cmonfils | August 30, 2011
www.myhealthguide.com
MyHealthGuide Source: David Slaughter, Thompson Publishing, 8/26/2011, http://smarthr.blogs.thompson.com/
Todd Leeuwenburgh, Editor, Employer Health Benefits, Thompson Publishing Group, says, “David Slaughter’s Blog reports an interesting and unprecedented use of ERISA (not HIPAA) by Liberty Mutual to resist Vermont’s health claims data-reporting mandate. The state agency’s top attorney tells David in an exclusive interview that it is backing down from its initial demand for claims data about the company’s ERISA plan participants.” (more…)
Category: ERISA, Vermont |
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cmonfils | August 30, 2011
www.myhealthguide.com
MyHealthGuide Source: Mary V. Bauman, Miller Johnson Attorneys and Counselors, 8/25/2011, Miller Johnson Article
Article recommend by John H. Eggertsen, Esq., Eggertsen Consulting, P.C., www.jhelaw.com
Currently, Michigan imposes a 6% use tax on Medicaid HMOs and plans providing Medicaid mental health services. The purpose of the use tax is to finance the state’s share of Medicaid. The federal government has indicated it will bar Michigan from continuing this financing approach. As a result, Michigan needed to repeal the use tax and come up with a replacement revenue stream. (more…)
Category: ERISA, Michigan |
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cmonfils | August 30, 2011
www.myhealthguide.com
MyHealthGuide Source: Rebecca Moore, PlanSponsor, 8/25/2011, PlanSponsor Article
Case: Baker v. Pennsylvania Economy League Inc. Retirement Income Plan, E.D. Pa., No. 2:10-cv-06738-AB, 8/23/11
Editor’s Note: While the subject of case is a pension plan, the court’s ruling against plan administrator and fiduciary breach has application for self-funded ERISA plans. Court rules that plaintiff./ claimant could continue with her claim against plan administrators’ actions constituted a fiduciary breach. (more…)
Category: ERISA, Pennsylvania, Plan Language, Self-Funding |
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cmonfils | August 25, 2011
www.subrogation.org
Federal Employee Health Benefit Plan Recoveries Under Attack
Recently, four putative class action lawsuits, challenging a Federal Employee Health Benefits plans’ right to recover or subrogate, have been filed. The suits, one filed in New York and the others filed in Missouri, allege that the Federal Employee Health Benefit Act (FEHBA) does not preempt state anti-subrogation laws and that the health plans’ recoveries, on behalf of Federal Employee Health Benefit (FEHB) plans, are not allowed. The suits also seek the refund of past FEHB plan subrogation recoveries. (more…)
Category: Health Insurance, Missouri, New York, Subrogation |
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cmonfils | August 25, 2011
Braintree, Massachusetts 08/23/11 – A class action lawsuit was recently filed in the State of New York (Rebecca Meek-Horton v. Trover Solutions, Inc. et.al, State of New York, Supreme Court, New York County, Case No. 108804-2011), which alleges that Medicare Advantage Plans violate a New York State law when they impose liens on participants who receive personal injury settlements, arising from injuries for which said Advantage Plan has already advanced payment. (more…)
Category: Collateral Source Rule, Medicare, New York, Reimbursement |
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cmonfils | August 22, 2011
Coordination of Benefits Employee Benefits Series THOMPSON July 2011 | VOL. 19, No.3
Legal Brief
We are familiar with cases holding that state laws limiting reimbursement to self-funded ERISA health plans from tort settlements or judgments through the madewhole, common-fund and collateral source rules are preempted by ERISA. However, we are not familiar with cases where there is a conflict between the right of a self-funded ERISA health plan to recover the benefits it paid under its plan provisions and the right of a hospital to recover its unpaid costs through a state statutory lien. We now have a case that discusses and resolves that conflict. The case is Osterman v. Smith, 2011 WL 1343056 (C.D. Ill., March 17, 2011). (more…)
Category: ERISA, Self-Funding, State Law |
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cmonfils | August 22, 2011
Coordination of Benefits Employee Benefits Series THOMPSON July 2011 | VOL. 19, No.3
Legal Brief
Contrary to two recent decisions, a health plan in New York failed in its effort to intervene in a plan participant’s lawsuit against a third party, which would have let the plan in on settlement negotiations or made it a party to the court’s allocation of the settlement proceeds. A recent decision, Robles v. Bruhns, 2011 WL 1564649 (N.Y. Sup. Ct., Suffolk Cty., April 26, 2011), refused to allow such an intervention. (more…)
Category: New York |
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cmonfils | August 22, 2011
www.nytimes.com
By MICHAEL COOPER August 12, 2011
The provision in President Obama’s health care law requiring Americans to buy health insurance or face tax penalties was ruled unconstitutional on Friday by the United States Court of Appeals for the 11th Circuit, in Atlanta.
