News & Analysis as of

Health Insurance

Health Alert (Australia) 4 September 2017

by DLA Piper on

In This Issue: - Judgments; Legislation; and Reports. - Excerpts from Judgments: 30 August 2017 - Australian Competition and Consumer Commission v Medibank Private Limited [2017] FCA 1006 - In this proceeding,...more

26 Days: Congress and Health Care as FY 2017 Comes to a Close

by Epstein Becker & Green on

Congress returns from August recess today, facing a daunting workload to complete before the end of the current fiscal year (FY) on September 30. Big picture issues include raising the national debt ceiling and passing a...more

Workplace Wellness Program Incentives Under Fire - Again

by Pierce Atwood LLP on

For years, employers have been trying to find the right incentives for employees to embrace wellness programs. If incentives are too meager, employees are not likely to participate. If they are weighted too heavily in favor...more

Authorization of the Children's Health Insurance Program Set to Expire at End of September

by Baker Donelson on

Federal funding for the Children's Health Insurance Program (CHIP) – which covers approximately 9 million children nationwide at a cost of approximately $15 billion per year – expires September 30. Thus far, congressional...more

EEOC’s Wellness Program Rules in Doubt

by Pepper Hamilton LLP on

Q.  Are the EEOC’s Wellness Program rules still valid? A.  The ADA and the Genetic Information Nondiscrimination Act both permit an employer to seek medical information as part of a wellness program if the employee...more

Capitol Hill Healthcare Update

by BakerHostetler on

Some Republican lawmakers, led by Sen. Lindsey Graham (R-S.C.), are pushing new plans to overhaul the Affordable Care Act (ACA), but other policy priorities and tight legislative deadlines this month are likely to thwart...more

ACCC v Medibank decision provides some comfort for health funds

by DLA Piper on

On 30 August 2017, the Federal Court delivered its decision in the Australian Competition and Consumer Commission's (ACCC's) case against Medibank Private Limited (Medibank), dismissing each of the ACCC's allegations against...more

Cyber Briefing: Second “Envelope” Lawsuit Against Aetna, Yahoo to Answer for 1.5 Billion Hacked Accounts and Eighth Circuit...

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

D.C. Circuit Holds Cyber-Theft of Customers’ Medical Identifying Information Created Sufficient Increased Risk of Harm to...

Earlier this month, an appellate panel of the federal DC Circuit unanimously held that individuals affected by a healthcare insurer’s data breach in 2014 could pursue claims against the insurer stemming from the cyberattack....more

California’s Surprising New “No Surprise” Health Care Billing Law

by King & Spalding on

As it “rolls out” over time, California’s new “No Surprise” billing law will prohibit certain physicians and other clinicians from billing and collecting more than applicable deductibles and co-paysfrom their patients....more

Employee Benefits Developments - August 2017

by Hodgson Russ LLP on

The Employee Benefits practice group is pleased to present the Benefits Developments Newsletter for the month of August, 2017. Affordable Care Act – “I’m not dead yet!” - The Patient Protection and Affordable Care Act...more

Tracking State Efforts to Stabilize and Reform Health Insurance Markets

by Faegre Baker Daniels on

As efforts to make sweeping legislative changes to the Affordable Care Act (ACA) at the federal level have stalled, states are increasingly looking to stabilize and reform their own health insurance markets. Section 1332 of...more

Health Alert (Australia) 28 August 2017

by DLA Piper on

In This Issue: - Judgments; Legislation; and Reports. - Excerpts from Judgments: Queensland (QLD) 21 August 2017 - A Practitioner v The Health Ombudsman [2017] QCAT 265 - PROFESSIONS AND TRADES – HEALTH CARE...more

Value-based health care: the role of payors

by Ropes & Gray LLP on

Bill Knowlton, Ropes & Gray health care partner, examines the critically important role of payors in value-based health care programs. ____________ Payors are critically important to value-based health care because they're...more

Court Directs EEOC to Reconsider Wellness Rules, Leaves Current Rules in Effect

by Seyfarth Shaw LLP on

On Tuesday, August 22, the US District Court for the District of Columbia ordered the EEOC to revisit its controversial rules placing certain limits on employer-sponsored wellness programs under the Americans with...more

Well, Well, Wellness: DC Court Strikes Down EEOC Rules on Corporate Wellness Programs

When is a financial incentive in an employee-sponsored wellness program so high that employees can’t afford not to participate—rendering the program no longer voluntary? Well (pun intended), the District Court for the...more

Senate HELP Committee to Examine Ways to Stabilize Individual Health Insurance Markets

by Reed Smith on

The Senate Committee on Health, Education, Labor, and Pensions is holding a series of hearings in September 2017 to focus on “actions Congress should take to stabilize and strengthen the individual health insurance markets.”...more

Aetna and its Vendor Face Class Action Lawsuit over HIV Disclosure

A Pennsylvania man has filed a class action lawsuit against Aetna Inc., accusing it of violating his privacy rights when the insurer mailed him prescription information in an envelope with a large, clear window that disclosed...more

Ripeness: A Question of Subject Matter Jurisdiction - Allied World Surplus Lines Insurance Company v. Blue Cross and Blue Shield...

by Nexsen Pruet, PLLC on

Addressing a contractual requirement to exhaust Alternative Dispute Resolution (ADR) prior to commencing litigation, the United States District Court for the District of South Carolina chose to forge its own path, rejecting...more

Healthcare Insurer Rebuked for Exposing Policyholders’ HIV Status

Two legal advocacy groups have accused Aetna Inc. – the Hartford-based healthcare company – of “gross” breaches of privacy and confidentiality including violations of federal healthcare law when a third-party vendor...more

IRS Reminder that ACA Employer and Individual Tax Penalties Are Not Waived

by Dickinson Wright on

With all the heated rhetoric surrounding the Affordable Care Act ("ACA"), including the President's Executive Order issued on January 20, 2017 and the recent efforts to repeal and replace the law, employers and individuals...more

Under the Dome: Inside the Maine State House

by Pierce Atwood LLP on

Under the Dome: Inside the Maine State House provides a high-level overview of recent activity at the Maine State House. Republicans Challenge Wording of Medicaid Expansion Question on Fall Ballot - Question 2 on...more

ACA Cost-Sharing Reductions– A Momentary Reprieve and Ongoing Doubts

The Future of CSRs – A Tale Told in Tweets. In follow-up to our May 5, 2017 blog post, “ACA Cost-Sharing Reductions: An Uncertain Future,” on August 16, 2017, the Trump Administration made an announcement (Announcement) that...more

DOL Releases Draft Model Form for Mental Health Parity Disclosure Requests

by Ballard Spahr LLP on

The U.S. Department of Labor (DOL) recently released a draft model form for plan participants to request disclosures from group health plans and insurers about restrictions on mental health coverage. The form is designed to...more

IRS Reaffirms ACA's Employer Mandate

by Barley Snyder on

While the long-term future of the Affordable Care Act may be in doubt, the law’s application to employers remains largely unaffected by recent political developments....more

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