News & Analysis as of

Discrimination › Medicare

Discrimination is prejudicial treatment related to (or inappropriate consideration of) an individual's actual or perceived membership in a particular class, group or category, such as an individual's... more +
Discrimination is prejudicial treatment related to (or inappropriate consideration of) an individual's actual or perceived membership in a particular class, group or category, such as an individual's race, religion, gender, age, to name a few.  less -
Jackson Lewis P.C.

“Final” Section 1557 Nondiscrimination Regulations – Round 3: Impact on Employer Health Plans

Jackson Lewis P.C. on

Section 1557 is the non-discrimination provision of the Affordable Care Act (ACA). Section 1557, which has been in effect since 2010, is intended to prevent discrimination in certain health programs or activities that...more

Whiteford

New CMS Guidance on Use of Algorithms and AI in Prior Authorizations and Utilization Management

Whiteford on

Use of algorithms and artificial intelligence (AI) in prior authorization and utilization management is facing growing criticism and litigation. Notable lawsuits include alleged automatic authorization denials for tests that...more

Manatt, Phelps & Phillips, LLP

CMS Weighs in on the Use of Algorithms and Artificial Intelligence in Coverage Determinations

Manatt, Phelps & Phillips, LLP on

Apparently in light of recent litigation against Medicare Advantage (MA) plans, on February 6, 2024, CMS published responses to frequently asked questions (FAQs) regarding the use of algorithms and artificial intelligence in...more

Cozen O'Connor

The State AG Report – 4.28.2023

Cozen O'Connor on

Here are curated AG and federal regulatory news stories highlighting key areas in which state and federal regulators’ decisions are having an impact across the US: •FTC Targets Optometrists, Ophthalmologists Suspected of...more

Sheppard Mullin Richter & Hampton LLP

2023 Payment Rule’s Nondiscrimination Provisions and Anticipation of New Section 1557 Rules

Sheppard Mullin Richter & Hampton LLP on

On January 5, 2022, we discussed the Notice of Benefit and Payment Parameters for 2023 proposed rule released by the Centers for Medicare & Medicaid Services (CMS). On April 28, 2022, CMS issued the NBPP 2023 Final Rule. CMS...more

Michigan Auto Law

The Risks of Older Drivers Using Medicare instead of Michigan No-Fault Auto Insurance

Michigan Auto Law on

By allowing seniors to opt out of No Fault for Medicare, SB 787 jeopardizes seniors’ medical and financial health after a car crash - It sounds good, at first. Allowing senior and elderly drivers to opt out of Michigan auto...more

Manatt, Phelps & Phillips, LLP

How Will the Trump Administration Impact Healthcare Litigation?

Manatt, Phelps & Phillips, LLP on

Editor's Note: In a dramatic conclusion to the heated debate surrounding the American Health Care Act (AHCA), the bill was withdrawn after it became clear that House leadership did not have enough votes to pass it. There is...more

Fisher Phillips

The Patient Is Not Always Right: Discriminatory Staffing Requests Can Create Legal Exposure

Fisher Phillips on

Employer reports of bigoted or inappropriate comments made by customers to employees or other patrons have become increasingly common for employers in all industries. In the healthcare industry, this often takes the form of a...more

FordHarrison

Texas Court Enjoins Enforcement of Regulation that Would Forbid Discrimination in Healthcare on the Basis of Gender Identity and...

FordHarrison on

As LGBTQ rights have taken center stage in political and social issues, FordHarrison has been following ground-breaking litigation related to LGBTQ rights and providing updates. In the latest decision, a federal judge in...more

Tucker Arensberg, P.C.

Telehealth News

Tucker Arensberg, P.C. on

Iowa Supreme Court Rejects Ban on Telemedicine Abortions - An Iowa Board of Medicine rule requires the presence of a physician when abortion inducing drugs are provided....more

Proskauer - Employee Benefits & Executive...

Eighth Circuit Says That Considerations Of Health Care Cost Savings Could Be Proxy For Age In ADEA Suits

Proskauer - Employee Benefits & Executive... on

The Eighth Circuit recently concluded that an employer may violate the ADEA by terminating an older employee in order to reduce its health care premiums. Tramp v. Associated Underwriters, Inc., 2014 WL 4977396 (8th Cir....more

Winstead PC

U.S. Supreme Court Ruling: Defense of Marriage Act ("DOMA")

Winstead PC on

While the U.S. Supreme Court(the “Court”) ruled section 3 of the Defense of Marriage Act (“DOMA”) unconstitutional, that does not mean that the changes for human resources departments and employee benefits plans can be...more

Sherman & Howard L.L.C.

2013 and 2014 under the Affordable Care Act - Updated as of May 14, 2013

Sherman & Howard L.L.C. on

This is an update on an earlier Client Advisory on this subject, with updates to reflect recently issued guidance. Employers should consider the following checklist of new requirements as the nation moves ahead with...more

Ervin Cohen & Jessup LLP

In Case You Were Confused, Medicare is for the Benefit of Employees, not Employers

Ervin Cohen & Jessup LLP on

Most employers these days know that they cannot set a mandatory retirement age for employees. This arcane practice runs directly afoul of the Age Discrimination in Employment Act (ADEA)....more

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