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Manatt, Phelps & Phillips, LLP

Harnessing Claims Data to Address Today's Healthcare Challenges

State All Payer Claims Databases (APCDs) can provide users with broad insights about the health of our populations and the performance of our health care system, across payers (insurers) and over time, and may be used to: ...more

Robinson+Cole Data Privacy + Security Insider

Attempt to Predict Person’s Date of Death with Artificial Intelligence

Launched in July 2024, Death Clock is an application that uses artificial intelligence (AI) to predict when its users will die. Death Clock trained its AI model using over 1,200 life expectancy studies. It then uses the...more

Bennett Jones LLP

Ontario Court of Appeal Holds That a Claim is Limitations-Barred for an Entire Class

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In Fehr v Sun Life Assurance Company of Canada, 2024 ONCA 847 (Fehr), the Ontario Court of Appeal dismissed the representative plaintiffs’ appeal seeking post-certification leave to amend their statement of claim and to...more

Bricker Graydon LLP

Five Year End To Dos for Your Self-Insured Health Plan

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Santa is not the only person who should be making a list and checking it twice this December. All sponsors of self-insured medical plans should also make sure that they double-check their year end to do lists....more

Kramer Levin Naftalis & Frankel LLP

IAIS Adopts Group Capital Standard

Internationally active insurance groups (IAIGs) should take note of a critical new group capital standard adopted by a global insurance standard-setting body. This could have an effect on capital requirements for these large...more

Goldberg Segalla

Fraud Doesn’t Pay in New York – November 2024 Update

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As a part of our Quarterly Practice Group Update, we are pleased to produce yet another installment with examples of our continued success in the area of fraud litigation. ...more

McDermott+

ACO REACH: What Recent Performance Results Could Mean for the Model’s Future

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Decisions, decisions, decisions. The Centers for Medicare & Medicaid Services (CMS) under the Trump Administration will have its hands full making decisions about Center for Medicare and Medicaid Innovation (CMMI) models...more

Husch Blackwell LLP

California District Court Compels Arbitration of Reinsurance Dispute

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A California federal district court recently compelled arbitration of a reinsurance dispute, finding that it “had little difficulty concluding that this case falls within the parties’ arbitration agreement.” Truck Insurance...more

Wiley Rein LLP

Section 111 Bulletin: Mitigating Medicare Section 111 Reporting Risks - With Civil Money Penalties on the Line, Are You Certain...

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Under a long anticipated Centers for Medicare & Medicaid Services (CMS) final rule that took effect in October, casualty insurers face risks of incurring Civil Money Penalties (CMPs) if they fit the Section 111 definition of...more

Whiteford

Private Company M&A – Rep & Warranty Insurance: A “Zero-Liability” Promised Land for Sellers?

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Representation & Warranty Insurance (“RWI”) is specialty insurance coverage purchased for M&A deals which provides third-party insurance coverage for certain breaches of the Seller’s representations and warranties in the...more

McAfee & Taft

Gavel to Gavel: Justice Department takes aim at private health plan fraud

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Historically, the U.S. Department of Justice has directed its efforts on combatting healthcare fraud by focusing on persons and companies who defraud or attempt to defraud federally funded healthcare programs, such as...more

Hinshaw & Culbertson - Insights for Insurers

Key Insurance Decisions, Trends, and Developments in 2024 and a Look Ahead to 2025

Introduction - As 2025 rapidly approaches, we look back at some of the key decisions, trends, and developments impacting the U.S. insurance industry in 2024 and provide a forecast of potential trends and developments for...more

Woodruff Sawyer

Short-Form Mergers and D&O Insurance

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Do you serve as a director or officer of a company that is largely—but not wholly—owned by another company? If yes, this week’s D&O Notebook article is for you. My colleague Walker Newell discusses “short form” mergers,...more

Pullman & Comley - Connecticut Health Law

New Connecticut Health Care Laws Becoming Effective January 1, 2025

Hospitals and health insurance companies will bear the brunt of several new legal requirements taking effect on January 1, 2025. These requirements stem from the 2024 legislative session of the Connecticut General Assembly...more

J.S. Held

Damage Assessment & Scope Development in the Property Claims Management Process

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Introduction: Overview of Site Inspections & Scope Development - Construction consulting experts are often engaged by insurance companies, attorneys, or others to assess reported damage to property and determine the scope...more

Akerman LLP - Health Law Rx

NYDFS Highlights Strategies to Combat AI Cybersecurity Risks

The increased use of artificial intelligence (AI) in the banking, insurance, and financial services industries has led the New York State Department of Financial Services (NYDFS or Department) to publish an Industry Letter on...more

DLA Piper

New York issues extensive new pharmacy benefit manager regulations

DLA Piper on

On November 27, 2024, the New York State Department of Financial Services (DFS) will be releasing new regulations governing pharmacy benefit managers (PBMs). Beginning with legislation in 2021, New York has been active in...more

Stikeman Elliott LLP

OSFI Focuses on Culture Risk Issues in New Regulatory Notice

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On November 21, 2024, the Office of the Superintendent of Financial Institutions (“OSFI”) released a regulatory notice on managing culture risk (the “Notice”). The Notice follows industry feedback on OSFI’s February 2023...more

White and Williams LLP

Do You Have the Receipt? Pennsylvania Court Finds Insufficient Evidence That Defendant Sold the Product

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In State Farm Fire & Cas. Co. v. Coway USA, Inc., No. 22-cv-3516, 2024 U.S. Dist. LEXIS 192849, the United States District Court for the Eastern District of Pennsylvania (District Court) considered whether the plaintiff...more

Snell & Wilmer

2024 End-of-Year Plan Sponsor “To Do” List (Part 3) Qualified Retirement Plans

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As 2024 comes to an end, we are pleased to present our traditional End-of-Year Plan Sponsor “To Do” Lists. This year, we present our “To Do” Lists in four separate SW Benefits Updates. Part 1 addressed health and welfare plan...more

Bradley Arant Boult Cummings LLP

Key MHPAEA Issues for Plan Sponsors: What to Know for 2025

The Mental Health Parity and Addiction Equity Act of 2008 (MHPAEA) mandates that group health plans and health insurance issuers that offer mental health or substance use disorder (MH/SUD) benefits must provide such benefits...more

Stoel Rives LLP

Negotiating Insurance Provisions for Commercial Landlords

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When commercial landlords negotiate leases with prospective tenants, they understandably focus on key commercial terms, such as rental rate and renewal options. While that focus is justified, landlords should never overlook...more

Woodruff Sawyer

Q3 2024 Commercial Insurance Market: Some Good News and Some Challenges

Woodruff Sawyer on

The good news for insurance buyers is that the North Atlantic Hurricane season has not significantly impacted property rates or coverage, and rates are continuing the trend of decreases that we noted in our last update....more

Jackson Lewis P.C.

Tobacco Surcharge Litigation Flares Up

Jackson Lewis P.C. on

Although the Department of the Treasury, Department of Labor, and Department of Health and Human Services believe that wellness programs are delivering on their promise of improving health and reducing costs, one type has...more

The Volkov Law Group

American Life Insurance Company Settles with OFAC for $178,421 Related to Apparent Violations of Iranian Transactions and...

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The U.S. Department of the Treasury’s Office of Foreign Assets Control (“OFAC”) recently settled with American Life Insurance Company (“ALICO”), a Delaware-based subsidiary of MetLife, Inc., for $178,421, addressing apparent...more

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