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Weber Gallagher Simpson Stapleton Fires &...

Schedule of Disabilities Chart for New Jersey Workers’ Compensation

In this WG Alert, you will find the 2025 Schedule of disabilities chart for New Jersey workers’ compensation claims. The Statutory maximum and minimum for 2025 have increased to $1,159 and $309 respectively. There were no...more

Manatt, Phelps & Phillips, LLP

CMS Releases Proposed Forms to Effectuate Medicare MFP Under the IRA of IPAY 2026 and IPAY 2027

On October 28, CMS requested public comment​ on four proposed information collections (ICRs) it intends to impose on drug manufacturers and pharmacies in order to effectuate maximum fair prices (MFP) under the Inflation...more

Alston & Bird

When Disaster Strikes: Issues and Relief for Health Benefit Plans

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In the wake of a federally declared disaster, employees may face issues with their benefit plans. Our Employee Benefits & Executive Compensation Group discusses what plan administrators should know and the agency guidance...more

Carey Olsen

Insurance M&A: Bermuda’s change of control requirements

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This article, the first in a multi-part series on M&A in insurance, considers the change of control regime under the Bermuda Insurance Act 1978 (the “Insurance Act”) as it applies to shareholder controllers of Bermuda...more

A&O Shearman

UK Prudential Regulation Authority Policy Statement on the April Occasional Consultation Paper

A&O Shearman on

The U.K. Prudential Regulation Authority has published a policy statement to its occasional consultation paper (CP6/24). The statement provides feedback to responses the PRA received to the consultation paper, as well as the...more

Sheppard Mullin Richter & Hampton LLP

California Limits Health Plan Use of AI in Utilization Management

California Governor Newsom signed Senate Bill 1120 into law, which is known as the Physicians Make Decisions Act. At a high level, the Act aims to safeguard patient access to treatments by mandating a certain level of health...more

Fenwick & West LLP

California’s SB 1120 Regulates AI in Health Plan Utilization Review and Management Activities Starting in January

Fenwick & West LLP on

On September 28, California Gov. Gavin Newsom signed Senate Bill 1120 Health Care Coverage: Utilization Review into law, amending § 1367.01 of the Health and Safety Code and § 10123.135 of the state’s Insurance Code....more

McGuireWoods LLP

Northern District of Indiana Excludes Battery Expert Opinions Based on Flawed Methods

McGuireWoods LLP on

On Sept. 30, 2024, the U.S. District Court for the Northern District of Indiana released an opinion and order excluding the opinions of a proposed lithium-ion battery expert. The now dismissed case, American Home Assurance...more

Cozen O'Connor

Minnesota AG Settles with Blue Cross Blue Shield over Mental Health Parity

Cozen O'Connor on

Minnesota AG Keith Ellison has reached a settlement with BCBSM, Inc. d/b/a Blue Cross and Blue Shield of Minnesota, and HMO Minnesota d/b/a Blue Plus (collectively, “Blue Cross”) to resolve allegations that the insurer...more

Harris Beach PLLC

“No Surprises Act” Ruling Favors Regulators, Insurers

Harris Beach PLLC on

Share Federal regulators recently won a large legal victory when the Fifth Circuit Court of Appeals upheld several provisions of the rule regulating Qualified Payment Amount (“QPA”) calculations under the No Surprises Act...more

Lowenstein Sandler LLP

In Bad Faith: Understanding Bad Faith Claims and Policyholder Protection

Lowenstein Sandler LLP on

In this episode of “Don’t Take No for An Answer,” Eric Jesse, partner in Lowenstein Sandler’s Insurance Recovery Group, is joined by Alexander B. Corson to discuss bad faith in insurance claims. Highlighting a recent example...more

Holland & Knight LLP

CMS Releases CY 2025 OPPS and ASC Final Rule

Holland & Knight LLP on

The Centers for Medicare & Medicaid Services (CMS) has released the calendar year (CY) 2025 Hospital Outpatient Prospective Payment System (OPPS) and Ambulatory Surgical Center (ASC) Payment System Final Rule with comment...more

