News & Analysis as of

Employee Retirement Income Security Act (ERISA) Medicare

McDermott+

McDermott+ Check-Up: September 13, 2024

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House Education & the Workforce Health, Employment, Labor, and Pensions Subcommittee Holds Hearing on ERISA’s 50th Anniversary. Members and witnesses assessed how the Employee Retirement Income Security Act of 1974 (ERISA)...more

Hall Benefits Law

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

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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

Holland & Knight LLP

Florida Enacts Comprehensive Pharmacy Benefit Plan Regulation

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This legislative session, Florida has joined Arkansas and Oklahoma among the most regulatory-minded states with respect to pharmacy benefit plans and programs as well as pharmacy benefit managers (PBMs). Florida's...more

Pillsbury Winthrop Shaw Pittman LLP

Don’t Let Bank Uncertainty Delay Payroll: Considerations for Employers

With bank uncertainty making headlines, we answer employers’ most frequently asked questions about the consequences of payroll delays, strategies for mitigating risk and more. ...more

Holland & Hart - The Benefits Dial

Closing Time…for the COVID-19 National Emergency and Public Health Emergency

The Biden administration announced on January 30 that the COVID-19 national emergency and the public health emergency will be coming to an end after May 11, 2023. The national emergency is currently set to expire on March 1,...more

Willcox & Savage

You've Heard of Medicare and ERISA Liens, but What About the Federal Medical Care Recovery Act? The Federal Law Controlling the...

Willcox & Savage on

Claims adjusters are frequently warned to identify and resolve Medicare and Employee Retirement Income Security Act (“ERISA”) liens before finalizing settlements in personal injury claims. But there is another federal law...more

Venable LLP

REMINDER: October 15 Is the Deadline for Prescription Drug Notices and the Extended Deadline for Form 5500s

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Does your company's health plan provide prescription drug coverage? If so, you have until October 15, 2022 to send a notice to individuals who are enrolled in Medicare Part A or Part B and are eligible for the company's...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

Mitchell, Williams, Selig, Gates & Woodyard,...

National Association of Insurance Commissioners (NAIC) 2022 Summer Meeting Summary

The Mitchell Williams Insurance Regulatory team of lawyers recently attended the National Association of Insurance Commissioners (NAIC) 2022 Summer National Meeting which was held in Portland, Oregon on August 9-13th. We have...more

Kilpatrick

Supreme Court Upholds ERISA Plan Design for Dialysis Coverage

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The Supreme Court released an opinion Tuesday, June 21, 2022, holding that the Marietta Memorial Hospital Employee Health Benefit Plan (“Marietta Plan”) did not violate the Medicare Secondary Payer statute merely because it...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

Rivkin Radler LLP

Supreme Court to Hear DaVita’s Medicare Secondary Payer Act Case

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The U.S. Supreme Court has agreed to review the scope of the Medicare Secondary Payer Act (MSPA) as it relates to the treatment of patients with end-stage renal disease (ESRD). The case to be heard by the high court, Marietta...more

Verrill

Employee Benefits & Executive Compensation 2021 Summer Client Advisory

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This Client Advisory summarizes developments in the law governing employee benefit plans prompted by the COVID-19 pandemic. We explain what these developments mean for plan sponsors and highlight the need to adopt plan...more

Dorsey & Whitney LLP

The Supreme Court - July 2, 2021

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Hughes v. Northwestern University, No. 19-1401: Whether allegations that a defined-contribution retirement plan paid or charged its participants fees that substantially exceeded fees for alternative available investment...more

McGuireWoods Consulting

The Courts and Healthcare Policy - April 2021

2020 saw the courts continuing to play an important role in health policy with several notable lawsuits related to the Affordable Care Act (ACA). Several other Trump administration policies were challenged, including Medicare...more

McDermott Will & Emery

Health Plan Sponsor Assessed Attorneys' Fees for Pursuing Meritless ERISA Claims against Plan Administrators

McDermott Will & Emery on

The US Court of Appeals for the Eighth Circuit upheld an award of attorneys’ fees payable by a health plan sponsor to the plan administrators that the plan sponsor had sued. See Central Valley Ag Cooperative, et al. v....more

Holland & Hart - The Benefits Dial

Our D.I.V.O.R.C.E. … Is Going To Be Tricky For My Employer To Handle

Nonqualified deferred compensation plans often include anti-assignment language prohibiting a plan participant from assigning benefits to anyone. Because top-hat plans are exempt from most aspects of ERISA including the...more

ArentFox Schiff

The Medicare Secondary Payer Act Prohibits Disparate Impact Discrimination, the Sixth Circuit Rules

ArentFox Schiff on

The Sixth Circuit has issued an important decision that condemns plan provisions that provide different benefits based on a patient’s need for continued dialysis, even if the provision applies to all dialysis patients and not...more

Hinshaw & Culbertson LLP

The LHD/ERISA Advisor: New York Court Rejects Claim that Health Insurer Violated the Parity Act

In Julie L. v. Excellus Health Plan, Inc., 2020 U.S. Dist. LEXIS 47734 (W.D.N.Y. March 19, 2020), a New York district court rejected the plaintiff's claims that a health insurer improperly imposed stricter medical necessity...more

Hinshaw & Culbertson LLP

The LHD/ERISA Advisor: Eighth Circuit Upholds Payment for Out-of-Network Air Ambulance Flight at 150 Percent of Medicare Rates

In Mitchell v. Blue Cross Blue Shield of N.D., 2020 U.S. App. LEXIS 8818 (8th Cir. Mar. 20, 2020), the Eighth Circuit upheld the payment of 150% of Medicare rates for an out-of-network air ambulance flight, although the...more

Hinshaw & Culbertson LLP

The LHD/ERISA Advisor: Sixth Circuit Rejects MSPA and ERISA Discrimination Claims

Seeking to control healthcare costs, many group health plans have adopted amendments that lower reimbursement rates for the treatment of end-stage renal disease ("ESRD"), which requires long-term dialysis treatment or a...more

Groom Law Group, Chartered

Year-End Challenges and Opportunities: Congress Passes SECURE Act, Caddy Tax Repeal, and More

On Thursday, December 19, the Senate passed two spending bills to fund the government through September 30, 2020, one of which (H.R. 1865, the “Further Consolidated Appropriations Act of 2020” or the “Act”) contains the...more

McGuireWoods LLP

House Committees Bring Pelosi's Drug Bill to Floor; Action Expected by Late November

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In keeping with U.S. House Speaker Nancy Pelosi’s schedule for pushing H.R. 3, the Lower Drug Costs Now Act, through the House of Representatives, the three committees of jurisdiction held mark-ups and passed the proposal, as...more

King & Spalding

House Drug Pricing Proposal Released; Surprise Billing Legislation Stalls

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On September 19, 2019, House Speaker Nancy Pelosi (D-CA) released H.R. 3, the Lower Drug Costs Now Act, to make a series of changes to Medicare to lower the price of prescription drugs. The bill must move through three...more

McGuireWoods Consulting

Washington Healthcare Update - September 2019 #3

This week in Washington: Hearings on the public health impact of e-cigarettes, making prescription drugs more affordable and promoting healthy aging. ...more

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