News & Analysis as of

Health Insurance

The Enforcement Risks for Medicare Advantage Plans Continue: A New False Claims Act Settlement in Florida

Recent activities of the Department of Justice (“DOJ”) and Qui Tam whistleblowers reveal that Medicare Advantage Plans remain at the forefront of investigations for violations of the federal False Claim Act (“FCA”) for...more

FY2018 Massachusetts Budget Update: Final Senate Budget

On May 25, 2017, the Massachusetts Senate unanimously approved a $40.84 billion FY2018 budget by a 38-0 roll call vote. Over three days of debate, Senators considered 1,031 amendments to the budget proposed by the Ways and...more

Two States Make Strong Statements About Their Obamacare Markets

by Faegre Baker Daniels on

Since last November’s election, the future of the Affordable Care Act (ACA) has been very much in doubt. It can be debated whether the health insurance exchanges (Exchanges) are in a “death spiral” as President Trump...more

US: Governor Cuomo and NY Department of Financial Services Respond to Congressional Efforts to Repeal the Affordable Care Act with...

by Hogan Lovells on

On 5 June 2017, in response to the Congressional efforts to “repeal and replace” the Affordable Care Act (the ACA), the New York Department of Financial Services (NYDFS) issued a press release entitled “Governor Cuomo...more

Arizona Enacts “Surprise Out-Of-Network” Balance Billing Law

by Snell & Wilmer on

Arizona has joined the national trend of trying to solve the “problem” of “surprise medical out-of-network bills.” The prevalence of this concern was reported in the New England Journal of Medicine which stated that 22% of...more

Out-of-Network Physician’s Claim Against Insurer Not Preempted by ERISA

The Second Circuit concluded that a promissory estoppel claim by an out-of-network provider against an insurer was not completely preempted by ERISA and thus remanded the claim to state court for further proceedings. The...more

ERISA Exemption Upheld for Religious-Affiliated Hospitals

Hospitals that are “church-affiliated” may be breathing easier this week, following the U.S. Supreme Court’s decision on Monday that defined benefit qualified retirement plans (a/k/a pension plans) are not subject to the...more

Insurance Confusion — Breast Cancer

We have all seen the catchy T-shirts for the Susan B. Komen walks “Protect the Tatas.” Few adult diseases have received as much fund-raising attention as Breast Cancer, and for good reason....more

Handful of State “Job Killer” Bills Move On to Second House

According to reporting from the California Chamber of Commerce, several recently introduced bills have passed the California State Senate or Assembly and now move on to a vote in the second house...more

Can Congress Get to “Yes” on Replacing the Affordable Care Act?

Senate Majority Leader Mitch McConnell recently gave a candid assessment of the chances of getting an Affordable Care Act (ACA) replacement bill through the Senate, saying “I don’t know how we get to 50 (votes) at the...more

The American Health Care Act Moves Forward: What Employers Need to Know About the House-Passed Bill

by Alston & Bird on

Stage two of repealing and replacing the Affordable Care Act (ACA) is now underway as focus shifts to the Senate, where significant changes are expected to be made to the American Health Care Act (AHCA) as passed by the...more

Fifth Circuit’s Pierre Deference In ERISA Cases Trumps Texas’s Anti-Discretionary Language Statute

by DeWitt Law, LLC on

In Ariana M. v. Humana Health Plan of Texas, Inc., No. 16-20174, 2017 U.S. App. LEXIS 7072(5th Cir. Apr. 21, 2017), which involved a claim for benefits under an ERISA-governed health policy, the Fifth Circuit held that...more

No-Fault vs. health insurance: What’s the better choice for crash victims?

by Michigan Auto Law on

Health insurance is full of landmines for unsuspecting car crash victims, who are subject to ‘auto exclusions,’ coverage limitations, managed care, HMOs and medical pre-approval requirements and ERISA liens....more

