THE ACCIDENTAL ENTREPRENEUR PART V video
THE ACCIDENTAL ENTREPRENEUR PART V Podcast
Health Reimbursement Arrangement Update
Podcast: Health Reimbursement Arrangements
K&L Gates Triage: 340B Update: CMS Finalizes 340B Program Reimbursement Cut on Part B Drugs
K&L Gates Triage: 340B Regulatory Update: CMS Proposal and Draft Executive Order Could Have Big Impact on 340B Program
Though the employer shared responsibility provisions of the Patient Protection and Affordable Care Act (PPACA) do not apply to small employers (generally, employers with fewer than 50 full-time equivalent employees), many...more
During a time when recruiting and retaining qualified employees is becoming more and more difficult, it is crucial for employers to consider (or even reconsider) their benefits offerings and determine if there are any...more
The implications of the United States Supreme Court’s decision in Dobbs v. Jackson Women’s Health Organization that overturned Roe v. Wade’s constitutional right to abortion have had sweeping implications that affect...more
Not surprisingly, leading up to and in the wake of the U.S. Supreme Court’s decision in Dobbs v. Jackson Women’s Health Organization, our employee benefits team has been spending a lot of time helping our clients wade through...more
On June 24, 2022, the Supreme Court of the United States issued its highly anticipated decision in Dobbs v. Jackson Women’s Health Organization, No. 19-1392. The Dobbs decision expressly overrules the two key precedents that...more
On January 10, 2022, the Departments of Labor, Health and Human Services, and Treasury (collectively the “Departments”) issued Affordable Care Act FAQs Part 51 which addresses, in relevant part, payment for over-the-counter...more
The January Monthly Minute highlights the new OTC COVID-19 test coverage mandate (eff. January 15, 2022), group health plan provider compensation disclosure rules, and updated standards for ERISA plan financial statement...more
On August 11, 2021, United Healthcare and its affiliates were served with separate enforcement lawsuits by the Department of Labor (DOL) and the New York Attorney General (NY AG) involving mental health parity, among other...more
Plaintiff Doug Heckman participated in Nike's employee welfare benefit plan (the "Plan"), which was funded by UnitedHealthcare Insurance Co. ("UHC"), and included healthcare benefits. Mr. Heckman's wife was covered under the...more
In recent years, reports have indicated robust, and in some respects increasing, enforcement activities by the US Department of Labor (DOL) related to ERISA. The DOL recently issued its enforcement statistics for fiscal year...more
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
New legislation passed in the 2019 session of the Texas Legislature, SB 1264, went into effect on January 1, 2020. The statute protects Texas residents from so-called surprise billing, where patients receive costly medical...more
Synopsis: Two Courts of Appeal reach opposite results on ERISA preemption, thus continuing the judicial quest for a definitive meaning of ERISA preemption. Stay tuned for more such decisions, and yet more Supreme Court...more
ERISA health care plans typically include reimbursement and subrogation clauses, which give plans a right to reimbursement of medical expenses paid on behalf of a beneficiary where the injury is caused by a third party. While...more
Adherence to the COBRA health care continuation rules is not always high on an employer’s list of priorities. Compliance is often “outsourced,” and even when handled “in-house,” it rarely consumes much attention. A recent...more
Seyfarth Synopsis: In a major victory for ERISA plans and other payors, the Fifth Circuit recently overturned a district court’s notorious decision in favor of a healthcare provider and reinstated a plan administrator’s...more
On October 13th, President Trump signed an Executive Order directing various federal agencies to consider how to achieve three administration health reform objectives: (1) expand access to Association Health Plans (AHPs); (2)...more
Preemption is not a foreign concept when dealing with the Employment Retirement Income Security Act of 1974 (ERISA). Preemption arguments frequently and increasingly arise, for example, in the context of claims by health care...more
A frequently litigated issue in reimbursement cases brought by in- and out-of-network healthcare providers against insurers under the Employee Retirement Income Security Act of 1974 (“ERISA”) is provider standing. Because...more
The first Alert in this two-part series discussed three common issues facing out-of-network medical providers in asserting reimbursement claims against employee benefits plan administrators (whether an insurance company or...more
While public attention is currently focused on the upcoming high profile Supreme Court decision in King v. Burwell (which involves subsidies for exchange-based coverage under the ACA), the Supreme Court recently decided to...more
In This Issue: - Editors' Overview - Supreme Court Revisits Meaning of 'Appropriate Equitable Relief' in US Airways v. McCutchen - Rulings, Filings, and Settlements of Interest ...more