Reimbursements

News & Analysis as of

Expenses Can Be Expensive: Cochran v. Schwan’s Home Service, Inc. Revisited

Most California employers know that they have to reimburse employees for business-related expenses. Indeed, California Labor Code section 2802(a) provides that an employer “shall indemnify his or her employee for all...more

BCBSNC Release of Data

After objecting to the release of hospital reimbursement rates mandated under North Carolina’s Health Care Cost Reduction and Transparency Act of 2013 (NCGS Section 131E-214.5), Blue Cross Blue Shield of North Carolina...more

The Supreme Court Hears Case Regarding Private Enforcement of the Medicaid Act Against States

On Tuesday, January 20, 2015, the U.S. Supreme Court will hear oral argument in a significant Medicaid-preemption case from the Ninth Circuit, Exceptional Child Center, Inc. v. Armstrong. In that case, Medicaid-participating...more

Did You Know…Employers Must Reimburse Employees for Personal Cell Phone Use

Last August, in Cochran v. Schwan’s Home Service, Inc., a California Court of Appeal held that employers must reimburse employees for required work-related use of personal cell phones, even if the employees incur no...more

New Year’s Resolutions for the California HR Manager

So what’s it going to be for 2015? Get up and run three miles every morning? Finally pay off those credit cards? Learn to speak French? Before you finish the list of New Year’s resolutions, consider adding a few on the human...more

New York Passes Telemedicine Reimbursement Legislation

New York became the 22nd state to sign into law legislation that will require commercial and Medicaid plans to provide coverage of telehealth and telemedicine services. The law, originally intended to take effect on January...more

Children’s Hospitals Obtain Temporary Injunction Against CMS

Challenging actions by the Centers for Medicare & Medicaid Services (CMS) under the Administrative Procedures Act (APA), Texas Children’s Hospital and Seattle Children’s Hospital obtained a preliminary injunction that enjoins...more

Immediate Action Required for Employers that Provided Transit Benefits to Employees in 2014

On December 19, 2014, President Obama signed the Tax Increase Prevention Act of 2014 (“TIPA”), which in part retroactively increases the monthly limit for employer-provided transit benefits to $250 from $130 (the same...more

Want to Reimburse Your Employees for Healthcare Coverage?

Fine, but make sure that you do so correctly. Many employers prefer to reimburse employees for healthcare insurance premiums rather than hassle with providing coverage under a group healthcare plan. In so doing, these...more

Fenwick Employment Brief - January 2015

Waiting for and Undergoing Security Checks Not Compensable Time - The United States Supreme Court recently held in Integrity Staffing Solutions, Inc. v. Busk et al. that time spent waiting for and undergoing post-shift...more

Residents Can Be Hazardous to a Community Hospital's Medicare Health

Although Medicare graduate medical education reimbursement can be a helpful source of financing to facilitate resident training, many community hospitals have suffered a “gotcha” moment when trying to establish new programs....more

Health Law Alert: The ACA’s Increased Medicaid Reimbursement for Primary Care Expires December 31, 2014

Medicaid primary care providers will usher in the new year with a reimbursement reduction. For the past two years, Medicaid programs have been required to reimburse primary care providers at Medicare levels. ...more

A New Year and We Will “Ring In” Even Lower PCS Reimbursement Rates: Time for Litigation?

I received an email today from an owner of a home care agency that reminded me that, especially during the holidays, many people are struggling. This home care agency owner, “we will call him Al,” informed me that he...more

Employer Cash Payments To Reimburse Employees For Health Insurance Costs – No!

Many employers offer or provide cash to employees to reimburse them for the cost of purchasing an individual health insurance policy. Others offer employees with high claims risk a choice between enrolling in the company’s...more

Second Circuit Rejects Plan’s Claim For Reimbursement From Another Plan

Where an ERISA plan specifically sets forth in the plan document its rights to reimbursement/subrogation vis-à-vis a plan participant then there is no requirement that recovery be conditioned on the plan being able to trace...more

California Employers Beware: Cell Phones Present Another Area for Class Action Potential

In August 2014, the California State Court of Appeals (2nd Circuit, Division 2) decided in Cochran v. Schawan's Home Service that employers were responsible for reimbursing employees for the business use of personal cell...more

California Supreme Court Denies Review of Cell Phone Reimbursement Case

The California Supreme Court has denied a petition to review Cochran v. Schwan’s Home Service, Inc., Court of Appeal of California, Second Appellate District, Division Two, No. B247160 (August 12, 2014). As a result of the...more

Eleventh Circuit Enforces Subrogation Clause

The Eleventh Circuit recently concluded that Robert Montanile, a welfare plan participant, could not avoid reimbursing the National Elevator Industry Health Benefit Plan for benefits it paid on his behalf after he recovered...more

Alert: Closing Affordable Care Act Loopholes

The U.S. Departments of Labor, the Internal Revenue Service and the Department of Health and Human Services recently issued guidance clearly stating that employers may not, without incurring penalties, reimburse employees who...more

Reimbursement Changes, Shift to Consumerism Discussed at Akerman Healthcare Briefing

Changing reimbursement models and a shift to consumerism were two of the hot topics discussed at Akerman LLP's recent Healthcare Briefing event titled "Financial and Corporate Implications of the Affordable Care Act: A Look...more

Weekly Update Newsletter - November 2014 #2

GAO Bid Protest Annual Report to Congress for Fiscal Year 2014 - The Government Accountability Office (GAO) has issued its bid protest annual report to Congress for fiscal year 2014 reporting each instance in which a...more

Indemnification and Reimbursement Sought from Insurers Based on Allegedly Fraudulent Funding Program: Fifth Third Bancorp v. Ace...

Who: Plaintiffs: Fifth Third Bancorp and Fifth Third Bank Defendants: Ace Insurance Company, Axis Insurance Company, Certain Underwriters at Lloyd’s, Continental Insurance Company, Federal Insurance Company,...more

Massachusetts Supreme Judicial Court Strengthens Policyholders’ Ability to Pursue Consumer Protection Claims against Insurers for...

The Massachusetts Supreme Judicial Court (“SJC”) has made it clear that an insurer cannot avoid claims for failing to defend a policyholder merely by tendering payment to the policyholder at the last minute. The central issue...more

Will the Mid-Term Elections Help Telemedicine Reimbursement?

Our recent survey of senior-level health care executives reinforced that lack of reimbursement remains the primary barrier to providers in adopting telemedicine services. Of our respondents, 41 percent indicated that their...more

Is Provider-Based Reimbursement Going Away?

We get this question every year: will Medicare, Medicaid or other payors continue to recognize hospital-level facility fee reimbursement for hospital outpatient departments meeting the provider-based designation criteria at...more

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