News & Analysis as of

AGG Helps Hospice Weather the Perfect Storm of Aggressive Medicare Payment Denials and Administrative Appeal Backlog

Medicare’s implementation of post-payment review through private contractors who are overly aggressive in denying payments, combined with a severe backlog of cases in queue for hearing before an Administrative Law Judge...more

Bankruptcy Law News: Recoupment or Setoff? - A Distinction with a Difference

Setoff is commonly encountered in bankruptcy and non-bankruptcy situations. If there are mutual debts between two entities, either may generally offset the debts. These debts frequently arise where one entity is a vendor to...more

Health Care Rep and Warranty Insurance: New Solutions for Private Equity Buyers and Sellers

Whether in an auction or proprietary transaction, risk allocation has typically been a function of indemnities tied to reps and warranties and the type of credit supporting the type of supporting credit. Holdbacks, earnouts,...more

Policyholder Warning: What One Provision Giveth (Defense Costs), Another Provision May Taketh Away

Professional liability insurance policyholders often breathe a sigh of relief when their insurer begins funding the costs of defending against a civil claim or government investigation. That is one of the reasons they bought...more

SEC Proposes New Clawback Rules

Last Wednesday, the Securities and Exchange Commission (SEC) proposed new Rule 10D-1 to require public companies to adopt and enforce clawback policies to recoup incentive-based compensation paid to current and former...more

Insurance Recovery Law - March 2015

New York Federal Court Rejects Insurer’s Request for Recoupment - Why it matters: The federal court, applying New York law, held that an energy drink manufacturer’s advertising coverage claim—arising from underlying...more

The Duty To Defend Broader Than The Duty To Indemnify? Your Insurer Doesn’t Think So, And Surprisingly, Some Courts Agree

Insurance law practitioners learn on day one that the duty to defend is broader than the duty to indemnify, encompassing even uncovered claims if at least one claim against the insured is potentially covered. See Bridge Metal...more

No Private Right to Recoup Funds Based on Corporate Practice of Medicine Violation

The United States District Court for the Western District of Washington ruled recently that the state’s corporate practice of medicine doctrine does not provide a private right of action, either express or implied, and...more

Righting a Wrong: The “Claim of Right” Doctrine and Other Tax Considerations for the Repayment of Pension Plan Overpayments

Pension plan overpayments to participants and their beneficiaries are an all-too-common occurrence. When overpayments occur, a plan administrator’s duties are fairly clear. Typically, the plan administrator must seek...more

D&O Carrier Allowed to Recoup Defense and Indemnity Costs After Employees Plead Guilty to Misconduct

In Protection Strategies, Inc. v. Starr Indemnity & Liability Co., the U.S. District Court for the Eastern District of Virginia allowed an insurer to recoup more than $670,000 in costs paid for the insured first to respond to...more

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