With nearly 150 similar class action lawsuits pending nationwide, the ruling is a win for the ERISA plaintiff's bar, potentially supporting their expansive view of plan fiduciaries' duty to monitor investments.
As...more
The U.S. Supreme Court heard oral argument to decide a circuit split and determine what ERISA requires of ERISA-governed pension plan fiduciaries with respect to investment fees and recordkeeping. A decision is expected in...more
The Departments of Health and Human Services, Labor, and Treasury, and the Office of Personnel Management issued this Fall their second long-awaited interim final rule implementing the federal No Surprises Act (the “Act”),...more
The Department of Labor (DOL) recently issued new guidance on best practices for maintaining cybersecurity in connection with ERISA plans (the Guidance).
The Guidance, which is intended for sponsors, fiduciaries, record...more
8/9/2021
/ Benefit Plan Sponsors ,
Best Practices ,
Cybersecurity ,
Data Protection ,
Department of Labor (DOL) ,
Employee Retirement Income Security Act (ERISA) ,
Fiduciary Duty ,
New Guidance ,
Plan Administrators ,
Plan Participants ,
Popular ,
Retirement Plan ,
Third-Party Service Provider
On July 1, 2021, the Departments of Health and Human Services, Labor, and Treasury, and the Office of Personnel Management, released a much-anticipated interim final rule designed to protect Americans from surprise medical...more
States seeking to regulate pharmacy benefit managers (PBMs) and prescription drug pricing received a win from the Supreme Court, which reversed an Eighth Circuit decision that had invalidated an Arkansas law governing...more
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
Last month, in Pharmaceutical Care Management Association v. Tufte et al. No. 18-2926 (8th Cir. August 7, 2020), the United States Court of Appeals for the Eighth Circuit invalidated legislation in North Dakota on the grounds...more
Medical providers treating patients covered by ERISA-governed health plans on an out-of-network basis can assert state-law claims to hold plans to their payment promises without running afoul of ERISA’s preemption provision...more
Below are six reimbursement issues that health care providers should be on “high alert” for as the COVID-19 crisis persists.
An increasing number of patients will be losing their health insurance coverage....more
Lawmakers remain in negotiations among the three key committees in the House of Representatives: Energy & Commerce, Ways & Means, and Education & Labor, along with the Senate Committee on Health, Education, Labor and Pensions...more
In January, the Supreme Court issued its highly anticipated opinion in Retirement Plans Committee of IBM v. Jander, No. 18-1165, a case that promised to clarify the pleading standard applicable to ERISA stock-drop cases. But...more
2/4/2020
/ Breach of Duty ,
Certiorari ,
Corporate Officers ,
Defined Benefit Plans ,
Dismissals ,
Duty of Prudence ,
Employee Retirement Income Security Act (ERISA) ,
Employee Stock Purchase Plans ,
ESOP ,
Failure To Disclose ,
Fiduciary Duty ,
FIfth Third Bancorp v Dudenhoeffer ,
Fraud ,
Insider Information ,
Plan Participants ,
Pleading Standards ,
Pleadings ,
Remand ,
Retirement Plan ,
Retirement Plans Committee of IBM v Jander ,
SCOTUS ,
Securities Violations ,
Stock Drop Litigation ,
Vacated
A federal court in Nebraska recently rejected a health plan’s fiduciary breach claims under the Employee Retirement Income Security Act of 1974 (ERISA) against third-party service providers, holding that the service providers...more
The Senate Health, Education, Labor, and Pensions Committee recently voted to advance bipartisan legislation, called the Lower Health Care Costs Act (the Act), aimed at, among other things, curbing surprise medical bills. ...more
7/13/2019
/ Bipartisan Agreement ,
Department of Health and Human Services (HHS) ,
Drug Pricing ,
Healthcare Costs ,
Legislative Agendas ,
Out of Network Provider ,
Patient Rights ,
Prescription Drug Coverage ,
Proposed Legislation ,
Public Health ,
Surprise Medical Bills ,
Transparency
The US Court of Appeals for the Third Circuit recently confirmed that “anti-assignment” provisions — provisions prohibiting insureds from assigning their rights under a health plan to third parties, including medical...more