cmonfils | April 27, 2011
April 27, 2011 – The Self-Insurance Institute of America, Inc. (SIIA) today announced that it will be launching a new initiative next month to build a national grassroots advocacy and political action network designed to further bolster its lobbying capabilities in Washington, DC. (more…)
cmonfils | April 26, 2011
New York Senate Bill 4576
The New York anti-subrogation law is back! The latest bill seeks to clarify and expand limits on subrogation. As you may remember, in 2009 the State of New York passed a law that eliminated subrogation and reimbursements rights for health and disability plans in personal injury and wrongful death actions based upon settlement of a claim. (more…)
cmonfils | April 25, 2011
All of you have undoubtedly dealt with a situation where there are only a few hospitals in a region, and they abuse that fact liberally. This dispute, which was recently settled in Texas, is titled United States of America and State of Texas v. United Regional Health Care System, 2011 WL 846762 (N.D.Tex.). You will recognize the story, as it has certainly happened to you, too! (more…)
cmonfils | April 25, 2011
www.businessinsurance.com April 18, 2011
While the use of accountable care organizations to improve health care quality while holding down costs may be new to Medicare, the private sector has been successfully experimenting with similar initiatives since 2007. (more…)
cmonfils | April 25, 2011
www.businessinsurance.com April 18, 2011
FORT LAUDERDALE, Fla.—The U.S. District Court for the Southern District of Florida dismissed a lawsuit alleging that financial incentives to participate in a voluntary wellness program as part of a health plan provided to employees by Broward County, Fla., violated the Americans with Disabilities Act. (more…)
cmonfils | April 25, 2011
www.businessinsurance.com April 18, 2011
While accountable care organizations authorized under the health care reform law hold the promise of lowering costs for Medicare beneficiaries, they could have the opposite effect on employer-sponsored benefit costs, health care experts warn. (more…)
cmonfils | April 25, 2011
www.businessinsurance.com April 18, 2011
WASHINGTON—Employers were pleasantly surprised last week when congressional negotiators agreed to strip a provision in the health care reform law requiring employers to offer low-wage employees company-paid vouchers to purchase coverage in state health insurance exchanges. (more…)
cmonfils | April 25, 2011
MyHealthGuide Source: James Vicini, Reuters, 4/18/2011, www.reuters.com
The U.S. Supreme Court took no action on April 18 on a request to speed up a ruling on President Barack Obama’s healthcare overhaul law, his signature domestic accomplishment that has provoked a fierce political battle. (more…)
cmonfils | April 25, 2011
MyHealthGuide Source: Fred Hunt, Active Past President, Society of Professional Benefits Administrators, 4/18/2011, www.SPBATPA.org
CAPITOL HILL is a ghost town for their recess until April 29th.
So, Congressmen and exhausted staff were bailing out as soon as the votes were completed Friday. The good news is that the health related parts reported to you a week ago (such repealing the vouchers based on finding the total household income of employees) in the Continuing Resolution (CR) agreement for the rest of 2011 have been formally voted into law. (more…)
cmonfils | April 25, 2011
By Kurt Haag April 1, 2011
In this post-health care reform environment, benefit advisers – and their employer clients – face a new world order. For instance, with new restrictions on capping lifetime maximum benefits, the burden of managing the potential financial risk posed by even one employee’s catastrophic illness looms large.
Stop-loss insurance may be a way to address this challenge. (more…)
cmonfils | April 25, 2011
By Stanley D. Baum on April 21, 2011
In Hansen v. Harper Excavating, Inc., No. 08-4089 (10th Cir. 2011), the plaintiff, Jeffery Hansen (“Hansen”), had worked for the defendant, Harper Excavating, Inc. (“Harper”), for six months beginning in 2003. During this time, he attempted to enroll in Harper’s health insurance plan (the “Plan”). The Plan is subject to ERISA. However, unknown to Hansen, Harper never enrolled him in the Plan, although it did deduct Plan contributions from his paycheck. (more…)
cmonfils | April 25, 2011
April 19, 2011 (PLANSPONSOR.com) – The effective dates for the new claims and appeals requirements under PPACA have changed more than once (even since we’ve written about this issue before).
Not surprisingly, we have been receiving a number of questions asking us to clarify these various dates.
The Department of Labor issued a grace period – does the grace period apply to all of the new claims and appeals requirements? (more…)
cmonfils | April 25, 2011
April 15, 2011
The ruling in Seff V. Broward County has helped to establish guidance as to what is permissible with respect to the design of wellness programs under the Americans With Disabilities Act (ADA). The U.S. District Court for the Southern District of Florida ruled that Broward County’s wellness program fell within the ADA’s safe harbor provision. (more…)
cmonfils | April 22, 2011
2011 WL 846762 (N.D.Tex.) (Trial Pleading) United States District Court, N.D. Texas. Wichita Falls Division UNITED STATES OF AMERICA and State of Texas, Plaintiffs, v. UNITED REGIONAL HEALTH CARE SYSTEM, Defendant.No. 7:11CV00030.
February 25, 2011.
Complaint
For Plaintiff United States of America, Christine A. Varney, Assistant Attorney General for Antitrust. Joseph F. Wayland, Deputy Assistant Attorney General. Patricia A. Brink, Director of Civil Enforcement. Joshua H. Soven, Chief, Litigation I Section. Peter J. Mucchetti, Assistant Chief, Litigation T Section. Scott I. Fitzgerald (WA Bar #39716), Andrea V. Arias, Amy R. Fitzpatrick, Adam Gitlin, Steven B. Kramer, Richard Liebeskind, Richard D. Mosier, Mark Tobey, Kevin Yeh, Attorneys for the United States, United States Department of Justice, Antitrust Division, Litigation I Section, 450 Fifth Street, N.W., Suite 4100, Washington, DC 20530, Telephone: (202) 353-3863, Facsimile: (202) 307-5802. For Plaintiff State of Texas, Greg Abbott, Attorney General of Texas. Daniel T. Hodge, First Assistant Attorney General. Bill Cobb, Deputy Attorney General for Civil Litigation. John T. Prud’homme, Jr., Chief, Antitrust Division, Office of the Attorney General, 300 W. 15th St. 7th floor, Austin, TX 78701, Telephone: (512) 936-1697, Facsimile: (512) 320-0975.The United States of America, acting under the direction of the Attorney General of the United States, and the State of Texas, by and through the Texas Attorney General, bring this civil antitrust action to enjoin defendant United Regional Health Care System (“United Regional”) from entering into, maintaining, or enforcing contracts with commercial health insurers that effectively prevent those insurers from contracting with United Regional’s competitors, in violation of Section 2 of the Sherman Act, 15 U.S.C. § 2, and to remedy the effects of its unlawful conduct. Plaintiffs allege as follows: (more…)
