Understanding Pharmacy Benefit Managers: The PBM Landscape Explained
DOJ’s New Self-Disclosure Policy and Corporate Whistleblower Awards Pilot Program
AGG Talks: Healthcare Insights Podcast - Episode 4: What to Do When Insurance Companies Deny Behavioral Health Claims
Video: Braidwood v. Becerra – Challenging the Affordable Care Act’s Preventive Services Coverage Provision – Thought Leaders in Health Law
Updates to Statute 1557 that Healthcare Providers Need to Know
The No Surprises Act: A Cost Saving Opportunity for Employer Plan Sponsors
Podcast: Health Equity – Behind the Buzzwords – Diagnosing Health Care
Opting Out of Medicare: When and How to Do It
The Burr Broadcast April 2023 - The Official End of COVID-19 Emergencies
Video: Health Care's Past, Present, and Future - Diagnosing Health Care Podcast
Taking the Pulse, A Health Care and Life Sciences Video Podcast | Episode 117: Chris Severn, Co-Founder & CEO, Turquoise Health
Taking the Pulse, A Health Care and Life Sciences Video Podcast | Episode 115: Dr. Michael Havig, CEO, HealthMe
Taking the Pulse, A Health Care and Life Sciences Video Podcast | Episode 106: Dr. James McElligott, MUSC & Dr. Shawn Stinson, BlueCross BlueShield of SC
PODCAST: Williams Mullen's Benefits Companion - Health Plan Transparency Requirements
Thinking About a Concierge Medical Practice? Assure Compliance with Payor Requirements and the Law
PODCAST: Williams Mullen's Benefits Companion - New Prescription Drug and Health Coverage Reporting Requirements
Video: Getting Ready for the No Surprises Act - Thought Leaders in Health Law
Podcast: What Is the Future of the Acute Care Hospital Industry? - Diagnosing Health Care
PODCAST: Williams Mullen's Benefits Companion - Can Employers Impose a Health Insurance Surcharge on Plan Participants Not Vaccinated for COVID-19?
Compliance Into The Weeds - Delta Airlines Responds to the Delta Variant
Within days of one another, the U.S. Court of Appeals for the Ninth and Second Circuits ruled—on issues of first impression for both—that ERISA expressly preempts state law breach of contract and promissory estoppel claims...more
Regulators Hit Jackpot: Off-Channel Communications - Several years before announcing the first “off-channel” communications enforcement action, the SEC and FINRA cautioned broker-dealers and investment advisers about...more
The California Court of Appeal, in a major win for managed care payors and claims administrators, affirmed a lower court decision granting summary judgment in favor of United Healthcare (United), finding that United did not...more
In Ratliff v. Wycliffe Assoc., Inc., No. 6:22-cv-1185-PGB-RMN, 2023 WL 3688082 (M.D. Fla. May 26, 2023), the plaintiff, a software developer, sued the defendant, a Bible translation ministry, for sex discrimination under...more
Plaintiff Cannot Cure Defective Malpractice Opinion Letter with an Affidavit Connecticut law requires that a plaintiff in a medical malpractice action demonstrate the existence of his or her good faith by obtaining a written...more
In an important win for healthcare providers, on July 17, 2020, the Third Circuit determined in a published opinion that an out-of-network provider’s direct claims against in insurer for breach of contract and promissory...more
Second Circuit Affirms Decision Rejecting ERISA Claims for Retiree Health Benefits The U.S. Court of Appeals for the Second Circuit has affirmed a district court’s decision dismissing claims under the Employee Retirement...more
A long-term care insurance class action filed in May 2018 highlights the importance of clearly defined policy language. At dispute in the lawsuit pending in the United States District Court for the Northern District of...more
In at least one state, California, the answer to the question of “Do issues related to long-term care and elder abuse intersect?” is yes. The California Welfare and Institutions Code defines “financial abuse” of an elder...more
In this episode, Gary Qualls discusses a recent development in payer litigation, regarding a provider’s recovery of Medicare Advantage payments pursuant to a Medicare Advantage contract. Specifically, a recent federal case...more
In a decision last week that could affect $12 billion that insurers assert is owed by the federal government, the Federal Circuit decided that HHS was not required to pay amounts required by statute because Congress had...more
Many provisions of the Affordable Care Act (“ACA”) have been the subject of litigation over the last decade, with several high-profile Supreme Court cases including: NFIB v. Sebelius, King v. Burwell, and Burwell v. Hobby...more
On November 2, Humana filed a lawsuit in the United States Court of Federal Claims to recover approximately $600 million allegedly owed by the United States government. See Humana Inc. v. U.S., case number 1:17-cv-01664. ...more
In July, in Hancock v. Americo Financial Life & Annuity Co., Americo achieved a total victory on its motion to dismiss a putative class action in the Eastern District of North Carolina that challenged its premium and COI...more
As we head into the new week, here’s a quick summary of major data security developments from around the country. Aetna Hit With Second “Envelope” Lawsuit - Aetna Inc. is now facing a second lawsuit over the disclosure...more
On May 12, Anthem announced that it was terminating all efforts to complete its proposed merger with Cigna. The deal, announced back in 2015 and valued at $54 billion, would have combined the country's second and fifth...more
When was the last time your organization reviewed your insurance policies? Not all policies are equal. Many religious organizations are underinsured. Most should have general liability, property, professional liability,...more
Editor's Overview - This month, we review the Second Circuit's ruling in New York State Psychiatric Ass'n, Inc. v. UnitedHealth Grp. wherein the Second Circuit ruled that: (i) a provider association has associational...more
Retirement Plans - IRS Issues Guidance on Benefit Suspension Voting under MPRA - As we have written in prior alerts, the Multiemployer Pension Reform Act of 2014 (MPRA) permits trustees of financially troubled...more
An Illinois appellate court recently rejected applying the inevitable disclosure doctrine in a trade secret misappropriation spat arising out of a failed business transaction....more
On October 10, 2014, the Ninth Circuit affirmed a grant of summary judgment in favor of Manatt client The MEGA Life and Health Insurance Company. In an unpublished memorandum opinion, the Ninth Circuit held that a health care...more