Manatt on Health Reform: Weekly Highlights - June 2017

House Ways and Means Committee advances three discrete healthcare bills as part of the broader repeal and replace effort; Nevada sends Medicaid-for-all legislation to the Governor; and New York requires insurers to remain in...more

Fiduciary Responsibility . . . You Mean that Stuff Applies to the Health Plan I Sponsor, Too?

by Poyner Spruill LLP on

In the summer of 2016, over 100 of CIGNA’s self-insured health plan clients were sued with the complaint alleging breach of the defendants’ fiduciary duties under ERISA for engaging in widespread fraudulent behavior involving...more

How Medicaid Affects Behavioral Health: Coverage, Expansion and Reform

Medicaid expansion has already had a huge impact on whether mental health needs are treated in certain populations. That may not be at the top of all the stories lately about the U.S. House of Representatives passing its...more

Congress Returns for June Session to Face AHCA, User Fees and More

Congress returns from its Memorial Day recess to four full weeks of legislative activity. The drama of the American Health Care Act (AHCA) now hangs over the Senate. The House will return to its regular work once they advance...more

Telemedicine: Proceed With Caution

by Fisher Phillips on

One of the hottest benefit trends in 2017 is the adoption of free or low-cost “telemedicine” programs to provide employees easy and affordable access to medical care. However, you need to proceed with caution when introducing...more

Manatt on Medicaid: Monthly Expansion Recap - May 2017

National Activity - House Passes AHCA, Senate Begins Drafting New ACA Replacement Legislation - The House passed the AHCA after a last-minute amendment providing $8 billion intended to reduce out-of-pocket costs for...more

Legally Mandated Benefit Plan Changes Still Require Bargaining

by McDermott Will & Emery on

A unanimous panel of the NLRB, including Chairman Philip A. Miscimarra, held that ACA mandates do not relieve an employer of its duty to bargain with a union representing its employees regarding certain health insurance...more

Manatt on Health Reform: Weekly Highlights - May 2017 #5

CBO says the House repeal and replace bill could destabilize the individual insurance market in some states; Indiana posts a work requirement amendment to its Medicaid expansion waiver application; and states allow insurers...more

Anthem Terminates $54 Billion Cigna Merger after Delaware Chancery Court Denies Injunction

by King & Spalding on

Anthem announced on Friday, May 12, 2017 that it delivered formal notice to Cigna of termination of the parties’ merger agreement. The announcement comes on the heels of a Delaware Chancery judge’s denial, issued late...more

To the Senate We Go: What's Going On With Health Care Behind Closed Doors?

by Kiesewetter Law Firm on

On May 4, the U.S House of Representatives went to the floor for a second time to vote on the American Health Care Act (AHCA) -- just 6 weeks after House Speaker Paul Ryan pulled the bill for not having enough Republican...more

Eighth Circuit Grants Slight Reprieve To Mother Of Transgender Son In ACA Discrimination Suit

by Seyfarth Shaw LLP on

Seyfarth Synopsis: The Eighth Circuit upheld dismissal of Title VII claims challenging an employee benefit plan’s blanket transgender exclusion because the exclusion impacted the employee’s transgender son, not the employee....more

2017 Minnesota Legislature Adjourns But After Special Session

by Stinson Leonard Street on

Minnesota lawmakers used every last minute available to them to try and complete their work prior to the deadline for the 2017 legislative session, but it was not enough time. At 12:01 a.m. early last Tuesday morning,...more

1,918 Results
|
View per page
Page: of 77
Cybersecurity

"My best business intelligence,
in one easy email…"

Your first step to building a free, personalized, morning email brief covering pertinent authors and topics on JD Supra:
Sign up using*

Already signed up? Log in here

*By using the service, you signify your acceptance of JD Supra's Privacy Policy.
*With LinkedIn, you don't need to create a separate login to manage your free JD Supra account, and we can make suggestions based on your needs and interests. We will not post anything on LinkedIn in your name. Or, sign up using your email address.