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Employee Retirement Income Security Act (ERISA) Medicare Advantage

Foley Hoag LLP

10th Circuit Invalidates Oklahoma Pharmacy Network Law as Applied to ERISA and Medicare Part D Plans

Foley Hoag LLP on

The U.S. Court of Appeals for the 10th Circuit issued a sweeping decision that (1) maintains long-standing federal protections for employer and union-sponsored health plans to design their health benefit plans, including...more

McDermott Will & Emery

Tenth Circuit Reaffirms Preemption of State Pharmacy Network Regulations

McDermott Will & Emery on

The US Court of Appeals for the Tenth Circuit recently held in Pharmaceutical Care Management Association (PCMA) v. Mulready that the Employee Retirement Income Security Act (ERISA) and Medicare Part D preempted several...more

McDermott Will & Emery

McDermott Health 2023 Annual Report: Managed Care 2022 Year in Review

McDermott Will & Emery on

The managed care space saw a number of regulatory and legislative developments in 2022 that are shaping the sector as we move further into 2023. Against this backdrop, the healthcare sector itself has continued to transform...more

King & Spalding

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

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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

Tucker Arensberg, P.C.

Updated Procedural History of UPMC – Highmark Litigation

Below is a summary of UPMC-Highmark dispute as of March 4, 2019. This information is limited to litigation proceedings with no discussion about prior contracts or negotiations....more

Foley & Lardner LLP

Health Care Policy Newsletter - July 2018 pt 2

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Foley & Lardner LLP’s (“Foley”) Bipartisan Public Policy Team is pleased to share our “Public Policy Weekly* Health Care Newsletter” in which we compile the latest Health Care policy news and legislation. *Please note that we...more

Foley & Lardner LLP

California: Proposed Legislation Regulating Health Care Rates for Payors and Providers

Foley & Lardner LLP on

An ambitious California proposal to regulate health care rates and curb long-term health care spending was unveiled last week in Assembly Bill 3087 (Proposed Legislation). The key concept in the Proposed Legislation is the...more

McGuireWoods LLP

Managed Care Quarterly Review: Issue 1

McGuireWoods LLP on

Tips for Managing Large Claims Disputes Part 1: Pre-Litigation Avoidance and Early Litigation Strategies - Large claims disputes brought by providers against payers are on the rise. Based on previous experience with dozens...more

Proskauer Rose LLP

The ERISA Litigation Newsletter - December 2016

Proskauer Rose LLP on

This month Richard Zall, Chair of Proskauer's Health Care Department, explores developments likely to occur with respect to the Affordable Care Act as a result of the new administration. In our Rulings, Filings and...more

BakerHostetler

Medicare Advantage Plan Arbitration Clauses Preempted by Medicare Appeals Process

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The Arizona Supreme Court, in an interesting case involving a Medicare-related coverage dispute between a Medicare Advantage plan administrator, United Behavioral Health (UBH), and two inpatient psychiatric care providers,...more

Proskauer - Employee Benefits & Executive...

Agencies Issue Final Regulations on the Summary of Benefits and Coverage (SBC) Requirements

As promised in the FAQ issued on March 30, 2015, the U.S. Departments of the Treasury, Labor and Health and Human Services (the Departments) have issued final regulations regarding the summary of benefits and coverage (SBC)...more

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