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Employee Retirement Income Security Act (ERISA) Healthcare

Troutman Pepper

9th Circ. Clarifies ERISA Preemption for Healthcare Industry

Troutman Pepper on

On May 31, the U.S. Court of Appeals for the Ninth Circuit published an opinion in Bristol SL Holdings Inc. v. Cigna Health and Life Insurance Co., which has significant implications for the healthcare industry. Originally...more

McDermott+

Healthcare Preview for the Week of: September 9, 2024

McDermott+ on

Congress is back from a long August recess. However, it is only back for a few weeks. During this window, there is only one major thing Congress must do: extend government funding past the September 30 deadline through a...more

Hall Benefits Law

9th Circuit Explains ERISA Preemption of State Law Claims Arising from Preservice Coverage Communications

Hall Benefits Law on

The U.S. Court of Appeals for the Ninth Circuit recently issued an opinion with critical implications for the healthcare industry. This court decision clarifies the expansive reach of the Employee Retirement Income Security...more

ArentFox Schiff

Cross-Plan Offsetting: Recent Eighth Circuit Opinion Affirms Dismissal of Cross-Plan Offsetting Case Concluding Plaintiffs Did Not...

ArentFox Schiff on

In a recent opinion, Smith et al. v. UnitedHealth Group Inc. et al., the US Court of Appeals for the Eighth Circuit affirmed the dismissal of an Employee Retirement Income Security Act (ERISA) class action suit brought by...more

Keating Muething & Klekamp PLL

Benefits Monthly Minute - July 2024

The July Monthly Minute considers the impact of the Supreme Court’s Loper decision in overturning the longstanding Chevron deference standard, along with a district court case awarding penalties for failing to produce plan...more

The Wagner Law Group

The Rise of Fiduciary Health Plan Litigation

The Wagner Law Group on

According to CMS, annual health care spending in the United States reached about $4.5 trillion in 2022, 9% of which (about $405 billion) was spent on prescription drugs.[1] CMS also reports that in 2022, 18% of annual health...more

Verrill

Can a Self-Funded Group Health Plan Exclude Coverage for Gender-Affirming Care?

Verrill on

We are sometimes asked whether a self-funded group health plan is required to cover gender-affirming medical services. As this post explains in detail, it is generally impracticable for a self-funded ERISA-covered plan to...more

Bass, Berry & Sims PLC

Welfare Plan Class Action Litigation Underscores Importance of Minding Your Fiduciary Duties

Bass, Berry & Sims PLC on

As mentioned in our recent blog post, the recently filed class action lawsuit against Johnson & Johnson (Lewandowski v. Johnson & Johnson et. al., D.N.J., No. 1:24-cv-00671 (Feb. 5, 2024)) over alleged excessive prescription...more

Keating Muething & Klekamp PLL

Benefits Monthly Minute - March 2024

The March Monthly Minute digs into an Ohio district court ruling that rejected application of a medical plan exclusion, missing participant guidance and related audit concerns, and responses to the Change Healthcare...more

Foley & Lardner LLP

To 457(b) or Not to 457(b): Five Rules You Must Follow to Keep Your 457(b) Plan Compliant

Foley & Lardner LLP on

Recruiting and retaining top executives can be challenging for non-governmental tax-exempt organizations such as Code §501(c)(3) organizations, private universities, and certain healthcare organizations (Nonprofits). Not only...more

Fenwick & West LLP

The Shifting Regulatory Landscape for Level-Funded Plans: An Alternative for Group Health Insurance

Fenwick & West LLP on

In the constantly changing health insurance landscape, level-funded health plans are steadily gaining ground as a viable middle approach between fully insured health plan and self-funded health plans—arguably offering...more

Seyfarth Shaw LLP

Wellness Apps and Privacy

Seyfarth Shaw LLP on

Employers looking to enhance their suite of employee benefit programs, and focused on lessons learned during the pandemic on wellbeing, are interested in providing greater access to wellness tools. And, the vendors who...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

