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Delaware court: settlement for statutory damages, calculated without reference to actual damages incurred, is for penalty, not covered loss

Wiley Rein LLP
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USA
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May 14 2013

A Delaware trial court has held that a settlement for statutory damages paid by a health care organization represents uncovered penalties rather than

Medicare narrows required reporting by insurers; Town Hall reveals disconnect with insurers on key questions regarding pre-1980 exposures

Wiley Rein LLP
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USA
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April 15 2013

On April 9, 2013, the Centers for Medicare & Medicaid Services (CMS) held its first Town Hall Teleconference of the year for Non-Group Health Plans

Congress passes long-awaited reforms to the Medicare secondary payer recovery process, including elimination of SSN reporting, but built-in regulatory delays could postpone insurer relief

Wiley Rein LLP
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USA
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January 4 2013

Both the Senate and the House have passed year-end legislation amending the Medicare Secondary Payer (MSP) statute and reforming the process by which

House Committee moves SMART Act forward; Medicare reaffirms position on mandatory insurer reporting under accident & health and short-term travel policies

Wiley Rein LLP
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USA
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September 25 2012

Legislation designed to fix problems with the Medicare Secondary Payer (MSP) process has moved forward in the U.S. House of Representatives while the Centers for Medicare & Medicaid Services (CMS) continues to dig in its heels on its questionable interpretations of existing MSP law

News report not notice of potential claim

Wiley Rein LLP
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USA
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July 27 2012

The Supreme Court of Nevada has held that a news report about a dentist’s arrest for anaesthetizing patients with cocaine did not constitute a “claim” that triggered coverage under the dentist’s claims-made-and-reported professional malpractice policy

Supreme Court decision upholding Affordable Care Act affirms contracting opportunities in insurance exchanges and Medicaid

Wiley Rein LLP
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USA
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July 26 2012

In the July 16, 2012 edition of Bloomberg BNA’s Health Care Policy Report, Wiley Rein attorneys Jim Slattery, Kathryn Bucher, Daniel P. Graham and Kate R. McDonald published an article on the implications for health care contractors of the Supreme Court’s decision in Nat’l Fed’n of Indep. Bus. v. Sebelius, No. 11-393, slip op. (U.S. June 28, 2012

CMS releases revised NGHP user guide but fails to provide expected guidance on important unresolved Section 111 issues

Wiley Rein LLP
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USA
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July 6 2012

On July 3, 2012, the Centers for Medicare & Medicaid Services released version 3.4 of the Medicare, Medicaid and SCHIP Extension Act Section 111 Medicare Secondary Payer Mandatory Reporting Liability Insurance (Including Self- Insurance), No-Fault Insurance and Workers' Compensation User Guide

Under California law, medical malpractice policies do not cover medical board professional disciplinary actions

Wiley Rein LLP
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USA
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June 15 2012

A New Jersey appellate court, applying California law, has held that a medical malpractice liability insurer had no duty to reimburse an insured physician for defense costs incurred in connection with a professional disciplinary action brought against him by the California Medical Board

GAO and federal court weigh in on Section 111 infirmities but it's business as usual for CMS during town hall call

Wiley Rein LLP
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USA
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April 27 2012

The most newsworthy Section 111 developments come from a federal District Court that recently declared a legal malpractice insurer not to be a Responsible Reporting Entity (RRE) and the U.S. Da Silva Moore

First Section 111 Town Hall of 2012 highlights need for further clarification of reporting responsibilities and frustration over improper claim denials for which insurers are taking the heat

Wiley Rein LLP
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USA
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February 29 2012

On February 24, 2012, the Centers for Medicare & Medicaid Services (CMS) held the first Section 111 Town Hall Teleconference of the year for Non-Group Health Plans (NGHPs

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