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
3/6/2024
/ Class Action ,
Continuing Legal Education ,
Department of Health and Human Services (HHS) ,
Department of Labor (DOL) ,
Employee Retirement Income Security Act (ERISA) ,
Health Care Providers ,
Health Insurance ,
Health Plan Sponsors ,
Insurance Litigation ,
Mental Health ,
Mental Health Parity Rule ,
MHPAEA ,
Proposed Regulation ,
Regulatory Agenda ,
Statutory Interpretation ,
Statutory Violations ,
Substance Abuse ,
U.S. Treasury ,
Webinars
In recent years, an unprecedented level of interest in the promise of psychedelics has taken hold. In the United States, many types of psychedelics are being investigated for use in treating an array of mental health...more
9/14/2023
/ Continuing Legal Education ,
Controlled Substances ,
FDA Approval ,
Food and Drug Administration (FDA) ,
Health Care Providers ,
Healthcare Reform ,
Legislative Agendas ,
Mental Health ,
Mental Health Parity Rule ,
Pharmaceutical Industry ,
Webinars
The Mental Health Parity and Addiction Equity Act (MHPAEA) requires health plans to provide mental health benefits, including coverage for substance use disorders (SUDs), that are in “parity” with medical and surgical...more
8/29/2023
/ Continuing Legal Education ,
Department of Health and Human Services (HHS) ,
Department of Labor (DOL) ,
Health Care Providers ,
Health Insurance ,
Health Plan Sponsors ,
Insurance Litigation ,
Mental Health ,
Mental Health Parity Rule ,
MHPAEA ,
New Guidance ,
Proposed Regulation ,
Substance Abuse ,
U.S. Treasury ,
Webinars
The Ninth Circuit has issued a new opinion in the long-running Wit v. United Behavioral Health litigation that changes the legal landscape for ERISA class actions. The Ninth Circuit’s opinion includes significant holdings on...more
2/8/2023
/ Abuse of Discretion ,
Class Action ,
Class Certification ,
Class Members ,
Corporate Counsel ,
Denial of Benefits ,
Employee Benefits ,
Employee Retirement Income Security Act (ERISA) ,
Health Insurance ,
Healthcare ,
Injury-in-Fact ,
Medical Necessity ,
Mental Health ,
Popular ,
Standing
On November 4 and 7, 2022, the California Department of Managed Health Care (DMHC) issued two All Plan Letters (APL 22-026 and APL 22-027) concerning compliance with the state’s network adequacy and timely access...more
The Mental Health Parity and Addiction Equity Act (MHPAEA) requires health plans to provide equal levels of coverage for mental health conditions and substance use disorders (SUD) as for physical illnesses. Understanding and...more
10/14/2022
/ Addiction Equity Act ,
Continuing Legal Education ,
Enforcement Actions ,
Health Care Providers ,
Health Insurance ,
Health Plan Sponsors ,
Mental Health ,
Mental Health Parity Rule ,
MHPAEA ,
Proposed Legislation ,
Substance Abuse ,
Webinars
Increasing mental health care needs for minors present a range of legal issues for children, parents, health care providers and health care payors. While state laws typically govern who has the power to consent to or refuse...more
3/30/2022
/ Consent ,
Department of Health and Human Services (HHS) ,
Health Insurance Portability and Accountability Act (HIPAA) ,
Healthcare Reform ,
Medical Records ,
Mental Health ,
Minor Children ,
OCR ,
Patient Access ,
Regulatory Agenda ,
Regulatory Standards ,
SAMHSA ,
Scope of Treatment ,
Substance Abuse
Despite the unprecedented challenges of the COVID-19 pandemic, mergers and acquisitions in the health care industry have continued apace and show no signs of slowing....more
On Tuesday, the U.S. Departments of Labor, Health & Human Services, and the Treasury (the Departments) issued their joint report to Congress on the Mental Health Parity and Addiction Equity Act (MHPAEA). The Consolidated...more
1/27/2022
/ Consolidated Appropriations Act (CAA) ,
Department of Health and Human Services (HHS) ,
Department of Labor (DOL) ,
Employee Benefits ,
Employer Group Health Plans ,
Health Insurance ,
Healthcare ,
Healthcare Reform ,
Insurance Industry ,
Mental Health ,
Mental Health Parity Rule ,
MHPAEA ,
NQTLs ,
Statistical Analysis ,
Substance Abuse
Commercials, news articles and targeted social media advertisements abound offering virtual mental health services from providers like Talkspace and Calm. These startups are just a few of the many companies offering...more
9/30/2021
/ Coronavirus/COVID-19 ,
Health Care Providers ,
Health Insurance ,
Health Technology ,
Infectious Diseases ,
Mental Health ,
Online Platforms ,
