News & Analysis as of

Employee Retirement Income Security Act (ERISA) Benefit Plan Reimbursements

Verrill

Primer on Severance Plans Under ERISA and the Tax Code

Verrill on

Many employers maintain formal or informal severance policies or practices that they use sporadically. Other employers may implement a severance program for a limited period of time to reduce the number of employees overall...more

Proskauer - Employee Benefits & Executive...

U.S. Supreme Court: No ERISA Preemption for State Law Regulating PBMs

In a unanimous (8-0) opinion authored by Justice Sotomayor, the U.S. Supreme Court held that an Arkansas state law regulating rates at which pharmacy benefits managers (PBMs) reimburse pharmacies is not preempted by ERISA. ...more

Jackson Lewis P.C.

U.S. Supreme Court To Hear ERISA Preemption Dispute

Jackson Lewis P.C. on

On October 6, 2020, the U.S. Supreme Court will hear argument on ERISA’s preemptive effect on a state law regulating pharmacy benefit managers’ (PBMs) generic drug reimbursement rates in Rutledge v. Pharmaceutical Care...more

Seyfarth Shaw LLP

Countdown to the Supreme Court’s ERISA Preemption Oral Argument in Rutledge — Two Noteworthy Case Developments

Seyfarth Shaw LLP on

Seyfarth Synopsis: As the Supreme Court prepares to hear oral arguments on a key case that could have major ramifications on the scope of ERISA preemption, two recent case developments show just how important the high court’s...more

Foley & Lardner LLP

SCOTUS Agrees to Take on ERISA Preemption Once Again!

Foley & Lardner LLP on

In January, the Supreme Court agreed to accept an appeal filed by the State of Arkansas of a decision by the Eighth Circuit Court of Appeals finding that Section 514 of ERISA expressly preempted the state’s maximum allowable...more

Hinshaw & Culbertson LLP

The LHD/ERISA Advisor: Sixth Circuit Rejects MSPA and ERISA Discrimination Claims

Seeking to control healthcare costs, many group health plans have adopted amendments that lower reimbursement rates for the treatment of end-stage renal disease ("ESRD"), which requires long-term dialysis treatment or a...more

Proskauer - Employee Benefits & Executive...

ERISA Preemption Makes A Return To The Supreme Court

The U.S. Supreme Court recently agreed to hear Rutledge v. Pharmaceutical Care Management Association, No. 18-540, a case that asks the Court to decide whether ERISA preempts an Arkansas state law that regulates rates at...more

Seyfarth Shaw LLP

Supreme Court Will Yet Again Opine on the Scope of ERISA Preemption

Seyfarth Shaw LLP on

Seyfarth synopsis: The Supreme Court has just granted certiorari in a case regarding the question of whether ERISA preempts state efforts to regulate Pharmacy Benefit Managers (PBMs). The decision will have important...more

Faegre Drinker Biddle & Reath LLP

The United States Supreme Court Granted Review in 3 Cases This Past Week

Rutledge v. Pharmaceutical Care Management Ass’n, No. 18-540. Most states have enacted legislation regulating “pharmacy benefit managers”— businesses that act as middlemen between health insurers and pharmacies, earning...more

Snell & Wilmer

California Cares . . . About Employees Losing Flexible Spending Account (“FSA”) Funds

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California recently approved Assembly Bill 1554, adding a flexible spending account notice requirement to § 2810.7 of the California Labor Code. The new law, which takes effect January 1, 2020, states...more

Dickinson Wright

Recent Developments in Mental Health Benefit Denials

Dickinson Wright on

The Mental Health Parity and Addiction Equity Act (Parity Act) requires health plans to provide the same coverage for mental health conditions as they provide for physical conditions, and that financial Requirements and...more

Dorsey & Whitney LLP

The Supreme Court Narrowly Defines an ERISA Plan’s Right to Subrogation in Montanile v. Board of Trustees of Nat. Elevator...

Dorsey & Whitney LLP on

Most ERISA group health plans have subrogation terms – that is, terms allowing the plan to recover benefits paid to injured participants who later recover a tort settlement for their injuries. These subrogation claims are...more

Littler

Supreme Court Limits ERISA Plans' Reimbursement Rights

Littler on

In Montanile v. National Elevator Industry Health Benefit Plan (January 20, 2016), the U.S. Supreme Court dealt a blow to ERISA plans that seek to recover health benefits paid to participants who sustain injuries caused by...more

Seyfarth Shaw LLP

The Magic 8 Ball Says – The Supreme Court’s Montanile Decision and The Seemingly Random Evolution of Supreme Court ERISA Remedies...

Seyfarth Shaw LLP on

It’s a common fact pattern. A plan participant is injured and received benefits for treatment of his injuries. The participant then sues a third party for damages based on his injuries. The plan then seeks to recover a...more

Seyfarth Shaw LLP

Equitable in Name Only?: Tracing a Long and Tortured Path

Seyfarth Shaw LLP on

Knowingly spending money that isn’t yours sounds like a no-no, but depending on how the Supreme Court rules in Montanile v. Board of Trustees of the National Elevator Industry Health Benefit Plan (No. 14-723), certain ERISA...more

Miles & Stockbridge P.C.

Supreme Court ERISA Cases: Plan Reimbursement for Overpayment (Part I)

Miles & Stockbridge P.C. on

In its current term, the Supreme Court is set to hear oral arguments on three cases that interpret the Employee Retirement Income Security Act of 1974 (ERISA). The three ERISA cases will inevitably have an effect on plan...more

Seyfarth Shaw LLP

ELL SCOTUS Series # 4 – Montanile v. Board of Trustees of the National Elevator Industry Health Benefit Plan

Seyfarth Shaw LLP on

In the fourth installment of articles looking at the employment law cases being heard by the US Supreme Court this fall term, Montanile addresses issues near and dear to every employer’s heart – ERISA plans and the...more

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