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Splits Are Not the Best for Business: Uncertainty after Conflicting Decisions on the Scope of Obamacare Subsidies

The recent decisions by the Fourth Circuit and the D.C. Circuit address a controversy that could have far-reaching consequences for the Patient Protection and Affordable Care Act (the “ACA”). Under the ACA, states and the...more

Circuit Court Split on ACA Could Impact Employer Penalties

In conflicting opinions released on July 22nd, two federal circuits split on whether Affordable Care Act subsidies are available under a federally operated health insurance exchange. “Pay or play” penalties apply only if...more

Halbig v. Burwell: A Death Blow for the Affordable Care Act?

On July 22, 2014, a three-judge panel of the U.S. Court of Appeals for the District of Columbia Circuit ruled in Halbig v. Burwell that the Affordable Care Act (ACA) authorizes the issuance of tax credits to assist...more

Employee Benefits Developments - April 2014

Supreme Court Holds Severance Payments Are Subject to FICA Taxes - Reversing a decision by the Sixth Circuit Court of Appeals, the U.S. Supreme Court ruled unanimously that severance payments to employees who were...more

HIPAA Impaired Providers and the ER - What Happens When Your Employee Becomes Your Patient?

I was speaking this week at IAHIMA’s Annual Conference on the issues relating to HIPAA audits and recent updates from OCR and ONC. As part of my program we typically solicit questions prior to the presentation, most of which...more

Labor & Employment E-Note - April 17, 2014

In This Issue: - Employers Face Increasing Number of Religious Bias Suits - Small Business Owners Concerned About Overtime Pay Requirements - Rising Number of Wage Theft Lawsuits Highlight Enforcement Issues -...more

Feds’ Argument in Favor of Premium Tax Credit Gains Momentum, Still Under Attack in Federal Courts

A second federal district court judge has ruled in favor of the government on one of the most serious challenges to the Patient Protection and Affordable Care Act of 2010 (ACA). The court dismissed a challenge to the...more

Reefer Madness: Employees May Use Medical Marijuana Yet Be Fired For Doing So

Despite twenty states allowing the use of medicinal marijuana and two more – Colorado and Washington – allowing recreational marijuana use, employers remain unaffected. Courts consistently find that employers may terminate...more

New York Federal Court Rules Public Hospitals Are Exempt from State Labor Laws

On October 16, 2013, a New York federal district court granted a partial motion to dismiss a Fair Labor Standards Act (FLSA) class action suit against the New York City Health & Hospitals Corp. (HHC), finding that HHC is a...more

Courts Split On Whether Mandatory Contraceptive Coverage Violates Religious Freedoms Of For-Profit Corporations

Under the Patient Protection and Affordable Care Act’s preventive services mandate, non-grandfathered group health plans must provide 100% coverage of contraceptives for women, subject to exemptions and safe harbors for...more

Medical Marijuana Comes To Illinois In 2014 – How Do Employers Weed Through The Impact On The Workplace?

Last month, Illinois became the 21st state to adopt a medical marijuana law. The law, which is tabbed as a four-year pilot program legalizing the use of marijuana for medical purposes, becomes effective on January 1, 2014 and...more

Hospital’s State Law Claims against Health Plan Held Preempted by ERISA, Rules NJ Appellate Division

Last month a NJ Appellate Division panel held in three consolidated appeals that a NJ hospital’s state law claims that a health care plan must pay full price for medical services the hospital provided to plan participants are...more

Healthcare Legal Alert: Former Nurse Asks U.S. Supreme Court To Settle Circuit Split On Meal Break And Timekeeping Issue

On July 22, 2013 a former nurse asked the U.S. Supreme Court to resolve a circuit split, which she claims the Sixth Circuit created when it found that the nurse's admitted failure to follow the hospital's procedures for...more

Supreme Court Clarifies Subrogation Rights, Emphasizes Need for Precise Plan Language

Plan sponsors, particularly those that sponsor self-funded health plans, should review plan document provisions in light of the recent decision of the Supreme Court of the United States in US Airways, Inc. v. McCutchen. In...more

Employees Who Smoke (Part II) – The Exception for Health Insurance Plans

So yesterday, I made a convincing case that employees who smoke outside the workplace can’t be treated differently than your non-smokers. ...more

The ERISA Litigation Newsletter - September 2012

In This Issue: - Editor's Overview - ERISA Preemption in Provider Misrepresentation Claims: An Overview of the Jurisprudence Leading Up to the Fifth Circuit's En Banc Review of Access Mediquip and What Lies...more

Affordable Care Act Runs Into Religious Freedom Issues in Court

Although the Supreme Court, in a landmark decision earlier this summer, affirmed the constitutionality of the Patient Protection and Affordable Care Act (ACA), the challenges to and controversies surrounding that Act are far...more

Employers in Florida Face State-Specific Employee Benefit Plan Issues

Employers with Florida employees face certain state-specific employee benefits compliance challenges. While in general ERISA preemption will serve to minimize the number of state laws applicable to the ERISA-governed benefit...more

Labor: Employment protections under medical marijuana laws

Originally published in InsideCounsel.com - February 20, 2012. Delaware’s Medical Marijuana Act exemplifies the battle between state and federal marijuana laws The age of medical marijuana has arrived. Sixteen...more

Effect of New Michigan Health Insurance Claims Assessment Act on Group Health Plans

The new Michigan Health Insurance Claims Assessment Act imposes a 1-percent tax on “paid claims” for health-related services of employer-sponsored health and welfare plans. Employer plan sponsors with...more

Pharmaceutical Sales Representative Case Goes to Supreme Court

In a previous post in August, I questioned whether the pharmaceutical companies were losing the exemption battle as it related to pharmaceutical sales representatives and the outside sales exemption. The Supreme Court had...more

Supreme Court to Hear Challenges to Health Care Reform

The Supreme Court announced on Monday, November 14, 2011 that it will hear challenges to the Patient Protection and Affordable Care Act (PPACA). President Obama signed PPACA on March 23, 2010, and legal challenges to the...more

Healthcare Update - November 2011 No. 4

In This Issue: A Look Ahead: Four Trends Healthcare Employers Should Continue to Watch By A. Kevin Troutman (Houston) With the year drawing to a close, this is a good time to examine four significant trends in...more

When Negligence Becomes Deliberate

When pharmacists actively obstruct access to birth control, what are the appropriate legal measures to take in protecting the patient's rights to basic health care while respecting a pharmacist's rights to free speech? This...more

SmithKline Beecham Wins On "Outside Salesman" Exemption

The Ninth Circuit U.S. Court of Appeals (Alaska, Arizona, Hawaii, Idaho, Montana, Nevada, Oregon, and Washington) has added another chapter in the saga of whether pharmaceutical sales representatives (PSRs) qualify for the...more

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