News & Analysis as of

Claim Procedures Patient Protection and Affordable Care Act (PPACA)

New Disability Claims Regulations Take Effect for All Plans April 1, 2018

by Snell & Wilmer on

As noted in our previous blog post, The New Disability Claims Regulations: They Don’t Only Apply to Disability Plans, the Department of Labor (“DOL”) issued regulations that revise the ERISA claims procedure regulations for...more

No More Delays! New Disability Claims Rules to Take Effect April 2, Says DOL

On April 2, 2018, significant changes to ERISA’s disability claims procedures will take effect. These new rules will require all ERISA-covered plans which provide disability benefits to make significant modifications to the...more

DOL’s New Disability Plan Claims Regulations To Become Effective

by Seyfarth Shaw LLP on

The Department of Labor’s new regulations governing disability claims and appeals published on December 19, 2016 will go into effect on April 1, 2018, as announced by the DOL on January 5, 2018. ...more

ERISA Newsletter - Fourth Quarter 2017

by Proskauer Rose LLP on

Editor's Overview - For over two decades, federal law has required covered health plans and insurers to ensure that certain mental health benefits are in parity with offered medical/surgical benefits. The meaning of...more

The New Disability Claims Regulations: They Don’t Only Apply to Disability Plans

by Snell & Wilmer on

The Department of Labor (“DOL”) issued regulations that revise the ERISA claims procedure regulations for employee benefit plans that provide disability benefits (the “New Disability Claims Regulations” or “New Regulations”)....more

Disability Claims Procedures Should be Updated for New Regulations

As open enrollment approaches for many benefit plans, employers and plans sponsors should check to make sure their claims procedures for disability claims are consistent with regulations that become effective for plan years...more

Updated Health Care Reform Legislation Comparison Chart

The chart below compares key provisions of the Affordable Care Act (ACA), the American Health Care Act (AHCA) and the Better Care Reconciliation Act (BCRA). This chart is current as of July 13, 2017, and as of that date,...more

Health Care Reform in Transition While Congress Deliberates

by Ballard Spahr LLP on

Changes are imminent for the Affordable Care Act and a range of other laws and regulations affecting the health care industry. Ballard Spahr attorneys established a Health Care Reform Initiative in 2008 to monitor and analyze...more

DOL Tightens Disability Claim Processing Rules

by Balch & Bingham LLP on

“Isn’t this an ACA blog?” Yes, it is. “So, why are you writing about disability plan administration?” Because they said so. The preamble to the proposed rules explains – Inasmuch as disability and lost earnings can be sources...more

Claims Administrator Not Liable Under ERISA For Alleged Failure to Follow ACA’s Enhanced Benefit Claim Procedures

A federal court in New York appears to have issued the first published decision addressing alleged violations of the enhanced benefit claim procedures arising out of the Affordable Care Act (ACA). The new procedures contain...more

Ordering/Referring Phase 2 Begins May 1st - Claims Will Be Denied

by Baker Donelson on

In an April 24, 2009 transmittal, CMS announced a two-phase claims editing expansion designed to allow verification that the physician or non-physician practitioner (NPP) listed as the ordering/referring provider on a...more

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