Reimbursements

News & Analysis as of

California Supreme Court Upholds Limited Right of Carrier to Seek Recovery of Unreasonable Fees Directly from Insured’s...

On August 10, 2015, in Hartford Casualty Insurance Company v. J.R. Marketing, LLC, et al., the California Supreme Court held that in some circumstances insurers may seek reimbursement of payments made to the insured's...more

AmerisourceBergen Guest Post: Solutions to Overcome Reimbursement Challenges in Personalized Medicine

The continued development and refinement of personalized medicine (PM) has offered an opportunity to revolutionize medical practice and improve outcomes by providing treatments for patients with the notion that “this drug is...more

The ERISA Litigation Newsletter - August 2015

Editor's Overview - As the summer draws to a close, this month's Newsletter previews three cases that the U.S. Supreme Court already has agreed to hear that ought to be of particular interest to ERISA plan sponsors and...more

Independent “Cumis” Counsel Now Face Direct Claims for Reimbursement From Insurers

On April 30, 2015, we blogged about Hartford Casualty Insurance Company v. J.R. Marketing, LLC, Case No. S211645, then set for oral argument in the California Supreme Court. [see the prior post: California’s “Independent”...more

California Supreme Court: Insurer Can Directly Sue Independent Counsel for Excess Fees in Limited Circumstances

On August 10, 2015, the California Supreme Court issued a unanimous decision that could have broad implications regarding an insurer’s right to seek reimbursement of unreasonable fees and costs directly from so-called Cumis...more

5 Ways to Pay for College

Here in Arizona it seems that school starts earlier each year. With the new school year right around the corner it is a good time for soon- to – be seniors and current college students to put some time into planning out how...more

Congress Wows With Medicare Telehealth Parity Act of 2015, But Will It Succeed?

Rep. Mike Thompson (D-CA) and co-sponsors Rep. Gregg Harper (R-MS), Rep. Diane Black (R-TN), and Rep. Peter Welch (D-VT) announced, on July 7, 2015, the introduction of the Medicare Telehealth Parity Act of 2015,...more

That is SO last week - July 2015 #2

Last week, The New York Times’ The Upshot blog covered a topic that has been one of our top concerns for a while: how big data can discriminate. The post followed a Carnegie Mellon University study that reported, among many...more

Employment Law - July 2015

The Impact of National Same-Sex Marriage for Employers - Why it matters: How will employers feel the impact of the U.S. Supreme Court’s decision in Obergefell v. Hodges? The landmark ruling that the Fourteenth...more

GAO Report Examines Hospital Financial Incentives to Prescribe 340B Drugs to Medicare Beneficiaries

The Government Accountability Office (GAO) has issued a report examining financial and other characteristics of hospitals that participate in the 340B Drug Pricing Program, focusing on disproportionate share hospitals (DSH)...more

“Uber” Ruling Jars “Sharing Economy”

On June 3, 2015, Barbara Ann Berwick received a favorable ruling from a hearing officer for the California Labor Commissioner (the “CLC”) that the “ride sharing” company Uber must reimburse her for certain expenses...more

Labor Commissioner Finds Uber Driver To Be Employee, Not Independent Contractor

On June 3, 2015, the California Labor Commissioner determined that an Uber driver, Barbara Ann Berwick, was considered an employee of Uber, not an independent contractor. As such, she was entitled to reimbursement in the...more

Uber Driver—Independent Contractor or Employee? One Labor Commissioner Hearing Officer's Opinion

A hearing officer for the Labor Commissioner’s local office in San Francisco concluded earlier this month that an Uber driver was an employee of Uber, not an independent contractor. As a result, the hearing officer awarded...more

Former Uber Driver Gets a Lyft from the Labor Commissioner

A California Labor Commissioner has ruled that one of San Francisco-based Uber’s drivers, Barbara Ann Berwick, is an employee, not an independent contractor. The Labor Commissioner awarded Berwick just over $4,000 for...more

Uber Drivers as “Independent Contractors” – Maybe Not!

Employers face a variety of challenges when relying on “independent contractors.” Typically these disputes involve wages and/or hours worked or alleged entitlement to benefits. A recent case against Uber, however, brought a...more

Health Law Wire: Court Invalidates DOH Retroactive Clinic Rate Changes (6/15)

The Appellate Division Fourth Department recently invalidated DOH’s attempts to retroactively revise Diagnostic & Treatment Center (D&TC) rates and upheld statutory requirements for 30 day advance notice of capital rate...more

Uber Relieved or Uber Mad? What Does the Recent UBER Misclassification Ruling Mean for Employers?

Last week, the California Labor Commissioner ruled that Uber driver Barbara Berwick was an employee and not an independent contractor, as Uber classifies all its drivers. The ruling was based on the Labor Commissioner’s...more

Uniforms, Dress Codes, and the FLSA

The Fair Labor Standards Act (FLSA) does not prohibit employers from requiring employees to follow a particular dress code or wear a designated uniform. However, it does prohibit employers from requiring employees to pay for...more

Insurer Seeks Declaratory Judgment Against Policyholder for Data Breach

Late last month, Columbia Casualty Company instituted a declaratory judgment lawsuit in the United States District Court for the Central District of California against its insured, Cottage Health System. Columbia Casualty...more

Can Attorneys Get Paid for Defending Their Right to Get Paid? Supreme Court Set to Decide in Baker Botts, L.L.P. v. ASARCO, L ....

Currently before the Supreme Court is Baker Botts, L.L.P. v. ASARCO, L.L.C. ,in which the Court will determine whether bankruptcy judges have discretion to award compensation for the defense of a fee application under 11...more

Update: New Measures Adopted by Quebec to Promote Integrity in Public Contracts

On April 1, 2015, the Act to Ensure Mainly the Recovery of Amounts Improperly Paid as a Result of Fraud or Fraudulent Tactics in Connection with Public Contracts (Act) received assent following its unanimous adoption by...more

California’s “Independent” Cumis Counsel Regime Faces A Novel Challenge

On May 5, the California Supreme Court will hear argument in a case that has the potential to profoundly change the relationship between the insurer, its insured and the insured’s independent defense counsel under Civil Code...more

Middle District of Florida Remands Insurance Coverage Class Action, Reasoning Amount In Controversy Is Determined From Value Of...

The value of the claim at issue, not the value of the policy limit, is considered for purposes of determining the amount in controversy in an insurance coverage class action. That, the Middle District of Florida found, is the...more

Reimbursing Employees for Business Expenses: The FLSA Kickback Rule [Wage & Hour FAQs]

Over the last month, Domino’s has been in the news for some of the wrong reasons, with not one but two Fair Labor Standards Act (FLSA) class action lawsuits alleging that two large Domino’s franchisees paid delivery drivers...more

The Supreme Court Holds That Medicaid Providers Cannot Sue To Enforce Federal Reimbursement Rate Standards

On March 31, 2015, the U.S. Supreme Court issued its decision in Armstrong v. Exceptional Child Center, Inc., holding that Medicaid providers cannot sue to enforce reimbursement standards set forth in federal Medicaid law....more

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