered. For good?...more

Admissibility of Insurance Coverage: Sauce for the Goose

by Faegre Baker Daniels on

When Kerrie Evans’s child was born with cystic fibrosis, she sued her nurse practitioner and doctor for failure to adequately inform her about prenatal testing for CF, making concerns about cost the centerpiece of her...more

Vermont’s New Telemedicine Law Expands Insurance Coverage, Bans Recording

by Foley & Lardner LLP on

Vermont health care providers and patients can now enjoy a revamped, and significantly improved, telehealth commercial insurance coverage law. Vermont Governor Phil Scott signed S. 50 into law on June 7, 2017, expanding...more

A New Hurdle for Medical Malpractice Claimants: Legislation Establishing Medical Review Panels Takes Effect in Kentucky

by Reminger Co., LPA on

In a step toward tort reform, on June 29, 2017, Senate Bill 4 was signed into law and went into effect in Kentucky as KRS 216C.005 et seq., establishing a requirement that all potential medical malpractice lawsuits first be...more

Senate Unveils Changes to the Better Care Reconciliation Act of 2017: Significant Changes, but Uncertainty Remains

by Foley & Lardner LLP on

On July 13th, the Senate released the updated version of the Better Care Reconciliation Act (BCRA) of 2017. While the new version makes some significant changes to the original Senate proposal, the major components of the...more

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