News & Analysis as of

Remand Health Insurance

Parker Poe Adams & Bernstein LLP

NC Supreme Court Sets Direct Connection Test for Workplace Injuries

In most situations, medical treatment for workplace injuries is fairly straightforward. Workers' compensation statutes require coverage for procedures necessary to treat and correct injuries or illnesses that occurred at the...more

Sheppard Mullin Richter & Hampton LLP

Fifth Circuit Upholds ACA Risk Adjustment Program

Various smaller health insurance issuers have challenged the risk-adjustment program under the Patient Protection and Affordable Care Act (ACA), alleging, among other things, that its underlying methodology favors larger...more

Rivkin Radler LLP

Employee Relations Law Journal – From the Courts

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North Carolina District Court Permits Plan’s Lawsuit Against Third Party Administrator to Continue A federal district court in North Carolina has ruled that a plan subject to the Employee Retirement Income Security Act of...more

Morgan Lewis

High Court Checks Government in Risk Corridors Case

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In Maine Community, the US Supreme Court found on April 27, 2020, that the Risk Corridors program created by Congress was a “money-mandating obligation” requiring the federal government to make payments under Section 1342 of...more

Ballard Spahr LLP

Health Insurance Exchanges: A $12B Judgment

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The U.S. Supreme Court has determined that the federal government must pay over $12 billion to certain health insurers that participated in health insurance exchanges in the first three years that those exchanges were in...more

Akerman LLP - Health Law Rx

SCOTUS Rules Government Must Pay $12 Billion to Unprofitable ACA Insurers

Despite Congress’ efforts to use riders to neutralize a provision of the Affordable Care Act (ACA or Act), the Federal government (Government) owes certain insurers $12 billion....more

Troutman Pepper

Supreme Court Finds Insurers Entitled To Millions In ACA Payments

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On April 27, the U.S. Supreme Court held that the federal government is on the hook for $12 billion it failed to pay insurers under the Affordable Care Act (ACA) risk-mitigation program known as the Risk Corridors Program. ...more

Epstein Becker & Green

Supreme Court: The ACA & Risk Corridor Obligations

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The U.S. Supreme Court decision in Maine Community Health Options v. United States, is a major decision affecting healthcare and resolving a significant Obamacare dispute. The Affordable Care Act famously established online...more

Sheppard Mullin Richter & Hampton LLP

Supreme Court Issues Long Awaited Ruling on Affordable Care Act Risk Corridors Program

The Supreme Court issued a long-awaited ruling on April 27, 2020, directed at a more than $12 billion challenge related to the temporary risk corridors program established by the Affordable Care Act (the “ACA”). Challenges...more

Faegre Drinker Biddle & Reath LLP

Supreme Court Decides Moda Health Plan, Inc. v. United States

On April 27, 2020, the U.S. Supreme Court decided Moda Health Plan, Inc. v. United States, holding that the Affordable Care Act requires the federal government to compensate insurers for significant losses their health plans...more

Seyfarth Shaw LLP

Supreme Court Rules Government Must Pay $12 Billion to Health Insurers Under ACA Risk Corridor Program

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On April 27, 2020, the US Supreme Court ruled by an 8-1 decision that the federal government must pay billions of dollars to health insurers who sold consumer policies on exchanges under the Affordable Care Act’s (“ACA”)...more

Locke Lord LLP

Supreme Court Rules 8-1 That Government Must Pay Health Insurers Under ACA Risk Corridor Program

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In a major win for health insurers, the U.S. Supreme Court ruled in an 8-1 decision that the federal government owes roughly $12.3 billion to health insurers who claimed losses under the risk corridor program of the...more

Groom Law Group, Chartered

Texas, et. al., v. U.S. – The Fifth Circuit Rules

As you may recall, in late September, we expected a decision from the Fifth Circuit in Texas v. United States—the case challenging the constitutionality of the Patient Protection and Affordable Care Act (ACA)—in the fall of...more

King & Spalding

Fifth Circuit Rules ACA Individual Mandate Unconstitutional

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On December 18, 2019, the Court of Appeals for the Fifth Circuit ruled that the Patient Protection and Affordable Care Act (ACA) individual mandate is unconstitutional but remanded to the district court to assess whether the...more

Proskauer - Employee Benefits & Executive...

The Saga Continues – Fifth Circuit Affirms ACA Individual Mandate’s Unconstitutionality; Remands for Further Consideration

Roughly a year ago, we reported on a district court judge’s determination that the Affordable Care Act’s (“ACA”) individual mandate was unconstitutional and that, therefore, the entire ACA was invalid. A detailed summary of...more

Sheppard Mullin Richter & Hampton LLP

Update to Texas v. United States: Fifth Circuit Strikes Individual Mandate, Remands on Severability

On December 18th, 2019, the Fifth Circuit Court of Appeals released a long-awaited decision on a significant challenge to the Affordable Care Act (“ACA”), affirming a lower-court ruling that we discussed in a previous post....more

Dechert LLP

Do We Still (Obama-)Care About the Individual Mandate?— Fifth Circuit Holds the Mandate to Be Unconstitutional but Remands for...

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The Patient Protection and Affordable Care Act, often referred to as Obamacare (the “ACA”) has survived two trips to the U.S. Supreme Court. It remains to be seen whether there will be a third. ...more

Seyfarth Shaw LLP

Fifth Circuit Affirms Striking Down Individual Mandate of Affordable Care Act and Remands on Issue of Severability

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In a bold but conservative 2-1 decision Wednesday, The United States Court of Appeals for the Fifth Circuit affirmed the ruling of a federal district judge in Texas striking down the individual mandate of the Affordable Care...more

Cozen O'Connor

5th Circuit Holds Individual Mandate Is Unconstitutional, But Remands To District Court To Decide Severability

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In a 2-1 decision published on December 18, 2019, a 5th Circuit panel upheld the Texas District Court’s decision ruling that the ACA individual mandate tax which, since January 2019, has had no monetary consequence, is...more

Robinson+Cole ERISA Claim Defense Blog

Remand Directing Change in Standard of Judicial Review Is Not Sufficient Success on the Merits to Support Attorneys’ Fee Award

In Ariana M. v. Humana Health Plan of Texas, Inc., No. 18-20700, 2019 WL 5866677 (5th Cir. Nov. 8, 2019), the Fifth Circuit Court of Appeals rejected a plaintiff’s petition for attorneys’ fees under 29 U.S.C. § 1132(g).  This...more

Sheppard Mullin Richter & Hampton LLP

Arkansas and Kentucky Halt Medicaid Work Requirements

On April 10, 2019, the Department of Justice filed notices appealing two District Court rulings that struck down Medicaid work requirements in both Kentucky and Arkansas to the U.S. Court of Appeals for the District of...more

Fisher Phillips

Web Exclusive: January 2018: The Top 18 Labor And Employment Law Stories

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It’s hard to keep up with all the recent changes to labor and employment law. While the law always seems to evolve at a rapid pace, there were an unprecedented number of changes each month in 2017—and if January is any...more

Proskauer Rose LLP

The ERISA Litigation Newsletter - October 2015

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Editor's Overview - This month, we review the Second Circuit's ruling in New York State Psychiatric Ass'n, Inc. v. UnitedHealth Grp. wherein the Second Circuit ruled that: (i) a provider association has associational...more

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