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|Supreme Court to Weigh in on Providers’ Rights to Sue for Medicaid Reimbursements|
Zachary W. Behler, Michael R. Blum, Lauren B. Dunn, Samuel J. Frederick, Gilbert M. Frimet; Foster, Swift, Collins & Smith, P.C.;
March 20, 2015, previously published on January 27, 2015The Medicaid program, a public insurance program serving approximately 66 million low-income Americans, is at risk for losing participating providers who claim they are not being compensated fairly for their services. On January 19, 2015, the Supreme Court heard arguments in Armstrong v....
|California Issues Emergency Regulation on Access to Healthcare Providers|
Aaron J. Aisen, Sandra McDermott; Goldberg Segalla LLP;
March 12, 2015, previously published on February 17, 2015During his second inauguration, California Insurance Commissioner Dave Jones, announced a new emergency regulation relating to access to healthcare providers.
|Narrowing the Scope of Medical Expert Qualifications and Testimony under the Pennsylvania Rules of Evidence|
Angeline C. Panepresso; Marshall Dennehey Warner Coleman & Goggin, P.C.;
March 5, 2015, previously published on March 1, 2015As a general principle, the standard for qualification as an expert witness in Pennsylvania is a liberal one. Specifically, the test for qualifying as an expert is whether the expert has any reasonable pretension to specialized knowledge on the subject at issue, and the weight to be given to such...
|Final Regulations Regarding Limited Scope Vision and Dental Benefits and Employee Assistance Programs as Excepted Benefits|
Dan Brown, Kenneth B. Schnoll; Dentons Canada LLP;
November 17, 2014, previously published on October 1, 2014On October 1, 2014, the US Department of Treasury issued final regulations (the "Regulations") regarding limited-scope vision and dental benefits and employee assistance programs as excepted benefits for purposes of the Affordable Care Act.
|Two Important Deadlines Approaching for Self-Insured Group Health Plans|
Casey K. Fleming, Leigh C. Riley; Foley & Lardner LLP;
September 1, 2014, previously published on August 26, 2014If you sponsor a self-insured group health plan, then November includes two important deadlines: (1) you must obtain a health plan identifier for your plan, and (2) you must report the number of participants for whom a transitional reinsurance fee is due.
|House Bill 373 Enacted to Control the Level of Workers’ Compensation Insurance Premiums by Making Significant Changes in the Medical Reimbursements Allowable Under the Healthcare Payment System|
Paul V. Tatlow; Marshall Dennehey Warner Coleman & Goggin, P.C.;
August 6, 2014, previously published on July 31, 2014This Act makes substantial changes to Titles 18 and 19 of the Delaware Code designed to control the level of workers’ compensation premiums in Delaware. The most significant changes are: (a) a 33% reduction in medical costs to the workers’ compensation system, phased in over a period of...
|Can You Link Insurance Premiums To Smoking?|
F. Kytle Frye; Fisher & Phillips LLP;
July 15, 2014, previously published on July 1, 2014Rocked by soaring costs, including skyrocketing increases in health insurance premiums, employers are desperate to manage, and hopefully limit, whatever costs they can. Many employers have begun to look to the lifestyle choices of their employees and how those choices might influence their cost of...
|Union Carbide v. Bombardier: Confidentiality of Settlement Communications|
Margot Finley; Borden Ladner Gervais LLP;
May 30, 2014, previously published on May 29, 2014A decision of the Supreme Court of Canada released on May 8, 2014 has clarified that a confidentiality clause in a mediation contract will not restrict a party from producing evidence of communications made in the mediation context in order to prove the terms of the settlement, unless that is the...
|Potential Risks of Healthcare Joint Ventures Between Insurance Companies and Hospitals|
Charles L. Kreindler, Barbara E. Taylor; Sheppard, Mullin, Richter & Hampton LLP;
May 23, 2014, previously published on May 21, 2014Healthcare joint ventures are nothing new. Since the mid-2000’s, physician-hospital ventures have been resurgent, notwithstanding the Office of Inspector General’s skepticism regarding the risk of fraud and abuse when investors are sources of referrals and the filing of numerous...
|Important Court Decision For No-Fault Insurers; Second Circuit Court of Appeals Rejects Limitation On State Farm v. Mallela|
Jared Facher, William J. Natbony; Cadwalader, Wickersham & Taft LLP;
May 15, 2014, previously published on May 7, 2014We are pleased to inform you that our firm, together with our co-counsel Bob Stern of Stern & Montana, obtained a very favorable and significant decision for no-fault insurers on an issue of first impression at the appellate level. Specifically, on May 6, 2014, in the case of Allstate Insurance...