Adam V. Russo | February 29, 2008
Minnesota lawmakers are in the process of discussing possible compensation to victims of the Interstate 35W bridge collapse to make up for damages including lost wages and medical expenses. If the fund is established, insurance companies that already paid victims’ medical bills might have a right to take some of the money, through subrogation.Insurance companies including HealthPartners, Medica, Blue Cross Blue Shield, who cover “fully insured” businesses (usually private businesses that buy insurance coverage, and when there’s a claim, the insurance company pays), said they won’t fight to seek a portion of the compensation. However subrogation could still cause a threat to victims covered under of “self- insured” businesses. (more…)
Category: Subrogation |
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Adam V. Russo | February 29, 2008
Supreme Court Justice Anthony M. Kennedy declined an application for a continuance of the San Francisco ordinance that sets minimum levels of spending by employers on health care. SEE COURT ORDER
Category: 9th |
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Adam V. Russo | February 20, 2008
The Supreme Court held in LaRue v. DeWolff, Boberg & Associates that ERISA §502(a)(2) authorizes recovery for fiduciary breaches that impair the value of plan assets in a participant’s individual account.
Stevens, J., delivered the opinion of the Court, in which Souter, Ginsburg, Breyer, and Alito joined. Roberts filed an opinion concurring in part and concurring in the judgment, in which Kennedy joined. Thomas filed an opinion concurring in the judgment, in which Scalia joined. (more…)
Category: 4th, Supreme Court |
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Adam V. Russo | February 20, 2008
The Supreme Court will be granting certiorari to MetLife, et al., v. Wanda Glenn. While MetLife v. Glenn reinforces a third party administrator’s (“TPA”) right to make administrative decisions and interpret the terms of benefit plans when it is not the party funding the plan, this case asks whether a Plan Administrator faces a conflict of interest if it not only determines whether a claim is payable, but also pays the claim with its own funds. (more…)
Category: 6th, Claims Procedures, Claims Review, Supreme Court |
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Adam V. Russo | February 19, 2008
New York Attorney General Andrew Cuomo has announced an industry-wide investigation of health care claims consultant Ingenix, a UnitedHealth Group subsidiary, for manipulating reimbursement rates provided to their clients, such as BlueCross BlueShield. The investigation has exposed Ingenix’s intent to under reimburse their clients and members, and collect funds unrelated to relevant medical expenses for private gain. Cuomo issued 16 subpoenas to insurers and benefit plans that have been affected by the conduct. He also plans to file suit against Ingenix and its parent company, UnitedHealth Group. (more…)
Category: New York, News |
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Adam V. Russo | February 15, 2008
The Golden Gate Restaurant Association asked the Supreme Court to vacate the 9th Circuit panel’s stay of a district court decision invalidating the ordinance. The requested stay would prevent enforcement of the ordinance during the period leading up to a decision by the Ninth Circuit on the matter. (more…)
Category: 9th |
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Adam V. Russo | February 8, 2008
February 7, 2008
Las Vegas, Nevada
Adam V. Russo, Esq. and Ron Peck, Esq. presented at the HCAA 2008 Executive Forum held at the Venetian Resort & Casino, with their seminar on health care reform and the upcoming presidential election. See the entire presentation.
Category: ERISA |
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Adam V. Russo | February 5, 2008
Recently, in the wake of last August’s horrific bridge collapse on I-35 in Minnesota over the Mississippi River, state lawmakers in Minnesota are attempting to establish a recovery fund to ensure that victims in the disaster receive compensation for their losses. The problem is that a great majority of the victims had their medical coverage provided by ERISA governed welfare benefit plans. The politicians do not want any compensation to reach the hands of the insurance companies, who seek reimbursement through their subrogation provisions.State lawmakers are thus working on legislation to ensure that survivors’ insurers won’t be able to claim any of the money that insureds may receive in settlement. Due to rising health care costs, many of the health plans involved are increasingly laying claim to the money patients have won in settlement through subrogation action. (more…)
Category: Minnesota, News, Preemption |
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