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This month’s Friday Five covers cases relating to the enforceability of contractual statute of limitations provisions described as a “labyrinth,” ERISA claims when the carrier allegedly misrepresents benefits, federal courts retaining ERISA jurisdiction following a related state court case, a court...

In December 2023, the U.S. Department of Health and Human Services (“HHS”) Office for Civil Rights (“OCR”) announced a $480,000 settlement with a Louisiana medical group following a phishing incident. In 2021, the medical group filed a breach report with HHS stating that a hacker – through a...

On November 20, 2023, the U.S. Department of Health and Human Services (“HHS”) Office for Civil Rights (“OCR”) announced an $80,000 HIPAA settlement with Saint Joseph’s Medical Center (“SJMC”) in New York State. The settlement was the result of OCR’s investigation of SJMC after the Associated Press...

This month’s Friday Five explores a decision ordering an IME prior to a ruling on summary judgment motions, the extent claims reporting records can be sealed, the scope of ERISA preemption in the context of removal, and two decisions awarding summary judgment for the defendant despite the plaintiffs...

In early November, the U.S. Department of Health and Human Services (“HHS”) Office of Inspector General (“OIG”) released its General Compliance Program Guidance (the Guidance). This was HHS OIG’s first update since 2008. What You Need to Know: This is the first compliance compendium released by HHS...

On Halloween, the U.S. Department of Health and Human Services (HHS), Office for Civil Rights (OCR) announced a $100,000 settlement under the Health Insurance Portability and Accountability Act (HIPAA) with Doctors’ Management Services (DMS), a Massachusetts medical management company that provides...

This month’s Friday Five covers cases relating to petitions for attorneys’ fees, unpersuasive self-reported evidence of disability, and a dilatory attempt to augment the administrative record. The Saul Ewing Employee Benefits/ERISA Litigation Team Western District of Wisconsin Slashes “Eye-Popping”...

In October 2023, the U.S. Department of Health and Human Services (HHS) Office of Inspector General (OIG) published Advisory Opinion 23-07 and approved a plan by a multi-specialty physician practice to pay its employed physicians bonuses related to net profits derived from outpatient procedures...

“[I]ndustry can move a lot quicker than Washington can. That’s always been the case. But it would be good if there was more clarity from Congress on a lot of these [hemp-related] issues. And, unfortunately, until you have a debated and negotiated Farm Bill, [the 2018 version is] just going to carry...

This month’s Friday Five explores recent decisions that range from the effect on disability benefits when medical records are not provided after two appeals, to a case that examines how an award of death benefits is determined, to a finding that an insurer’s decision to terminate benefits was not...

On September 11, 2023, the U.S. Department of Health and Human Services (HHS) Office for Civil Rights (OCR) announced a settlement with LA Care related to potential violations of Health Insurance Portability and Accountability Act (HIPAA). LA Care is the largest publicly operated health plan in the...