Securities Health Insurance

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CMS Requests Input on Health Plan Innovation Initiatives

Medicare Advantage (“MA”) plans, prescription drug plans (“PDPs”), and other stakeholders have until November 3, 2014, to provide input into the Centers for Medicare & Medicaid Services’ (“CMS’s”) consideration of potential...more

Expect Focus - Regulators Are Watching: New Products, New Opportunities, New Risks - Volume III, Summer 2014

In This Issue: - IN THE SPOTLIGHT ..Standard CGL Policy Form Adds Data Breach Coverage Exclusion - LIFE INSURANCE ..Class Claims Against Lincoln National Barred in Section 419 Action – Again ...more

Unprecedented HIPAA Fine May Mean Increased Scrutiny and Penalties

Triple-S Management Corp. (“Triple-S”), a Puerto Rico-based health insurer, has been fined $6.8 million by the Puerto Rico Health Insurance Administration (“PRHIA”) following a Health Insurance Portability and Accountability...more

Insurance Topics We Will Be Watching in 2014

With the first month of the year behind us, this report outlines major insurance topics that we will be watching throughout 2014. Forces, trends and events that we believe will affect regulation, transactions and...more

Employment Law -- Jun 19, 2013

Exempt or Nonexempt, That is The Question - Employers who believe in multitasking could be facing unpaid overtime suits from managers after the California Court of Appeal ruled that a grocery store manager could not...more

Revision of Earnings Due to Overbilling Supports Fraud Claims

Allegations that a medical device manufacturer knowingly overbilled insurance companies and reported these unrecoverable accounts as income were sufficient to support security fraud claims. According to plaintiffs, Zynex...more

IRS Issues Guidance on the Deduction Limitation of Code Section 162(m)(6)

On December 23, 2010, the Internal Revenue Service issued Notice 2011-2, providing long-awaited guidance on the application of Internal Revenue Code (Code) section 162(m)(6) as added by the Patient Protection and Affordable...more

Scienter Inadequately Pled Under the Standard Set Forth in the PSLRA

The U.S. District Court for the Southern District of Indiana dismissed plaintiff’s securities fraud action against a nationwide health care benefits provider, and its officers and directors, in which plaintiff alleged that...more

Third Circuit Holds That Mixed Present/Future Statements Are Protected By Reform Act Safe Harbor

In In re Aetna, Inc. Securities Litigation, No. 09-2970, 2010 WL 3156560 (3d Cir. Aug. 11, 2010), the United States Court of Appeals for the Third Circuit held that certain allegedly misleading statements regarding the...more

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