It was the first appellate review to find the provision unconstitutional — a previous federal appeals court upheld the law — and some lawyers said that the decision made it more likely that the fate of the health care law would ultimately be decided by the Supreme Court. (more…)
Category: 11th, Georgia, Health Care Legislation, Health Insurance |
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cmonfils | August 22, 2011
www.myhealthguide.com
MyHealthGuide Source: Tony Evans, Idaho Mountain Express, 8/19/2001, IME Article
A plan that started in Ketchum last year to pool public employees in order to save health insurance costs has gathered the support of 37 cities in Idaho, including Hailey, Blackfoot, Jerome, Shoshone and Stanley. (more…)
Category: Idaho, Self-Funding |
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cmonfils | August 16, 2011
Epstein Becker Green
August 15, 2011
by Sarah K. Giesting, Amy Dow, and Daniel G. Gottlieb
On July 8, 2011, Governor Paul LePage of Maine signed into law LD 719, “An Act to Make Certain Prescription Drug Disclosure Laws Consistent with Federal Law” (“LD 719”). LD 719 repeals three statutes that require prescription drug manufacturers and labelers to disclose information related to clinical trials, ME. REV. STAT. ANN. tit. 22, § 2700-A (“§ 2700-A”); marketing costs, ME. REV. STAT. ANN. tit. 22, § 2698-A (“§ 2698-A”); and drug pricing, ME. REV. STAT. ANN. tit. 22, § 2698-B (“§ 2698-B”). The repeal becomes effective on September 28, 2011. This Client Alert discusses LD 719.
Read the full alert online
Category: Maine, News |
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cmonfils | August 15, 2011
www.modernhealthcare.com By Rich Daly August 8, 2011
The newly enacted debt-ceiling deal may have saved the nation from a financial crisis, but it also managed to paint a target on the backs of healthcare providers. And the potential size and scope of the cuts they could face has providers scrambling for a response. (more…)
Category: Health Care Legislation, Medicaid, Medicare, Reimbursement, Texas, Washington |
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cmonfils | August 15, 2011
www.haynesboone.com Michael Silhol 08/04/2011
Citing concerns that federal law does not adequately protect patient privacy, Texas recently enacted stringent new health privacy legislation that extends patient protections beyond those contained in the Health Insurance Portability and Accountability Act (HIPAA) or the Health Information Technology for Economic and Clinical Health (HITECH) Act. (more…)
Category: HIPAA, Texas |
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cmonfils | August 15, 2011
www.myhealthguide.com
MyHealthGuide Source: MiddletownPatch, 8/11/2011, MP Article
Middletown CT – Mayor Sebastian N. Giuliano has announced the decision to move from fully insuring the citys medical program to self-funding has saved taxpayers more than $800,000.
“We simply have to look at alternative ways to finance government operations,” Giuliano said, “changing the status quo based upon the best recommendations and practices as provided by our consultants have worked to the taxpayers advantage.” (more…)
Category: Connecticut, Self-Funding |
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cmonfils | August 10, 2011
Rebecca Meek-Horton v. Trover Solutions Inc. et al (State of New York, Supreme Court, New York County, Case No. 108804-2011)
A lawsuit naming 50 insurers as defendants has been filed in New York Supreme Court, New York County. The complaint relates to Medicare Advantage plans and accuses the insurers of violating a 2009 state law by imposing liens on patients who receive personal injury settlements. (more…)
Category: Medicare, New York |
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cmonfils | August 10, 2011
www.patriotledger.com
By Anonymous Posted Aug 09, 2011 @ 04:23 PM
STATE HOUSE, BOSTON — Massachusetts and Vermont led the nation in 2010 with average, individual market health insurance premiums topping $400 per person per month, about double the national average, according to an analysis released Tuesday. (more…)
Category: Health Insurance, Massachusetts |
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