Insurance | JD Supra

California Appellate Courts Clarify and Limit Plaintiffs’ Recovery for Medical Expenses

by Kimberly Jackanich | Sedgwick LLP on 5/25/2013

Throughout the years, plaintiffs’ attorneys in personal injury actions have tried to present the entire amount of medical expenses billed in efforts to increase the plaintiffs’ recovery. Despite the irrelevance of these...more

Reinsurance Redux - May 2013

by Braden A. Borger, Amy S. Kline, Patrick Nugent, Sean T. O'Neill, Brian Simons, Matthew Smith | Saul Ewing LLP on 5/24/2013

In This Issue: - District of New Jersey Stays Medical Malpractice Suit Pending Arbitration: Finding that a dispute between a medical malpractice insurer and a reinsurance underwriter fell squarely within the...more

The Burden of Excluded Parties After OIG’s Special Advisory Bulletin

by Mintz Levin - Health Law on 5/24/2013

The Office of Inspector General for the Department of Health and Human Services (“OIG”) recently issued an updated Special Advisory Bulletin on the Effect of Exclusion from Participation in Federal Health Care Programs, an...more

Department of Labor Releases Updated Model COBRA Election Notice - Notice Incorporates Alternatives to COBRA Available Through...

by Allison De Tal, Isabel Safie, John Wahlin | Best Best & Krieger LLP on 5/24/2013

The Department of Labor (DOL) recently released a revised model COBRA election notice which includes information about coverage available through the state insurance exchanges. This change is aimed at informing individuals of...more

Illinois Supreme Court Holds TCPA Damages Not Punitive

by Traub Lieberman Straus & Shrewsberry LLP on 5/24/2013

Today the Illinois Supreme Court issued its decision in Standard Mutual v. Lay, 2013 IL 114617 (2013). Locklear brought a class action claim against Lay under the Telephone Consumer Protection Act of 1991 (TCPA), which...more

Supplemental Life Benefits, Paid for by Employee, Governed by ERISA

by D. Michael Reilly | Lane Powell PC - ERISA Law on 5/24/2013

You know that many ERISA governed plans provide basic life insurance benefits. But what happens when the plan offers employees the choice to purchase supplemental life insurance? If the employee pays the entire premium...more

Cigna Agrees to Re-evaluate and to Compensate Disability Insureds in the Amount of $77 million

by Gary Bresee | Barger & Wolen on 5/24/2013

In a wide ranging re-evaluation of disability claims covering its insureds in California, Connecticut, Maine, Massachusetts and Pennsylvania, Cigna Corporation may pay up to $77 million in past disability income insurance...more

Florida Business Litigation Update: Florida Appeals Court Requires Insurer to Provide Separate Counsel for Multiple Insureds Under...

by Fuerst Ittleman David & Joseph, PL on 5/24/2013

In Univ. of Miami v. Great Am. Assur. Co., 38 Fla. L. Weekly D392 (Fla. 3d DCA 2013), Florida’s Third District Court of Appeals announced a ruling in a case of first impression that will have a substantial impact in Florida’s...more

Missouri Law Expands to Include Sponsored Captive Insurance Companies

by Sherry Doctorian, Mark Stahlhuth | Armstrong Teasdale LLP on 5/24/2013

With Governor Nixon’s signature on May 16, 2013, the state of Missouri has adopted legislation modifying its captive insurance law. The legislation, Senate Bill 287, will allow the formation of sponsored captive insurance...more

Justice Department Lawsuit Reveals Roadmap to Avoid False Claims Act Liability

by James Holloway | Ober|Kaler on 5/23/2013

Earlier this month, the Justice Department filed a lawsuit against Vitas Hospice Services, LLC, and related entities, alleging that Vitas fraudulently billed the Medicare program in violation of the False Claims Act (FCA)....more

A Recent Development in “Wage and Hour” Insurance

by Rachel Kronowitz, Jason Rubinstein | Gilbert LLP on 5/23/2013

In our August 1, 2012 blog entry titled “Insurance Coverage for Wage and Hour Litigation Claims,” we discussed the recent surge in wage and hour litigation and the potential for insurance coverage related to wage and hour...more

Insurance Coverage For Businesses Affected By The Oklahoma Tornado

by Koorosh Talieh | Perkins Coie on 5/23/2013

Many businesses in Oklahoma have been impacted by the devastating tornado that hit that state on May 20, 2013. Early estimates indicate the tornado caused upwards of $2 billion in damage....more

OIG's Special Advisory Bulletin on the Effect of Exclusion—Continuing the Focus on Individual Accountability

by George Breen, Jonah Retzinger, Carrie Valiant | Epstein Becker & Green, P.C. on 5/23/2013

