News & Analysis as of

Aetna

Ninth Circuit Holds that ERISA Preempts State Insurance Law Bans on Discretionary Clauses for Self-Funded ERISA Plans

by Seyfarth Shaw LLP on

Seyfarth Synopsis: The Ninth Circuit Court of Appeals recently confirmed that ERISA preempts state insurance law bans on discretionary clauses for self-funded ERISA plans....more

Cyber Briefing: Second “Envelope” Lawsuit Against Aetna, Yahoo to Answer for 1.5 Billion Hacked Accounts and Eighth Circuit...

As we head into the new week, here’s a quick summary of major data security developments from around the country. Aetna Hit With Second “Envelope” Lawsuit - Aetna Inc. is now facing a second lawsuit over the disclosure...more

Aetna and its Vendor Face Class Action Lawsuit over HIV Disclosure

A Pennsylvania man has filed a class action lawsuit against Aetna Inc., accusing it of violating his privacy rights when the insurer mailed him prescription information in an envelope with a large, clear window that disclosed...more

Healthcare Insurer Rebuked for Exposing Policyholders’ HIV Status

Two legal advocacy groups have accused Aetna Inc. – the Hartford-based healthcare company – of “gross” breaches of privacy and confidentiality including violations of federal healthcare law when a third-party vendor...more

Employee Benefits Developments - July 2017

by Hodgson Russ LLP on

The Employee Benefits practice group is pleased to present the Benefits Developments Newsletter for the month of July, 2017. Class Action Plaintiffs Target University 403(b) Plans - In June, an ERISA action – a proposed...more

Medicare Advantage Plans Under Fire: The Department of Justice Files Complaints-in-Intervention

As reported in earlier blogs, the federal Department of Justice (DOJ) has been actively looking into potential abuses by Medicare Advantage (MA) Organizations as to allegedly improper risk adjustment claims submissions and...more

Eighth Circuit Jimmies The Lid On Pandora’s Box

by Seyfarth Shaw LLP on

Seyfarth Synopsis: In an opinion that may result in increasingly complex ERISA benefits litigation, the Eighth Circuit has allowed a breach of fiduciary duty claim premised on alleged faulty claims handling practices to...more

Antitrust Division’s Spring Update 2017: Insights Regarding DOJ’s Enforcement and Policy

The Antitrust Division recently issued its 2017 annual spring update. The update emphasizes the Division’s recent litigation victories, particularly in the merger context. In his introductory remarks, Assistant Attorney...more

ERISA Newsletter - First Quarter 2017

by Proskauer Rose LLP on

After a brief hiatus, Proskauer's ERISA Newsletter is back with a brand new look. We hope you like it and find it is easier to navigate. In addition to implementing our new format, we have moved to a quarterly publication...more

Halo looms over new decision that adds to ERISA risks for claims administrators

by Thompson Coburn LLP on

The latest decision to rely on the influential Halo v. Yale Health Plan decision from the 2nd Circuit adds to a worrisome pattern of courts applying the strictest possible review to lawsuits brought by aggrieved plan...more

The Siege Continues: The Justice Department Is Investigating Four Additional Medicare Advantage Plans On Risk Adjustment Issues

WHO IS AT RISK - The federal government has indicated that it is still investigating, and could ultimately join a false claims whistleblower qui tam action against Aetna, Inc., Humana, Inc., Cigna, Inc. (through its Bravo...more

DOJ Prevails in Both the Anthem and Aetna Merger Trials

by Baker Ober Health Law on

During the summer of 2015, within a matter of days, Aetna announced an intention to merge with Humana and Anthem announced an intention to merge with Cigna. The deals, among the largest insurance industry combinations ever...more

ERISA (10th Circuit): Does the ERISA Plan Breach Fiduciary Duties by Informing the Employer of an Employee/Disability Claimant’s...

Can an ERISA plan administrator tell an employer about an employee’s substance abuse? Doesn’t that breach fiduciary duties to the employee/claimant? Probably not. Check the employer’s employment policies because an...more

DOJ Successfully Blocks Insurance Mergers: What Are the Takeaways?

In July 2016, following a lengthy review, the Antitrust Division of the Department of Justice (DOJ), together with several states, sued to block two proposed health insurer mergers: Aetna/Humana and Anthem/Cigna. On January...more

Health Update - February 2017

Securing the Safety Net for America's Vulnerable Populations - Editor's Note: America's population is aging rapidly. By 2029, 75 million baby boomers will have reached age 65 and older, and older adults will represent...more

Federal Court Blocks Anthem - Cigna Merger; King & Spalding Looks Deeper into Aetna-Humana Challenge

by King & Spalding on

On February 8, 2017, the United States District Court for the District of Columbia granted a request filed by the U.S. Department of Justice’s Antitrust Division for an injunction blocking Anthem, Inc.’s (Anthem) proposed $54...more

A tale of two mergers: Following their losses in DOJ merger challenges, Anthem fights on and Aetna gives up

In the past month, the DOJ and several state governments scored two trial wins in their challenges to mergers among some of the country’s largest health insurers. First, Judge Bates of the District of Columbia blocked the...more

Marketplace Shockwaves: Insurer Exits Leave Marketplaces Vulnerable

by Kiesewetter Law Firm on

Early this month, Aetna announced that in 2018, it will not expand its Health Insurance Marketplace ("Marketplace" or "Exchange") coverage, and is evaluating whether it will completely pull out of the Marketplaces created by...more

ERISA: 7 Things to Know About Limited Discovery in ERISA Long Term Disability Cases

You already know that discovery in ERISA cases is generally limited because of the “significant ERISA policy interests of minimizing costs of claim disputes and ensuring prompt claims-resolution procedures.”...more

"DOJ Continues Streak of Successful Merger Challenges With Blocked Aetna-Humana, Anthem-Cigna Deals"

In a continuation of recent Department of Justice (DOJ) successes challenging mergers, the U.S. District Court for the District of Columbia recently enjoined two more proposed mergers brought and litigated under the Obama...more

Your Daily Dose of Financial News

by Robins Kaplan LLP on

We’ve talked a fair amount about the switch to chip & pin card systems over the past few years. But how about a lack of cards altogether? Because that’s what the banks have in mind....more

Federal Court Blocks Aetna, Humana Merger

by King & Spalding on

On January 23, 2017, the United States District Court for the District of Columbia granted the Department of Justice, Antitrust Division’s (DOJ) request for an injunction to block Aetna Inc.’s (Aetna) proposed acquisition of...more

Aetna-Humana Merger Blocked

by Pierce Atwood LLP on

The District of Columbia federal court recently ruled that a proposed $37 billion merger between health insurance giants Aetna and Humana cannot proceed, granting the US Department of Justice’s bid to block the combination on...more

DOJ Successfully Blocks Aetna-Humana Merger

by King & Spalding on

On January 23, 2017, United States District Court for the District of Columbia granted the Department of Justice, Antitrust Division (the “DOJ”), request for an injunction blocking Aetna’s proposed $37 billion acquisition of...more

Your Daily Dose of Financial News

by Robins Kaplan LLP on

Judge John Bates of the US District Court for DC has blocked a proposed $37 billion mega-health-care-merger between Aetna and Humana, one of 2 major deals before the courts opposed by the Obama-era DOJ over antitrust...more

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