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This month’s Friday Five explores decisions from around the country discussing differences between LTD and LWOP policies, the breadth of discretion available to claims administrators and the always important topic of timely action by insurers in issuing claims decisions. The Saul Ewing Employee...

On April 22, 2024, the U.S. Department of Health & Human Services (“HHS”) Office for Civil Rights (“OCR”) announced a final rule to support reproductive health care privacy (the “Reproductive Rule”). According to the HHS OCR press release, the Reproductive Rule, “is one of many actions taken by HHS...

​The U.S. Department of Health and Human Services ("HHS"), Office for Civil Rights ("OCR") continues to be actively engaged in investigating and settling alleged HIPAA violations. In advance of Mother's Day, two decisions were announced for HIPAA-covered entities that allegedly did not provide...

This month’s Friday Five covers the treatment of job-related stress in assessing an attorney’s disability, the requirements surrounding the qualifications of a medical professional to review a claimant’s medical records in making disability determinations, the requirements for determining disability...

On February 14, 2024, the U.S. Department of Health and Human Services (HHS), Office for Civil Rights (OCR) issued two reports to Congress as required by the Health Information Technology for Economic and Clinical Health (HITECH) Act of 2009. The reports are helpful to health care providers (and all...

This month’s Friday Five covers cases relating to an alleged conflict of interest leading to discovery, two courts’ opposite treatments of subjective pain complaints, a decision that claims of fraud and misrepresentation were not preempted by ERISA and a court’s deference to an insurer’s...

On February 16, 2024, the HHS Office for Civil Rights (OCR) and the National Institute of Standards and Technology (NIST) published a final version of the cybersecurity resource guide (the “Guide”) with respect to the HIPAA Security Rule. As noted in the Guide’s abstract, “This publication provides...

On February 6, 2024, the HHS Office for Civil Rights (“OCR”) announced a settlement with Montefiore Medical Center (“MMC”) for alleged HIPAA Security Rule violations and MMC agreed to pay $4.75 million and enter into a two-year corrective action plan (“CAP”) with OCR. MMC admitted no wrongdoing...

This month’s Friday Five explores decisions regarding the transfer of an ERISA action that was filed in a state where an insurer did not maintain sufficient minimum contacts, an award of attorneys’ fees, costs, and prejudgment interest, deference to an insurer’s interpretation of a plan’s provisions...

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...

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”...

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...

This month’s Friday Five explores decisions regarding the timeliness of appeals, the support necessary to sustain an LTD termination decision, a court’s discretion to credit and discredit expert opinions, the circumstances under which an insured may be required to prove they were prejudiced by the...

This month’s Friday Five addresses two cases involving disability claims that touch on Covid-19, a Circuit Court ruling for an insurer, a district court ruling that a 20-year-old regulatory settlement precluded an insurer from relying on the opinions of physicians it hired, and a claim for breach of...

This month’s Friday Five covers cases relating to what constitutes a fiduciary function, a finding of disability despite working full-time, an enforcement of suit limitation clause, the circumstances under which reinstatement is an appropriate remedy, and ERISA preemption. The Saul Ewing LLP...