News & Analysis as of

Employee Retirement Income Security Act (ERISA) Health Care Providers

McDermott+

Healthcare Preview for the Week of: September 9, 2024

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Congress is back from a long August recess. However, it is only back for a few weeks. During this window, there is only one major thing Congress must do: extend government funding past the September 30 deadline through a...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

Proskauer - Health Care Law Brief

No Surprises Here!  Divergent Court Rulings Spotlight Ongoing Challenges in No Surprises Act Implementation; Tee Up Split in...

Two District Courts have reached opposite conclusions on the enforceability of arbitration awards under the No Surprises Act (“NSA”). The two decisions, while far from the final word on the subject, highlight the most recent...more

Fisher Phillips

Don't Forget About ERISA in Your Health Plan’s Cybersecurity Efforts: Important Reminders for Plan Fiduciaries in the Wake of...

Fisher Phillips on

Earlier this year, a cyberattack on a leading healthcare claims processing provider had an unprecedented impact on patients and healthcare providers across the country. While group health plans were not directly targeted in...more

Hall Benefits Law

DOL, HHS, and Treasury Release FAQs about No Surprises Act after TMA III

Hall Benefits Law on

The U.S. Departments of Labor (DOL), Health and Human Services (HHS), and Treasury, along with the Office of Personnel Management (OPM), released FAQs about the implementation of Title I of Division BB of the Consolidated...more

Nelson Mullins Riley & Scarborough LLP

Managing the Impacts of the Change Healthcare Cyberattack

UnitedHealth Group (“UHC”) announced on April 22, 2024, that it had paid a ransom to protect patient data potentially acquired in a late February cyberattack on its subsidiary Change Healthcare (“CHC”). In its announcement,...more

Arnall Golden Gregory LLP

California Federal District Court Rules That AGG Clients’ Case Against Cigna for Institutional Practice of Under-Reimbursing...

U.S. District Court Judge David O. Carter ruled in favor of AGG’s clients on March 18, 2024, in a case involving “matters of widescale public concern” and a strong “public interest in access” to some of Cigna’s most coveted...more

Manatt, Phelps & Phillips, LLP

[Webinar] Mental Health Parity Update 2024: The Latest Regulatory and Litigation Trends - March 26th, 1:00 pm - 2:00 pm ET

The Mental Health Parity and Addiction Equity Act (MHPAEA) requires health plans and insurers to offer mental health coverage in “parity” with a plan’s medical or surgical coverage. In 2024, as the post-COVID era brings a...more

Mandelbaum Barrett PC

The No Surprises Act: A Look at What Dentists Need to Know

Mandelbaum Barrett PC on

The Federal No Surprises Act (“NSA”) was signed into law on December 27, 2020, as part of the Consolidated Appropriations Act of 2021. Since its enactment, the NSA has been supplemented on two occasions by regulations which...more

Seyfarth Shaw LLP

Wellness Apps and Privacy

Seyfarth Shaw LLP on

Employers looking to enhance their suite of employee benefit programs, and focused on lessons learned during the pandemic on wellbeing, are interested in providing greater access to wellness tools. And, the vendors who...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

Hall Benefits Law

Health Care Stakeholders Support Passage of The Value in Health Care Act

Hall Benefits Law on

Seventeen healthcare stakeholder groups have come together to support The Value in Health Care Act, a bill that a bipartisan coalition reintroduced in Congress this summer. The bill supports a shift in the medical care...more

DRI

[Event] Life, Health, Disability and ERISA Seminar - March 20th - 22nd, Philadelphia, PA

DRI on

Whether you think of it as the City of Brotherly Love or the Cradle of Liberty, there can be no question that Philadelphia is the perfect venue for the nation’s premier Life, Health, Disability & ERISA (LHD&E) conference....more

King & Spalding

Provider Victory in Latest No Surprises Act Litigation Overturns QPA Rules

King & Spalding on

On August 24, 2023, Judge Kernodle of the Eastern District of Texas issued a fourth judgment overturning additional aspects of the No Surprises Act (NSA) rulemaking and guidance. This latest decision vacated aspects of...more

Snell & Wilmer

Another HIPAA Special Enrollment Deadline Extension – What’s a Group Health Plan to Do?

Snell & Wilmer on

Just when you thought the confusing COVID-19 ERISA deadline extensions were behind you, the Biden-Harris Administration asks you to reconsider. ...more

Ballard Spahr LLP

Gag-Clause Attestations Due by End of Year

Ballard Spahr LLP on

Summary - By December 31, 2023, health plans and insurers must submit an attestation of compliance with the anti-gag rules of the Consolidated Appropriations Act, 2021 (CAA). The rules apply to all agreements entered into...more

King & Spalding

Texas Medical Association Files Third Challenge to No Surprises Act

King & Spalding on

On November 30, 2022, the Texas Medical Association (TMA) filed a third lawsuit challenging the regulations implementing the No Surprises Act (NSA). TMA’s latest suit before the United States District Court for the Eastern...more

Morgan Lewis

House Passes Mental Health Matters Act: What Employers, Insurers, and ERISA Plan Administrators Need to Know

Morgan Lewis on

The Mental Health Matters Act, passed in the US House of Representatives on September 29, significantly expands the US Department of Labor’s authority to enforce or file civil litigation with respect to mental health parity...more

Hendershot Cowart P.C.

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

Hendershot Cowart P.C. on

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

Fox Rothschild LLP

The Supreme Court’s Dobbs Ruling Creates a Variety of Significant Legal Issues

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The Supreme Court of the United States held in Dobbs v. Jackson Women’s Health Organization, that the Constitution does not confer a right to abortion, overruling long-standing precedent in Roe v. Wade and Planned Parenthood...more

Jackson Lewis P.C.

Ohio’s Surprise Billing Law – Impact on Health Plans

Jackson Lewis P.C. on

Ohio’s Surprise Billing Law, R.C. § 3902.51, became effective January 12, 2022, but its impact on health plans is still evolving. The law strives to prevent patients from receiving and paying surprise medical bills,...more

Verrill

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

Verrill on

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

Ballard Spahr LLP

The CAA's New Rules for Health Care Provider Directories

Ballard Spahr LLP on

Summary - The Consolidated Appropriations Act (CAA) requires each group health plan and health insurer with a network of providers to maintain a database on a public website that lists the name, address, specialty,...more

Arnall Golden Gregory LLP

Ninth Circuit Sides With Plaintiff, Reviving $8.6M Reimbursement Suit

AGG Healthcare attorneys Matthew M. Lavin and Aaron R. Modiano recently secured a revival of an $8.6 million reimbursement suit against Cigna Health and Life Insurance. In Bristol SL Holding, Inc. v. Cigna Health and Life...more

King & Spalding

Don’t Be Surprised – The No Surprises Act Takes Effect January 1, 2022

King & Spalding on

The No Surprises Act (the Act), enacted December 27, 2021, will take effect on January 1, 2022. The No Surprises Act puts into place important patient protections from surprise medical bills, while imposing significant...more

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