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The No Surprises Act (“NSA”) is a federal law that went into effect January 1, 2022. The NSA statute was enacted as part of the Consolidated Appropriations Act, 2021 and has been implemented by three interim rule s jointly announced by the Office of Personnel Management within the Department of the...
October was National Cybersecurity Month. As part of its ongoing focus on HIPAA Security Rule awareness and compliance, the Office for Civil Rights (“OCR”) within the Department of Health and Human Services (“HHS”), published its HIPAA Security Rule Incident Procedures newsletter (the “Newsletter”)...
This month’s Friday Five covers cases relating to augmentation of the administrative record following new rationales, attempted alternative ERISA causes of action, untimely ERISA claims, plans governed by ERISA even in the absence of a written plan document, and the limited weight given to residual...
This month’s Friday Five covers cases relating to the interpretation of time periods for claims under life insurance and disability plans, a situation where three separate administrators handled a disability benefits claim (but came to different decisions), the Eleventh Circuit’s parsing of...
Property insurers faced with COVID-19 related claims for business income losses can take comfort in the recent trend of most appellate courts to find in favor of insurers that have denied coverage based on policy language requiring direct physical loss or damage. What You Need to Know: Many...
This month’s Friday Five covers cases relating to interpretation of ambiguous policy terms, evaluation of claimant’s expert witness, inclusion of law firms as appropriate parties from whom plan administrators may seek equitable relief, transfer of cases from the claimant’s choice of venue, and...
On August 23, 2022, the Office for Civil Rights (OCR) within the U.S. Department of Health and Human Services (HHS) announced a $300,640 settlement and a Corrective Action Plan ("CAP") with New England Dermatology P.C., d/b/a New England Dermatology and Laser Center ("NEDLC") to resolve allegations...
On July 15, 2022, the Office for Civil Rights (OCR) within the U.S. Department of Health and Human Services (HHS) announced the resolution of eleven investigations as part of its Health Insurance Portability and Accountability Act (HIPAA) Right of Access Initiative (the "Initiative"). OCR created...
This month’s Friday Five addresses cases considering: (1) whether monetary relief in the amount of lost benefits is an available remedy for breach of fiduciary duty; (2) the validity of an ex-spouse’s beneficiary designation that contradicts a subsequent divorce decree; (3) if waiver of a pre...
No ‘slam dunk fix’ in HIPAA privacy law to protect abortion patients The Biden administration wants to lean on the decades-old privacy law to protect abortion patients. What could it actually do? “Typically, the laws are trying to catch up with where the real world is, in terms of what’s going on...
On June 29, 2022, the U.S. Department of Health and Human Services Office for Civil Rights released two guidance documents addressing (1) disclosures under the HIPAA Privacy Rule relating to reproductive health care (“Disclosure Guidance”), and (2) the privacy and security of reproductive health...
As we have just passed the half-way point of 2022, many health systems are thinking about acquisitions they would like to complete before the end of the calendar year. In addition to the necessary due diligence, contracting considerations and licensure and regulatory issues, acquiring and selling...
This month’s Friday Five covers cases relating to interpretation of regulatory deadlines, the enforceability of discretionary clauses, circuit courts going both ways on appeals from summary judgment rulings in favor of plans, and a benefits award for a former professional football player where the...