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Insurance Health

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Arizona District Court Rejects Discovery of Medical Expert's Previous Reports in Bad Faith Case

by Jaburg Wilk on

The Holding - In Cheatwood v. Christian Brothers Services, 2018 WL 287389 (D. Ariz. Jan. 4, 2018) (Unpublished) (Order), a bad faith case arising from a health benefits claim, the Arizona District Court quashed portions of...more

Thank You IRS - Extensions for This Year’s ACA Tax Reporting

by Foley & Lardner LLP on

The “Bottom Line” - Employers will have until March 2, 2018 to furnish Form 1095-C (“Employer-Provided Health Insurance Offer and Coverage”) to employees.,,...more

Massachusetts Employers Should Prepare for Penalties and Other Changes to Law Regarding Health Care Contributions

In August 2017, Governor Charlie Baker signed into law, “An Act Further Regulating Employer Contributions to Health Care,” which became effective on January 1, 2018, and will remain on the books through the end of the 2019...more

Massachusetts Division of Unemployment Assistance Issues Final Regulations Implementing the EMAC Supplemental

As we reported in a previous post, Massachusetts Governor Charlie Baker in August 2017 signed into law H. 3822, “An Act Further Regulating Employer Contributions to Health Care” (the “Act”). Among other things, the law...more

ML Strategies Outlook: Health Care

“We’re going to have to get back next year at entitlement reform, which is how you tackle the debt and the deficit” Paul Ryan, Speaker of the House. Happy New Year!?! - 2017 was an eventful year for health care, and...more

Insurance Coverage for Opioid Litigation Costs

by Kelley Drye & Warren LLP on

Pharmaceutical companies at risk of opioid-related litigation should consider whether they are covered by their insurance policy. Liability insurance coverage may be available for defense costs under Comprehensive General...more

Defence + Indemnity: December 2017 - I. Insurance Issues C.

by Field Law on

I. INSURANCE ISSUES - E. A hospital insurer was held to owe a duty to defend a hospital employee sued for the privacy tort of inclusion upon seclusion, as such was an “invasion or violation of privacy” or an “invasion or...more

9 million reasons to doubt Trump-GOP argument that Obamacare is dead

Millions of ordinary Americans closed out 2017 with a powerful message to the Trump Administration and GOP lawmakers about the nation’s health care. Despite efforts to make it harder to re-enlist for insurance plans,...more

Virginia Supreme Court Considers Terms Of Assumption Reinsurance Transaction In Determining Obligations Of Insolvent Insurer

by Carlton Fields on

A group of Kentucky hospitals sought reimbursement for legal fees incurred in two lawsuits related to the insolvency of their insurer, Reciprocal of America (“ROA”). In the 1970s and 1980s, the hospitals created two trusts to...more

Massachusetts Appeals Court Upholds Liability Insurer’s Contractual Right to Settle

by Mintz Levin on

On Tuesday, December 12, 2017, the Massachusetts Appeals Court, applying New Hampshire law, held that a professional liability insurer did not breach the implied covenant of good faith and fair dealing by settling a New...more

State Regulator Enforces Network Adequacy Standards on ‘Obamacare' Health Plan: Will More Actions Follow?

by Faegre Baker Daniels on

In what may be the first enforcement action taken by a state regulator against an “Obamacare” health plan for provider network problems, the Washington State Office of the Insurance Commissioner imposed a fine and suspended...more

Memo to Massachusetts Employers for 2018 and 2019: How Not to Comply with the EMAC New Rules

In a November 20, 2017 post, we reported on Massachusetts’ passage of H. 3822, “An Act Further Regulating Employer Contributions to Health Care,” (the “Act”), the purpose of which is to shore up the finances of the...more

Appeals Court: No Bad Faith For An Insurer’s Legitimate Exercise Of A Contractual Right Or Its Settlement Within The Policy Limit...

In a Rule 1:28 decision applying New Hampshire law, the Appeals Court affirmed the entry of summary judgment dismissing a doctor’s suit accusing her professional liability insurer of improper settlement of a claim without her...more

Medicaid Expansion May Reduce Medical Divorce Rates

Medical divorce is a term coined some years ago to describe a divorce obtained for medical reasons. More specifically, according to an article by George Diepenbrock, researchers defined “medical divorce” as “an instance where...more

Tennessee Supreme Court Rejects Efforts to Alter Existing Law on the Collateral Source Rule in Personal Injury Cases

Last month the Tennessee Supreme Court, in Dedmon v. Steelman, affirmed the long-standing collateral source rule in personal injury cases. As long as an injured plaintiff can establish that the medical expenses they incurred...more

CVS Health to Acquire Aetna

On December 3, 2017, CVS Health, a giant in the retail pharmacy industry, announced plans to acquire Aetna. Aetna is one of the largest medical insurers in the nation, servicing approximately 46.7 million people. Under the...more

OIG Advisory Opinion 17-06: Another Medigap/PHO Arrangement Approved

by Baker Ober Health Law on

Advisory Opinion 17-06 joins a long list of opinions approving arrangements between a Medicare Supplemental Health Insurance (Medigap) insurer and a preferred hospital organization (PHO). While this advisory opinion does not...more

Connecticut District Court Provides Interpretation of ACA Provision - Decision Allows Insurers to Circumvent Hospitals in...

by Holland & Knight LLP on

• The ACA does not prevent insurers from declining to directly reimburse out-of-network hospitals for emergency care, and instead adjudicate and administer claims directly with individual patients, the U.S. District Court for...more

Abrupt Closure of SynerMed Shakes Up Medical Management Industry

by Nossaman LLP on

SynerMed, a Southern California-based physician management company, will be shutting down, per an email from its CEO earlier this month. Recently, the company had come under increasing scrutiny by health plans and California...more

Proposed Regulations Issued Implementing Massachusetts Employer Medical Assistance Contribution (EMAC) Supplemental Contribution

In an earlier post, we reported on the passage of H. 3822, “An Act Further Regulating Employer Contributions to Health Care,” (the “Act”), the purpose of which is to shore up the finances of the Commonwealth’s Medicaid...more

Medicaid Forecast: Slower Enrollment Growth and Higher Spending Growth for FY 2017 – 2018: Results from a 50-State Medicaid Budget...

by Baker Ober Health Law on

On October 19, Kaiser Family Foundation and Health Management Associates hosted a joint briefing to release their 17th Annual 50-State Medicaid Budget Survey for state fiscal years (FY) 2017 and 2018. The survey highlights...more

News from Second & State

Weekly Wrap - It was back to business as usual this week in Harrisburg, as the Senate returned for three days of voting session. While not in session, the House of Representatives was also busy, holding some public...more

Opioid Litigation Over Insurance Coverage – Coming to a Jurisdiction Near You

by Nexsen Pruet, PLLC on

A very recent appellate ruling in California provides a roadmap for opioid litigation over insurance coverage that is about to ramp up all over country. In Travelers Prop. Cas. Co. of Am. v. Actavis, Inc. et al, 2017 WL...more

Three Years Later, Foley Survey Reveals Positive Prognosis for Telemedicine

by Foley & Lardner LLP on

When we launched Foley’s inaugural Telemedicine and Digital Health Survey in 2014, it was apparent that health care executives weren’t ready to make telemedicine a significant focus of their business and patient strategies....more

NAIC Working Group Exposes Proposed Revisions to Life and Health Guaranty Association Model Act

by Locke Lord LLP on

On October 27, the NAIC Model Law (E) Working Group released an exposure draft of its proposed revisions to the Life and Health Guaranty Association Model Act (#520), intended to address the financial challenges of Long Term...more

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