News & Analysis as of

Medical Benefits

Goldberg Segalla

One-Time Change: Employers and Carriers Must Go Beyond Simply Authorizing the Benefit

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Florida law entitles injured workers to a one-time change in physicians. This one-time change is a procedural right, per Florida Statute 440.13(2)(f). When the change is granted, the employer or carrier must deauthorize the...more

Marshall Dennehey

Top 10 Developments in Delaware Workers’ Compensation in 2024

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1.    The Delaware Supreme Court affirmed an Industrial Accident Board decision that concluded that a COVID-19 workplace exposure at a poultry processing plant did not qualify as a compensable occupational disease. Fowler v....more

Marshall Dennehey

Top 10 Developments in Florida Workers’ Compensation in 2024

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1. As the employer/carrier was not able to overcome presumption, a firefighter’s COVID-19, requiring heart transplant, was found to be work-related. Seminole County, Florida and Johns Eastern Company, Inc. v. Chad Braden,...more

Marshall Dennehey

Top 10 Developments in New Jersey Workers’ Compensation in 2024

Marshall Dennehey on

1.    The Appellate Division addresses permanent partial vs. total disability. Hughes v. Port Auth. of N.Y. & N.J. and State of N.J. Second Inj. Fund, No. A-1188-22 (January 30, 2024)....more

Ballard Spahr LLP

IRS Guidance Expands List of Preventive Care Benefits Under HDHPs

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The IRS recently issued Notices 2024-71 and 2024-75, which expand the list of “preventive care” benefits permitted to be provided by a high deductible health plan (HDHP) without a deductible and the list of benefits...more

Marshall Dennehey

Commonwealth Court Paves the Way for Workers’ Compensation Fee Agreements Pertaining to Prospective Medical Benefits by Declaring...

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Key Points: A 20% Fee Agreement applicable to all workers’ compensation benefits, indemnity and medical, is per se reasonable and enforceable, regardless of whether the medical expenses have been incurred or will be incurred...more

Goldberg Segalla

Fraud Doesn’t Pay In New York — May 2024 Update — 3rd Anniversary Edition

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As a part of our Quarterly Practice Group Update, we are pleased to share our next installment of examples demonstrating our continued success in the area of fraud litigation. This report was originally conceptualized nearly...more

Marshall Dennehey

New Jersey Supreme Court Affirmed Appellate Division’s Findings, Noting the Petitioner Was in the Course and Scope of His...

Marshall Dennehey on

Keim v. Above All Termite & Pest Control, No. A-30-22 (Supreme Court, Nov. 21, 2023) - The New Jersey Supreme Court affirmed the Appellate Division’s decision, reinstated the claim petition, and remanded for further...more

Morris James LLP

What Workers' Compensation Benefits are You Entitled to in Delaware?

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In the unfortunate event that you are injured at work, it is crucial to understand the benefits you are entitled to under Delaware workers' compensation law, and how to access them. When you are dealing with an injury,...more

Bradley Arant Boult Cummings LLP

Genetic Testing Fraud: A New Wave of Medicine, a New Wave of Enforcement Actions

Genetic testing is a burgeoning area of preventative and predictive medicine. Such testing enables greater insight into a patient's unique genetic makeup and, in turn, more tailored and individualized medical decisions....more

Perkins Coie

Cannabis Legal Report - January 2023

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New York City Attempts to Crack Down on Illicit Cannabis Market - During a council hearing on Jan. 18, 2023, New York City lawmakers and law enforcement officials discussed the need for tackling the city’s illicit cannabis...more

Foley Hoag LLP - Cannabis and the Law

Cannabis Health Claims Face Increased Scrutiny As More States Roll Out Recreational Dispensaries

As the number of adult-use states continues to grow—with New York, New Jersey, Connecticut, Rhode Island, and Vermont recently joining the ranks—the scrutiny of cannabis-related advertising has grown with it...more

