News & Analysis as of

Out-of-Pocket Expenses

Are You Ready for AB 72?

by Buchalter on

To protect patients from receiving an unexpected surprise bill when they seek care at in-network facilities from out-of-network providers, Governor Brown signed AB 72: California’s surprise out-of-network law. The new law...more

When your Hospital-of-Choice is In-Network but, SURPRISE, your Anesthesiologist is Not: California’s AB-72 and Other State...

Regardless of a patient’s diligence in selecting an in-network hospital, ambulatory surgery center, or other health facility for treatment, patients are still being saddled with surprisingly high medical bills that include...more

What Are the New 2018 Health Savings Account Limits?

by McDermott Will & Emery on

In Revenue Procedure 2017-37, 2017-21 IRB, the IRS issued the annual inflation-adjusted contribution, deductible and out-of-pocket expense limits for 2018 for HSAs. For clear comparison, we have outlined the changes from 2017...more

Data Breach Lawsuit Survives Motion to Dismiss

by Bracewell LLP on

In an April 13, 2017 decision in Walters v. Kimpton Hotel, a California federal judge rejected the bid of hotel chain Kimpton Hotel and Restaurant Group, LLC to dismiss a proposed class action arising from a data breach last...more

Manatt on Health Reform: Weekly Highlights - April 2017

Consumers could use Marketplace subsidies to purchase off-Marketplace plans under proposed Senate bill; Oklahoma and Massachusetts will pursue Medicaid and Marketplace waivers; and a Medicaid expansion bill fails in Kansas...more

Obamacare Reform Watch: Reimbursement Strategies in an Environment of Growing Out-of-Pocket Costs and an Expanding Self-Pay...

by Hinshaw & Culbertson LLP on

The increase in patient financial responsibility for health care costs in the past ten years has outpaced consumer growth in wages. This escalation of out-of-pocket costs represents a major revenue cycle challenge for health...more

Top 9 Mini Tort facts for repairing car accident vehicle damage

by Michigan Auto Law on

What you need to know on the Michigan Mini Tort maximum recovery limit, getting your car fixed and paid for, what do do if you’re in a crash with an uninsured driver, time limits to file a claim....more

Why Having A “Gifted” Child In NJ May Cost You More Child Support

by Cozen O'Connor on

The benefits of enrolling children in extracurricular activities are endless. Not only do they learn how to play a sport or musical instrument, but also soft skills and valuable life lessons, such as teamwork, the importance...more

Is It Compensation Or Loan Repayment?

by Pessin Katz Law, P.A. on

In Scott Singer Installations, Inc., (TC Memo 2016-16, filed August 24, 2016)1, the U.S. Tax Court (the “Court”) ruled that the bulk of payments made to a sole shareholder of an “S” Corporation, characterized as reimbursement...more

Client Alert: IRS Announces Increases for Health FSAs and HSAs

by Fraser Trebilcock on

The IRS has just released its 2017 annual inflation adjustments, in which it announced that the dollar limitation under Code section 125 on voluntary employee salary reductions for contribution to health flexible spending...more

Despite Plaintiffs Satisfying Standing Requirements, Barnes & Noble Closes the Book on Data Breach Class Action

by Reed Smith on

In data breach class actions, standing is often the major obstacle, and has taken on renewed focus following the U.S. Supreme Court’s ruling in Spokeo v. Robins, 136 S. Ct. 1540 (May 24, 2016). See, e.g., Federal Court Finds...more

Manatt on Health Reform: Weekly Highlights - September 2016 #3

Study finds that Marketplace premiums are lower than employer-based premiums, even without federal subsidies; New York regulators move to shield insurers from outsized federal risk adjustment payments; and Missouri will seek...more

California puts curbs on surprise medical bills

Surprise! California lawmakers waited until the very end of their legislative session before joining an increasing number of states in protecting patients from unexpected out-of-network medical charges. As many as 70 percent...more

Manatt on Medicaid: Monthly Expansion Recap - August 2016

California - Medicaid Enrollees Are Largest Share of Newly Insured - A new survey from the Kaiser Family Foundation found that 33% of Californians uninsured in 2013 are now enrolled in Medi-Cal, the State’s Medicaid...more

Manatt on Health Reform: Weekly Highlights - August 2016 #4

HealthCare.gov plans an open enrollment pilot that will let consumers compare provider network breadth; new Medicaid enrollees reduce out-of-pocket spending on prescription drugs by nearly 60%; and Kansas’s Governor announces...more

You Are the Victim of Defamation: Should You Sue?

It is not unusual to get a telephone call from a client or prospective client (let’s call him John), who says, “Somebody is saying false things about me. I want it to stop, I want an apology, and I want damages.”...more

Manatt on Health Reform: Weekly Highlights - August 2016 #2

CMS targets Medicaid managed care pass-through payments; California proposes “California Qualified Health Plans” for the undocumented; and a new study finds out-of-pocket costs were reduced by nearly a third for Medicaid...more

Manatt on Health Reform: Weekly Highlights - July 2016 #4

CMS’ increase of the “income verification threshold” makes eligibility determinations easier for consumers; Oregon CO-OP policyholders can credit out-of-pocket spending towards new plans; and report finds that 13 million...more

HHS Sets New Requirements to Limit Surprise Medical Bills from Out-of-Network Providers

by Epstein Becker & Green on

The U.S. Department of Health and Human Services (“HHS”) recently released a final rule titled “Patient Protection and Affordable Care Act; HHS Notice of Benefit and Payment Parameters for 2017” (“Final Rule”)[1] that sets...more

Affordable Care Act Compliance Update for 2016

by Williams Mullen on

Affordable Care Act (ACA) reforms have become effective incrementally over the last six years. In 2016, most of the ACA changes are applicable. Employers that sponsor group health plans should ensure that they are in...more

Circuit Court Affirms Bankruptcy Order Requiring Creditor to Reimburse Trustee for Maintaining Collateral

by Burr & Forman on

In the case of Domistyle, Inc., 14-41463 (5th Cir. Dec. 29, 2015), the United States Court of Appeal for the Fifth Circuit affirmed an order of the bankruptcy court requiring a secured creditor to reimburse the trustee for...more

White & Case ECB News – Issue 2, 2015: 60 seconds around the globe – ECB News Issue 2, 2015

by White & Case LLP on

China - Changes to Employee contribution rates for work related injury insurance and maternity insurance - As of 1 October 2015, employer contribution rates for injury-at-work insurance and maternity insurance have...more

Maine Workers’ Compensation Alert: Board Revises Fee Schedule and Changes Reimbursement Rules

by PretiFlaherty on

The Maine Workers’ Compensation Board has published a new Medical Fee Rule and made revisions to rules regarding reimbursement and expense payments, effective October 1, 2015. The following are some key changes...more

Amazon.com Hit With Independent Contractor Misclassification Class Action Lawsuit By Delivery Drivers

by Pepper Hamilton LLP on

Amazon is the latest tech company to be sued in a proposed class action by drivers delivering its products – in this case, goods to be delivered within two hours of being ordered through Amazon’s “Prime Now” app. The drivers...more

Where to Draw the Line: HR’s Role in Disciplinary Decisions

In the recent case of Ramphal v. Department of Transport (DoT) the tricky question of where HR should draw the line in a disciplinary matter between guiding the decision-maker on the right decision, and making that decision...more

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