Out-of-Pocket Expenses

News & Analysis as of

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

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?

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

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

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

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

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

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

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

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

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

Texas Surgical Centers: Aetna Improperly Denies or Underpays Out-of-Network Claims

Aetna is now facing another set of claims calling into question its determination and payment methodology for out-of-network reimbursement. On September 4, 2015, six surgical centers in Texas (Allied Center for Special...more

Blog: Joining the Debate, Hillary Clinton Releases Plan to Curb Drug Prices

In the wake of the uproar about drug pricing, Hillary Clinton unveiled on Tuesday, a plan to address the rising cost of prescription drugs. The plan will focus on ending “excessive” profits, lowering out-of-pocket costs,...more

Healthcare Costs for the Average Family Have Risen Dramatically

According to consulting and actuarial firm Milliman’s “2015 Milliman Medical Index,” which measures the cost of healthcare for a typical American family of four receiving coverage from an employer-sponsored preferred provider...more

Client Alert: AB 533 Defeated

Johan Swanepoel © 123RF.com Controversial AB 533 did not obtain the necessary votes for approval and failed to pass. Assembly Health Committee Chair Rob Bonta proposed AB 533 in an attempt to purportedly address the problems...more

The Scoop on MOOP: McGuireWoods Healthcare Reform Guide: Installment No. 53

This is the 53rd in a series of WorkCite articles concerning the Patient Protection and Affordable Care Act and its companion statute, the Health Care and Education Reconciliation Act of 2010 (referred to collectively as the...more

IREG Update - August 2015 #2

Hot Topic: New York Emergency Medical Services and Surprise Bills Law - Earlier this year, New York’s Emergency Medical Services and Surprise Bills Law went into effect (the full text of the bill is available on the...more

Washington Healthcare Update

This Week: 21st Century Cures Legislation Passes House in Bipartisan Vote... CMS Releases Proposed CY 2016 Home Health Prospective Pay Rule... CMS Releases Final CY 2016 Hospital Outpatient Prospective Payment System (OPPS)...more

Reminder: Non-Grandfathered Plans Must Implement Embedded Out-of-Pocket Maximums

As employers and plans prepare for 2016 open enrollment, they must be sure to address in their benefit design and with their third party vendors the new embedded out-of-pocket maximum limitations on individuals that were...more

38 Results
|
View per page
Page: of 2
JD Supra Readers' Choice 2016 Awards

"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 to create your digest using LinkedIn*

*By using the service, you signify your acceptance of JD Supra's Privacy Policy.

Already signed up? Log in here

*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.
×