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Results: 1-8 of 8

Plan administrator not obligated to provide benefit accruals for unpaid hours

  • Hodgson Russ LLP
  • -
  • USA
  • -
  • July 29 2011

Nurse participants in a hospital retirement plan were upset that their unpaid meal breaks, during which they were required to work, and an unpaid 20-40 minute period of patient status review before the official start of their shifts were not counted for benefit purposes in the hospital's retirement plans

Self-insured medical plan’s claim for recovery of mistaken payment dismissed

  • Hodgson Russ LLP
  • -
  • USA
  • -
  • November 30 2011

The Court of Appeals for the Seventh Circuit held that a self-insured medical plan is not entitled to equitable relief in the recovery of payments it made for services rendered to a participant’s child who was never enrolled in the plan

Is PPACA constitutional?

  • Hodgson Russ LLP
  • -
  • USA
  • -
  • August 30 2011

On August 12, 2011, in State of Florida v. United States Department of Health and Human Services, the Court of Appeals for the Eleventh Circuit held that the provision in the Patient Protection and Affordable Care Act (PPACA) that requires individuals to buy health insurance or pay a tax penalty (the so-called “individual mandate”) is unconstitutional

Medical plan preauthorization language violates SPD standards

  • Hodgson Russ LLP
  • -
  • USA
  • -
  • August 29 2012

In Koehler v. AETNA Health Inc., the U.S. Court of Appeals for the Fifth Circuit held that Aetna’s benefits decision was not, as a matter of law, entitled to deference where the same document, Aetna’s certificate of coverage, served as both the plan document and summary plan description (SPD

Legal challenges to health care reform continue to work through the courts

  • Hodgson Russ LLP
  • -
  • USA
  • -
  • April 15 2011

In late January, a district court in Florida ruled that the Patient Protection and Affordable Care Act (PPACA) is unconstitutional

Supreme Court considers constitutionality of individual mandate

  • Hodgson Russ LLP
  • -
  • USA
  • -
  • April 27 2012

At the end of March, the U.S. Supreme Court heard arguments on the constitutionality of a provision in the Patient Protection and Affordable Care Act (ACA) that requires most U.S. residents to maintain health care coverage for themselves and their dependents

Same-sex domestic partner policy does not discriminate against opposite-sex couples

  • Hodgson Russ LLP
  • -
  • USA
  • -
  • April 15 2011

Reversing a decision by the Westchester County Human Rights Commission, a New York appeals court recently held that a policy adopted by a local Board of Cooperative Educational Services (BOCES) to offer health care to same-sex domestic partners did not unlawfully discriminate against opposite-sex domestic partners

Insurer not a fiduciary when negotiating rates

  • Hodgson Russ LLP
  • -
  • USA
  • -
  • February 11 2011

The Court of Appeals for the Sixth Circuit ruled that an insurer was not acting as a fiduciary when it negotiated rates with hospitals that favored its health maintenance organization clients over its self-funded plan clients