Chartwell Law

The Chartwell Chronicles: An Overview of New Jersey Workers' Compensation

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In Episode 1 of The Chartwell Chronicles, hosts Colin Davis and Brittany Atkinson cover the basics of workers' compensation claims in New Jersey. This episode is geared toward providing useful information to listeners who are...more

Epstein Becker & Green

District Court Upholds Medicare Beneficiary’s Challenge to Local Coverage Determination

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A recent decision by the U.S. District Court for the District of Columbia has clarified that a Medicare beneficiary may challenge a Medicare Local Coverage Determination (LCD) without first having to exhaust the lengthy...more

Davis Wright Tremaine LLP

Washington State's New Long-Term Care Statute Is a Mess – Can ERISA Preemption Provide the Cleanup?

Washington state has passed the nation's first public-operated, long-term care insurance program—the Long Term Care (LTC) Act—which is paid for by employees through employer withholding as a payroll tax. The statute is a...more

White and Williams LLP

NJ and PA Workers' Compensation Benefits for 2021

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Workers’ compensation benefits in New Jersey and Pennsylvania are calculated using a statewide average weekly wage (SAWW) that is published by the Departments of Labor every year. The year of the worker’s injury will...more

Chartwell Law

VIDEO: Are PA Workers Compensation Attorney Fees Now Taken from Medical Benefits Too?

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The Pennsylvania Commonwealth Court recently held that attorney fees for Pennsylvania Workers’ Compensation claims can be deducted from medical benefits paid on behalf of claimants, in addition to wage loss benefits....more

Carlton Fields

Cutting Costs With Employee Benefit Plans (Part 3 of 5) – Medical Benefit Costs

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Carlton Fields tax attorney Lowell Walters suggests potential ways to reduce the costs of employer-sponsored group health plans....more

Hogan Lovells

Strengthening of the French anti-benefits regulations: the wait is over! (almost)

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2020 marks a further milestone in stricter controls on HCPs interactions in France. French government has laid the remaining bricks for the new (and stricter) regulatory framework for interactions between the industry and...more

Bricker Graydon LLP

COVID-19 developments in employee medical insurance

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HDHP and HSA participants - The IRS has expanded prior guidance to allow health plans to pay first-dollar costs for testing and treatment of COVID-19 without jeopardizing the participant’s HSA eligibility. ...more

Pullman & Comley - Labor, Employment and...

IRS Guidance: High Deductible Health Plans May Waive Deductible for COVID-19 Testing

Employers and health plans that want to provide some relief for participants during the spread of the novel coronavirus (SARS-CoV-2, which causes the disease COVID-19) may waive deductibles for COVID-19 testing without...more

Littler

IRS Issues High Deductible Health Plan Guidance Related to COVID-19

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On March 11, 2020, the IRS issued Notice 2020-15, allowing health savings account (HSA)-compatible high deductible health plans (HDHPs) to provide coverage for testing and treatment of COVID-19-related services without an...more

Cozen O'Connor

IRS Announces High Deductible Health Plans Can Cover COVID-19 Expenses Without Applying a Deductible

Cozen O'Connor on

Employers across the country are currently considering what actions to put in place in light of the potential spread of COVID-19 (the coronavirus). Many employers offer their employees high-deductible health plans that can...more

Ballard Spahr LLP

IRS Provides Relief for High-Deductible Health Plans to Cover COVID-19 Testing and Treatment Without Deductibles

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The Internal Revenue Service (IRS) issued a notice that allows individuals to participate in a health savings account (HSA) while participating in a high deductible health plan (HDHP) that provides coverage for both the...more

Akerman LLP - HR Defense

IRS Issues Helpful Coronavirus-Related Guidance for Employers with High Deductible Health Plans

Benefit plan sponsors are responding to participant questions about the coronavirus/COVID-19. In particular, employers’ HR departments are fielding questions about whether their health plan will pay for any necessary testing...more

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