Seyfarth Shaw LLP

The Benefits of Flying into SFO; Employees Have Free Family Health Insurance – For Now

Seyfarth Shaw LLP on

Seyfarth Synopsis: In August, the Ninth Circuit Court of Appeals revived a challenge by Airlines for America (“A4A”), to San Francisco’s Healthy Airport Ordinance (the “Ordinance”), which requires airlines that use the San...more

Quarles & Brady LLP

Oklahoma Patient's Right to Pharmacy Choice Act Preempted by ERISA

Quarles & Brady LLP on

On August 15, 2023, the U.S. Court of Appeals for the Tenth Circuit issued an opinion in Pharmaceutical Care Management Association v. Glen Mulready, in his official capacity as Insurance Commissioner of Oklahoma, Oklahoma...more

McDermott Will & Emery

Key Takeaways | Putting Employee Wellness Programs to Work

McDermott Will & Emery on

During this session, panelists discussed the unique opportunities and challenges of digital-health wellness programs that partner with employers and health plans in considering, adopting and operationalizing wellness programs...more

Foley & Lardner LLP

Applying the ERISA Controlled Group and Affiliated Service Group Rules in the Health Care Industry

Foley & Lardner LLP on

Entities interested in entering into health care related industries must consider compliance with the corporate practice of medicine doctrine. In a number of states, the corporate practice of medicine doctrine prohibits...more

Pillsbury Winthrop Shaw Pittman LLP

Los Angeles Initiative Seeks to Impose $450,000 Cap on Annual Compensation of Executives in Health Care Facilities

The Los Angeles City Council will soon decide whether to adopt an initiative as an ordinance or refer it to voters for the 2024 ballot. If the initiative officially qualifies for the ballot, the Los Angeles City Council...more

Akerman LLP - HR Defense

Your Employee Benefit Plans May Need a Check Up: Nearing the End of the COVID-19 Public Health Emergency

Where did the time go? Just a brief 1,199 days after it began, the COVID-19 Public Health Emergency (PHE) is coming to an end. The PHE formally ends on May 11, 2023, short of any unexpected developments. And that means the...more

Ballard Spahr LLP

Spring Cleaning: Preparing for the COVID Emergency’s End

Ballard Spahr LLP on

Summary - The almost three-year-old COVID-19 national emergency and public health emergency declarations (Declarations) are slated to expire May 11, 2023....more

Manatt, Phelps & Phillips, LLP

Wit Redux: Ninth Circuit Issues New Superseding Opinion in Landmark Mental Health Case

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

Keating Muething & Klekamp PLL

Benefits Monthly Minute - July 2022

The July Monthly Minute addresses a steep settlement and corrective action plan resulting from a widespread HIPAA breach, along with recent employer-friendly cases that highlight judicial support for inclusion of actively...more

Patterson Belknap Webb & Tyler LLP

The Reversal of Roe: Impact on Employer-sponsored Benefits post-Dobbs

On June 24, 2022, the Supreme Court of the United States (the “Court”) issued its opinion in Dobbs v. Jackson Women’s Health Organization, overturning the long-standing precedent of Roe v. Wade. In its 6-3 decision, the Court...more

Clark Hill PLC

The Demise of Roe v. Wade – An Analysis of the Critical Group Health Plan Issues for Employers

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The essential holding of the Supreme Court’s recent 6-3 decision in Dobbs v. Jackson Women’s Health Organization is that a woman’s ability to obtain an abortion in the United States is now to be determined entirely under...more

Proskauer - Employee Benefits & Executive...

After Dobbs v. Jackson Women’s Health Organization: Impact on Employee Benefits

Employers and other group health plan sponsors are left with much to consider following the U.S. Supreme Court’s decision in Dobbs v. Jackson Women’s Health Organization, which overruled the Supreme Court’s prior landmark...more

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