Patient Access ,
Startups ,
Telehealth ,
Telemedicine ,
Therapeutic Services ,
Unicorns
On August 11, 2021, United Healthcare and its affiliates were served with separate enforcement lawsuits by the Department of Labor (DOL) and the New York Attorney General (NY AG) involving mental health parity, among other...more
9/14/2021
/ Department of Labor (DOL) ,
Employee Benefits ,
Employee Retirement Income Security Act (ERISA) ,
Enforcement Actions ,
Explanation of Benefits (EOBs) ,
Medical Reimbursement ,
Mental Health ,
Mental Health Parity Rule ,
MHPAEA ,
NQTLs ,
Out of Network Provider ,
Outlier Payments ,
Outpatient Services ,
Settlement Agreements
On July 22, 2021, a bipartisan group of senators led by Chuck Grassley (R-IA) introduced the False Claims Amendments Act of 2021 (S.B. 2428). As the name suggests, the bill proposes certain amendments to the False Claims Act,...more
As the race to vaccinate continues, state and federal enforcement agencies are hard at work investigating and prosecuting COVID-19-related health care fraud. As Acting Assistant Attorney General Nicholas L. McQuaid of the...more
Unprecedented Claims Reprocessing Order Stayed Pending Appeal to the Ninth Circuit -
On February 1, 2021, Chief Magistrate Judge Joseph C. Spero entered final judgment in Wit v. United Behavioral Health, No. 3:14-cv-2346...more
On August 3, 2020, the California Supreme Court held in Ixchel Pharma, LLC v. Biogen, Inc. that tortious interference with at-will contracts requires establishing wrongful conduct independent of interference itself. 9 Cal....more
On January 5, 2021, the California Department of Managed Health Care (DMHC) issued an All Plan Letter regarding the newly passed California Senate Bill 855 (Wiener, Stats. 2020, ch. 151 § 2) (SB 855). SB 855 became effective...more
On September 25, 2020, Governor Newsom signed Senate Bill 855 into law. SB 855 fundamentally alters California’s regulation of mental health and substance use disorder (MH/SUD) treatment, and it applies to all California...more
How is today’s volatile healthcare environment impacting litigation—and how can you protect your organization? Learn the answer at a new Manatt webinar.
Healthcare is facing a tidal wave of change—from tightening False...more
3/30/2020
/ Anti-Discrimination Policies ,
Continuing Legal Education ,
Coronavirus/COVID-19 ,
Employee Retirement Income Security Act (ERISA) ,
False Claims Act (FCA) ,
Fraud ,
Health Care Providers ,
Healthcare ,
Mental Health ,
Religious Beliefs ,
Substance Abuse ,
Webinars ,
Whistleblowers
In recent Employee Retirement Income Security Act of 1974 (ERISA) litigation challenging benefit decisions by plan administrators and fiduciaries, litigants have been pleading closely related claims under multiple ERISA...more
3/3/2020
/ Abuse of Discretion ,
Arbitrary and Capricious ,
Benefit Plan Sponsors ,
Breach of Duty ,
De Novo Standard of Review ,
Denial of Benefits ,
Employee Retirement Income Security Act (ERISA) ,
Pension Funds ,
Pensions ,
Plan Administrators ,
Scope of Discovery Requests ,
Standard of Review
Editor’s Note: Litigators and in-house counsel for both payers and providers in the reimbursement arena should be aware of recently enacted legislation regulating “surprise” medical billing. In this article, we discuss some...more
Editor’s Note: The Mental Health Parity and Addiction Equity Act (MHPAEA) requires health plans to provide comparable levels of treatment for mental health conditions and substance use disorders (SUDs) as they do for physical...more
Increased prescribing of opioid medications over the course of nearly two decades has led to widespread misuse of both prescription and nonprescription opioids. In 2018 alone, 10.3 million people misused prescription opioids,...more
Editor’s Note: The Mental Health Parity and Addiction Equity Act (MHPAEA) prohibits health plans and health insurance coverage from applying more stringent treatment limitations or financial requirements on mental health and...more
On August 26, 2019, Cleveland County, Oklahoma, District Court Judge Thad Balkman issued a 42-page decision ordering Johnson & Johnson to pay more than $570 million for harm it allegedly caused the state of Oklahoma by...more
In July 2019, Judge Gilliam of the Northern District of California issued an order interpreting the different avenues a plaintiff may pursue in bringing a parity claim—a decision that may be consequential to health plans and...more