On May 8, 2013, the U.S. Department of Health and Human Services' Office of Inspector General ("OIG") released an Updated Special Advisory Bulletin on the Effect of Exclusion from the Participation in Federal Health Care...more

Healthcare Law -- May 21, 2013

by Manatt, Phelps & Phillips, LLP on 5/22/2013

Clearing up the Rumors around Health Reform Delays: What Really Happened, What Won’t and Steps Employers and Insurers Can Take Now - Rumors are flying in health policy circles that the Obama Administration might delay...more

Exclusions: OIG Offers Relationship Counseling to Providers

by Summer Swallow | BakerHostetler on 5/22/2013

On May 8, 2013, the U.S. Department of Health and Human Services Office of Inspector General (OIG) issued an updated Special Advisory Bulletin on the Effect of Exclusion from Participation in Federal Health Care Programs...more

CMS Issues Final MLR Rule for Medicare Advantage and Part D Programs

by Roy M. Albert, Susan Berson | Mintz Levin - Health Law on 5/22/2013

Last week, CMS published a final rule implementing the ACA’s medical loss ratio (“MLR”) requirements that will apply to the Medicare Advantage (Part C) and prescription drug (Part D) programs beginning in contract year 2014. ...more

Groundhog Day for Tuomey: Jury Finds Hospital Violated Stark Law and False Claims Act

by Darby C. Allen, Donna S. Clark | BakerHostetler on 5/22/2013

On May 8, 2013, a jury in the Columbia Division of the U.S. District Court for the District of South Carolina returned a verdict finding that Tuomey Healthcare Systems, Inc. (Tuomey) violated the Stark Law and the federal...more

Do Liability Policies, Particularly Pollution Liability Insurance Policies, Exclude Coverage for All Injunctions? The Fifth...

by Robert S. Sanoff | Foley Hoag LLP - Environmental Law on 5/22/2013

The Fifth Circuit handed down an important decision last week, Louisiana Generating LLC v. Illinois Union Insurance Company, clarifying the scope of coverage under a Premises Pollution Liability Insurance Policy. The...more

U.S. Department Of Labor Issues Model Notices Of Health Insurance Options

by Michael N. Morea | Cole Schotz on 5/22/2013

By October 1, 2013, most employers will be required to provide their current employees and new hires with notices of health insurance options. The notice is required to, among other things, inform employees of the existence...more

Judicial Notice Doctrine Bolstered by Court of Appeal Decision

by Travis Wall | Barger & Wolen on 5/22/2013

A recent California decision should make it easier for insurers to attack allegations at the pleading stage in state court actions. ...more

The Employer's Playbook for ACA Compliance: Are You In The 2014 "Pay Or Play" Game?

by Dan S. Brandenburg, Sarah Lockwood Church, Joanne G. Jacobson, Paul Kasicky, Joni Landy, Kevin Wiggins | Saul Ewing LLP on 5/22/2013

For better or worse, the ACA or Health Care Reform is still with us. If you do not want to end up in the penalty box in 2014, you must know whether you are subject to the employer shared responsibility provisions of the ACA...more

CMS Prevails in DSH Challenge Involving Waiver-Expansion Days

by Thomas W. Coons | Ober|Kaler on 5/22/2013

Over the years, CMS and its contractors have wrestled with how days approved under a Medicaid demonstration project should be counted, if at all, for purposes of the Medicare disproportionate share hospital (DSH) calculation....more

CMS Updates Manual to Reflect Ambulance Fee Schedule Reduction for Non-Emergency BLS Transports of Patients With ESRD

by King & Spalding on 5/22/2013

On May 10, 2013, CMS issued a transmittal clarifying the requirement in Section 637 of the American Taxpayer Relief Act of 2012 (ATRA) that ambulance payments for non-emergency basic life support (BLS) transports for end...more

Historical Tort System Claim Values Cannot Be Reduced By "Nuisance" Settlements and "Implicit Defense Costs" To Determine Present...

by Timothy Durken on 5/22/2013

Delaware Bankruptcy Judge Judith Fitzgerald in the bankruptcies of Specialty Products Holding Corp. (a/k/a RPM, Inc.) and Bondex International, Inc. rejected the Debtors’ “novel” claim estimation approach that reduced from...more

Act Now Advisory: Important Affordable Care Act Deadline: Employee Notices of the Health Insurance Marketplace (Exchange) Due by...

by Michelle Capezza, Gretchen Harders | Epstein Becker & Green, P.C. on 5/22/2013

On May 8, 2013, the Employee Benefits Security Administration of the U.S. Department of Labor ("DOL") issued Technical Release No. 2013-02 ("Release") providing important guidance under the Patient Protection and Affordable...more

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