News & Analysis as of

Benefit Plan Sponsors › Out of Network Provider

Ogletree, Deakins, Nash, Smoak & Stewart,...

What the Final Mental Health Parity Rules Mean for Employers

Ogletree, Deakins, Nash, Smoak & Stewart,... on

The wait is over, and now the work begins for health plan sponsors. Much-anticipated final rules implementing the Paul Wellstone and Pete Domenici Mental Health Parity and Addiction Equity Act of 2008 (MHPAEA) were...more

Hall Benefits Law

9th Circuit Explains ERISA Preemption of State Law Claims Arising from Preservice Coverage Communications

Hall Benefits Law on

The U.S. Court of Appeals for the Ninth Circuit recently issued an opinion with critical implications for the healthcare industry. This court decision clarifies the expansive reach of the Employee Retirement Income Security...more

Hall Benefits Law

The No Surprises Act: A Cost Saving Opportunity for Employer Plan Sponsors

Hall Benefits Law on

Benefits costs continue to increase globally, and in the midst of high inflation and potentially a recession, executives are exploring cost effective methods to manage their self-insured health plans without compromising the...more

McDermott Will & Emery

Preparing for the End of the COVID-19 Emergency: Coverage of COVID-19 Vaccines

McDermott Will & Emery on

The Biden administration has announced its intent to end the COVID-19 National Emergency (NE) and the COVID-19 Public Health Emergency (PHE) on May 11, 2023 (read our prior article for more information). A topic of great...more

Snell & Wilmer

An Interesting Intersection: No Surprises Act Claims and the New Fee Disclosure Requirements for Group Health Plans

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As reported in our January 7, 2022 SW Benefits Blog “The DOL Asks and Answers Questions About the New Welfare Plan Fee Disclosure Rules,” group health plans must now comply with the ERISA Section 408(b)(2) disclosure...more

Fisher Phillips

Departments Delay Enforcement of Transparency Disclosure Requirements

Fisher Phillips on

Group health plan sponsors soon will face daunting new disclosure and transparency requirements under multiple laws including the Affordable Care Act (ACA), the No Surprises Act (the Act) and the Consolidated Appropriations...more

Ogletree, Deakins, Nash, Smoak & Stewart,...

Initial No Surprises Act Regulations Provide Some Clarity for Employer Plans

Ogletree, Deakins, Nash, Smoak & Stewart,... on

Plan participants can be hit with surprise medical bills when they receive care from out-of-network providers. Sometimes, this happens when participants do not know that the care they are receiving is from an out-of-network...more

Ogletree, Deakins, Nash, Smoak & Stewart,...

Surprise Medical Billing Protections Coming for Participants in 2022

Ogletree, Deakins, Nash, Smoak & Stewart,... on

Beginning in 2022, employer-sponsored health plans will be required to pay providers certain emergency and out-of-network charges that would have otherwise been balance billed to participants. That is the centerpiece of...more

McAfee & Taft

RADICAL new transparency rules likely to apply to your health plan in one year

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New rules published last month likely require your employer health plan to phase-in certain disclosures over a three-year period beginning in one year: 1. January 1, 2022 (three files must be disclosed): For plan years...more

Hinshaw & Culbertson - The LHD/ERISA Advisor

The LHD/ERISA Advisor: Eighth Circuit Upholds Payment for Out-of-Network Air Ambulance Flight at 150 Percent of Medicare Rates

Hinshaw & Culbertson - The LHD/ERISA Advisor on

In Mitchell v. Blue Cross Blue Shield of N.D., 2020 U.S. App. LEXIS 8818 (8th Cir. Mar. 20, 2020), the Eighth Circuit upheld the payment of 150% of Medicare rates for an out-of-network air ambulance flight, although the...more

K&L Gates LLP

K&L Gates Triage: Health Care Provider v. Payor Disputes Simplified: Getting Around ERISA Preemption

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In this week’s episode, Gary Qualls discusses the recent Louisiana federal district court decision in Crescent City Surgical Centre vs. United Healthcare of Louisiana, in which the court found that an out-of-network...more

Locke Lord LLP

[Webinar] 28th Annual Employee Benefits Seminar - September 21st, 8:20am Central / 9:20am Eastern

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Program Highlights Please join the Locke Lord Employee Benefits and Executive Compensation Group for our 28th annual employee benefits seminar via webinar.  Our attorneys will provide an overview of current developments...more

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