Adam V. Russo | February 17, 2010
Judy Greenwald
Employers are facing the challenge of maintaining a safe workplace while more states legalize the use of medical marijuana, experts say.
While courts generally have ruled that firms do not have to accommodate medical marijuana users, employers in some jurisdictions still are awaiting guidance on the issue.
Adam V. Russo | January 20, 2010
Roberto Ceniceros
The U.S. government’s first-of-its-kind lawsuit against all parties that settled a pollution liability case signals Medicare’s aggressive push to make sure it does not pay medical expenses when others are to be the primary sources of payment, observers say.
The suit filed Dec. 1, 2009, cites Medicare Secondary Payer provisions in federal law that allow [...]
Adam V. Russo | August 11, 2009
by Tim Hull, Courthouse News Service, www.courthousenews.com
LOS ANGELES (CN) – A federal accuses Blue Cross of a wide-ranging scheme to underpay claims from out-of-network hospitals. Methodist Hospital of Southern California claims Blue Cross refuses to let it transfer patients from emergency rooms, then underpays the hospital and sticks patients with hefty bills, falsely claiming the [...]
Adam V. Russo | June 29, 2009
by Michelle Massey, Texarkana Bureau, http://www.setexasrecord.com
MARSHALL – After turning over nearly $400,000 to buy what they thought was an ERISA employee welfare benefit plan, two Virginia doctors believe they were the victims of an elaborate nationwide theft ring and are suing to get their money back.
Adam V. Russo | July 29, 2008
The Brualdi Law Firm, P.C. has issues a press release regarding suit they have filed against Lehman Brothers Holdings, Inc. for potential violations of ERISA. The suit concerns Lehman Brother’s 401(k) plan, which comes within the purview of ERISA. Brualdi, representing members of the Plan, assert that Lehman Brothers and other administrators of the Plan [...]
Adam V. Russo | November 28, 2007
There is a recent newsworthy item that I wish to discuss, as it is pertinent to our industry. The November 20, 2007 Wall Street Journal featured an extremely negative cover story, relating to the self-insured industry’s subrogation activities under ERISA. These types of prominent news stories do nothing for the self-insured industry except motivate the [...]
Adam V. Russo | November 13, 2007
On September 25, 2007, a Federal District Court in New Jersey held in Mulholland v. UFCW Local 1776 Participating Employers Health and Welfare Fund, 2007 WL 2814648 (DNJ) that the purchase of stop loss insurance does not preclude self-funded ERISA status. The court went on to say that because self-funded plans can come close to [...]
Adam V. Russo | April 4, 2007
In this case, an employee of a company with a self funded ERISA plan was receiving benefits due to her disabled status. The TPA hired a physician to re-examine the employee, and based on her diagnosis, terminated benefits. The physician determined that the employee could perform sedentary work, which meant she was no longer “disabled” [...]
Adam V. Russo | April 4, 2007
An employee left her job due to carpal tunnel syndrome. She began receiving benefits under her employer’s self funded ERISA plan. The syndrome became worse, and the employee underwent surgery. She exhausted her short term benefits and applied for long term benefits under the same plan. The plan denied the benefits, and the employee sued. [...]
Adam V. Russo | April 4, 2007
In March of 2005, Poyner was injured when an automobile struck her while she was riding her bicycle and received nearly $ 200,000.00 in medical benefits. Subsequently she recovered $ 10,000.00 from the insurer of the automobile which struck her and $100,000.00 from her own under insured motorist coverage. The Plan attempted to persuade Poyner [...]