McDermott+

Digesting the Huge Buffet of CMS Regs: Highlights from the CY 2025 PFS Final Reg

McDermott+ on

While we all are focused on the election results, let’s take a quick break to digest some regs and eggs. The Centers for Medicare & Medicaid Services (CMS) “spoiled” all of us in the health policy world with a huge buffet of...more

Woodruff Sawyer

SCOTUS on Securities: Waiting for NVIDIA

Woodruff Sawyer on

In private securities class actions, the motion to dismiss is critical. A victory can mean a quick and relatively inexpensive conclusion to litigation. A loss can mean many months of expensive and intrusive discovery. This...more

Faegre Drinker Biddle & Reath LLP

Pollution Exclusions and Greenhouse Gases

On October 7, 2024, the Hawaii Supreme Court issued a ruling in a case dealing with whether an insurance company owes a defense in cases where the defendant, a fossil fuel company, is being sued by county governments for...more

McDermott Will & Emery

This Week in 340B: October 29 – November 4, 2024

McDermott Will & Emery on

Find this week’s updates on 340B litigation to help you stay in the know on how 340B cases are developing across the country. Each week we comb through the dockets of more than 50 340B cases to provide you with a quick...more

Holland & Knight LLP

Simplifying Pennsylvania Insurance Provider Licensing Requirements

Holland & Knight LLP on

Pennsylvania Gov. Josh Shapiro signed into law Senate Bill No. 1241 on Oct. 31, 2024, which modifies the Insurance Department Act of 1921 by simplifying licensing under the Insurance Producer Licensing Act (the Act)....more

McDermott+

CMS Releases CY 2025 Hospital Outpatient Prospective Payment and ASC Payment Systems Final Rule

McDermott+ on

On November 1, 2024, the Centers for Medicare & Medicaid Services (CMS) released the calendar year (CY) 2025 Hospital Outpatient Prospective Payment and Ambulatory Surgical Center Payment Systems Final Rule [CMS-1809-F],...more

Searcy Denney Scarola Barnhart & Shipley

The Role of Witnesses in Florida Auto Accident Claims

When you suffer serious injuries in an auto accident, proving what happened (and who was at fault) is essential for recovering the financial compensation you deserve. While Florida personal injury lawyers can use various...more

McDermott+

CMS Releases CY 2025 Physician Fee Schedule Final Rule

McDermott+ on

On November 1, 2024, the Centers for Medicare & Medicaid Services (CMS) released the calendar year (CY) 2025 Revisions to Payment Policies Under the Physician Fee Schedule (PFS) and Other Revisions to Medicare Part B...more

McDermott+

Physician Fee Schedule Payment System Data Dashboard

McDermott+ on

Have Medicare physician fee-for-service payment rates increased for X-ray services? How have remote patient monitoring prices evolved over the last five years? How much is your service paid in Alaska compared to Alabama?...more

Goldberg Segalla

Healthcare Insurers Take Note: New Federal Whistleblower Program is Coming for You

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Late this past summer, the Department of Justice (DOJ) launched a new initiative to crackdown on corporate misconduct. Beginning August 1, whistleblowers can submit original information to the DOJ regarding various types of...more

Sherman & Howard L.L.C.

AI Risks: Are You Covered?

You can’t go anywhere these days without hearing about the impact of generative artificial intelligence on … well, everything. The insurance industry is not immune from these impacts; it has been affected by AI in countless...more

Amundsen Davis LLC

Impact of Strengthened Mental Health Parity Laws: What Employers and Health Care Providers Need to Know

Amundsen Davis LLC on

Insurance coverage requirements for mental health and substance use disorders (“MH/SUDs”) is changing in a way that impacts group health plans, employers, and behavioral health providers. These changes are due to final rules...more

Stikeman Elliott LLP

Alberta Insurance Regulator Considers When Automobile Extended Warranty, Dealer Loyalty and Similar Products are Insurance in...

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On October 10, 2024, the Alberta Superintendent of Insurance issued Interpretation Bulletin 05-2024 (“Bulletin”) on the insurance regulatory treatment of motor vehicle warranty contracts, dealership loyalty programs and...more

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