News & Analysis as of

Dispute Resolution Employer Group Health Plans

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

Second Circuit Renders Important Decision on Vested Retiree Benefits

In a significant ruling on February 5, 2025, the U.S. Court of Appeals for the Second Circuit addressed the enforceability of an arbitration provision in an expired collective bargaining agreement (CBA) in the case of Xerox...more

Verrill

The Gag Clause Quandary for Self-Insured Group Health Plans—New FAQ Guidance

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The Departments of Labor, Health and Human Services, and the Treasury, with the Office of Personnel Management (the “Departments”) jointly released FAQs About Consolidated Appropriations Act, 2021 Implementation Part 69...more

McDermott+

Special Report - No Surprises Act Update: The TMA III Decision - August 2023

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The Texas Medical Association and additional plaintiffs have brought four Administrative Procedure Act (APA) challenges to the rules and guidance implementing the No Surprises Act (NSA) (termed TMA I, II, III and IV). The...more

Keating Muething & Klekamp PLL

Benefits Monthly Minute - May 2023

The May Monthly Minute examines a recent Seventh Circuit decision upholding unambiguous plan language against class action attack, the status of the federal IDR process under the No Surprises Act, and the DOL’s recent...more

Hendershot Cowart P.C.

Texas ER Physicians Sue Insurer for Underpayment – Thousands of Claims at Stake

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An appeal brought before the Texas Supreme Court could unleash a wave of legal action by out-of-network ER physicians pursuing insurers for underpayment of claims. Unlike in-network providers who negotiate reimbursement...more

Williams Mullen

Court Strikes Down Portions of Rule Implementing Independent Dispute Resolution Process Under the Federal No Surprises Act

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The newly enacted federal No Surprises Act (NSA), intended to protect consumers from surprise balance billing, continues to be the subject of considerable controversy. On February 23, 2022, a U.S. District Court in Texas...more

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

No Surprises Act: Federal Court Invalidates Parts of the Independent Dispute Resolution Process

On February 23, 2022, the U.S. District Court for the Eastern District of Texas struck down the part of the interagency interim final rule implementing the “independent dispute resolution” (IDR) procedures created by the No...more

Verrill

Surprise Medical Bills: Texas District Court Vacates Portion of Independent Dispute Resolution (IDR) Process in Agency Rule

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The U.S. District Court for the Eastern District of Texas recently vacated a portion of the Requirements Related to Surprise Billing, Part II, Interim Final Rule (the “Rule”) regarding the independent dispute resolution (IDR)...more

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

Initial No Surprises Act Regulations Provide Some Clarity for Employer Plans

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

Holland & Knight LLP

HHS Issues Interim Final Rule Implementing Certain Provisions of the No Surprises Act

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The U.S. Departments of Health and Human Services (HHS), Labor and Treasury, along with the Office of Personnel Management, on July 1, 2021, issued a much-anticipated Interim Final Rule with Comment Period (IFC) –...more

Husch Blackwell LLP

The "No Surprises Act:" How Does It Affect Employer-Sponsored Health Plans?

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The Consolidated Appropriations Act, 2021, signed into law at the end of 2020, includes the “No Surprises Act” which prohibits hospitals and doctors from issuing surprise medical bills for certain healthcare services. The Act...more

Epstein Becker & Green

Take 5 Newsletter: An Employer's "Top 5" Action Items for 2014

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It's December, and human resources professionals and law departments are reflecting on the issues addressed in 2013 and giving thanks for incident-free holiday parties. But the big question is this: What issues should get...more

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