cmonfils | July 11, 2011
The Subrogator Spring/Summer 2011
Amidst the deluge of healthcare reform, anti-subrogation legislation was passed in the State of New York on November 12, 2009, which purported to eliminate the right of fully insured carriers and self-funded benefit plans, coming within the purview of state law, to pursue subrogation and reimbursement. Accordingly, benefit plans in New York which are not private, self-funded plans, no longer have an enforceable right to subrogation and/or reimbursement. The Phia Group has never accepted anti-subrogation legislation without a fight. When the Phia Group received word of the statutory shift, its attorneys immediately began to seek out ways to enforce plan rights. (more…)
Category: Collateral Source Rule, New York, Subrogation |
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cmonfils | July 4, 2011
www.pnhp.org By Douglas Turner The Buffalo News, June 20, 2011
WASHINGTON — Conservative House Republicans, flush from their 2010 victory over the perceived overreach of the Obama health care law, flooded the Capitol with heroic-sounding legislation last winter. (more…)
Category: Health Care Legislation, New York |
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cmonfils | May 3, 2011
Coordination of Benefits April 2011 | Vol. 19, No. 2
New York Trial Court Lets Health Plan Intervene in Malpractice Action
Until recently, all the cases we see involving subrogation and reimbursement involve situations where someone who incurred serious medical expenses and received a favorable tort settlement ends up in competition with his or her own health plan exercising reimbursement rights on the settlement or judgment proceeds.
We are now beginning to see cases where the plan participant has died from the injuries leading to the tort settlement or judgment, and the deceased plan participant’s family seeks to recover damages for their own loss arising from the plan participant’s death, usually based on state statutes providing for a cause of action by those family members in those circumstances. (more…)
Category: Collateral Source Rule, New York |
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cmonfils | April 26, 2011
www.subrogation.org
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…)
Category: New York, Subrogation |
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cmonfils | March 1, 2011
Thompson Publishing January 2011 Volume. 19, No. 1
New York late in 2009 barred subrogation and reimbursement rights for insured health plans. While it seems clear that the New York law does not apply to self-insured ERISA health plans, a health insurer’s preemptive attempt to force the issue was rejected by the U.S. District Court for Western New York. Citizen suits against states are barred by the 11th Amendment of the U.S. Constitution, and a lawsuit to compel a government official is limited to targeting only the official who has purview for enforcement of the challenged provision — and then only if the official actively enforced it, the court said. New York’s Attorney General (now Governor) Andrew Cuomo (D) has done nothing to challenge any self-insured ERISA plan’s use of subrogation and has said he had no intention of doing so. (more…)
Category: ERISA, New York |
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cmonfils | January 6, 2011
January 6, 2011
Anti-subrogation legislation was passed in the State of New York on November 12, 2009, which purported to eliminate the right of fully insured carriers and self-funded benefit plans, coming within the purview of state law, to pursue subrogation and reimbursement. We here at The Phia Group have never accepted anti-subrogation legislation without a fight. When we received word of the statutory shift, our attorneys immediately devised ways to enforce plan rights. (more…)
Category: New York, Subrogation |
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Adam V. Russo | October 6, 2010
Lawsuit by an ERISA plan sponsor challenging New York’s anti-subrogation statute.
Click the link below to see the Court’s September 13th decision:
http://www.erisaboard.com/forum/attachment.php?attachmentid=1534&d=1284573407
Category: New York, Subrogation |
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Adam V. Russo | August 12, 2010
CCH® BENEFITS, www.hr.cch.com
California
The California Public Employee’s Retirement System (CalPERS) has approved an average increase of more than 9% in health premiums next year for state and local government workers. CalPERS blamed the rate increase on rising costs for hospital care, doctor visits, and prescriptions. The increase will mean higher premiums for public agencies and their 1.3 million employees, dependents, and retirees. For more information, visit http://www.calpers.ca.gov/. (more…)
Category: California, Connecticut, Health Care Legislation, Kansas, Louisiana, Maine, Massachusetts, New York, Ohio, Utah, Washington D.C., Wisconsin |
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Adam V. Russo | June 28, 2010
New York. Governor David Patterson recently signed a bill into law that reinstates the New York State Insurance Department’s authority to review and approve health insurance premium increases before they take effect. The law will apply to all rate increases taking effect on or after Oct. 1, 2010. Since 2000, New York had regulated health insurance premiums under a law that limited the state’s ability to disapprove health insurance premium increases and allowed the insurance industry to self-regulate. The new law also requires health insurers to spend more of every premium dollar on medical costs and not administrative expenses. Under the federal Patient Protection and Affordable Care Act, health insurers will be required to report justifications for “unreasonable” rates increases, as well as the percentage of premiums spent on claims, quality of care, taxes, and administrative costs. In addition, the Department of Health and Human Services recently announced the availability of $51 million in Health Insurance Premium Review grants under the Affordable Care Act. For more information, visit http://www.ins.state.ny.us/.
Category: Health Care Legislation, New York |
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Adam V. Russo | March 22, 2010
By Lindsey C. Bruning and Kristin C. Cummings, Zelle Hoffman Voelbel & Mason LLP, Dallas, Texas
New York, like many states, has a collateral source statute that prevents an injured party from recovering from a tortfeasor amounts that the injured party has already received from another source, such as insurance proceeds. (N.Y. C.P.L.R. 4545) CPLR 4545 requires a court to reduce any damages awarded to a plaintiff by the amount the plaintiff has received from any collateral source. (more…)
Category: New York, Subrogation |
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Adam V. Russo | January 18, 2010
Recently, the State of New York passed into law a statute which many trial lawyers and members of our industry are calling the “anti-subrogation law.” While the law may limit subrogation rights in the State, we certainly feel that the matter deserves more investigation. Over the past few months we at The Phia Group have been researching the issue and have created new procedures to protect reimbursement rights to the highest degree possible. All payers in New York need to seek out ways to protect their rights to pursue reimbursements for charges arising from third party responsibility. We want all of you to know that The Phia Group can help. (more…)
Category: New York |
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Adam V. Russo | November 18, 2009
The bill will eliminate subrogation and reimbursement rights for fully-insured health insurance plans in New York. The actual ramifications of this new legislation will not ne known until it has been tested in trial and appellate courts have had a chance to interpret the new law and its implications. (more…)
Category: ERISA, New York |
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Adam V. Russo | November 13, 2009
An anti-subrogation bill attempting to bar subrogation claims related to personal injury is still pending and expected to be seen again in New York’s next legislative session.
Category: New York, Subrogation |
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Adam V. Russo | November 11, 2009
New York took the drastic step yesterday of passing a law that eliminates subrogation and reimbursement rights for numerous lines of business. Last night the New York Assembly and Senate passed the anti-subrogation bill. Although the bill was passed by both chambers, they are technically awaiting on the governor’s signature.
Category: New York, Subrogation |
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Adam V. Russo | February 4, 2009
Forty-seven states ban in-network providers from billing insured patients more than their required copayment or deductible and federal law prohibits providers from billing Medicare beneficiaries for unpaid balances. Some states also ban additional charges for insured patients who seek care from out-of-network providers and emergency departments. While national statistics on the practice are unavailable, economists and patient advocates estimate that consumers pay at least $1 billion annually for medical bills that they are not legally responsible to pay. (more…)
Category: California, Florida, Idaho, Kentucky, New Jersey, New York, Pennsylvania, Vermont |
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