Adam V. Russo | January 25, 2010
This is a huge win for the subrogation industry.
The court held that Sereboff, rather than Knudson, controlled in this case. Like in Sereboff, the Plan targeted specific funds for recovery , Cusson’s LTD payments, and identified the specific portion to which Liberty is entitled— the amount of the overpayment while Cusson was receiving benefits under the LTD Plan. (more…)
Category: 1st, 8th, ERISA |
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Adam V. Russo | June 24, 2009
by John H. Eggertsen, Esq. and Michael Friedman, Esq. of SIIA, www.siia.org
I. District of Columbia’s Efforts to Regulate PBMs Preempted by ERISA
In their efforts to combat the ongoing initiatives on the part of several states to regulate the business activities of pharmacy benefit managers (“PBMs”), the PBMs recently won a skirmish. In Pharmaceutical Care Management Association v. District of Columbia, et al. 2009 WL 711771 (D.C.D.C.), a Federal District Court for the District of Columbia held that by regulating the relationship between PBMs and ERISA plans, the District of Columbia’s Access Rx Act of 2004 (the “Act”) “impermissibly intrudes upon a field exclusively reserved for federal regulation,” and thus, is preempted under ERISA. (more…)
Category: 1st, ERISA, Maine, Preemption, Washington D.C. |
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Adam V. Russo | May 28, 2009
by Fred Schneyer of PLANSPONSOR, www.plansponsor.com
After tweaking their standard for how federal judges should handle employee benefits denial cases involving a conflicted plan administrator, federal appellate judges have ordered more hearings in just such a case. (more…)
Category: 1st, Claims Review |
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