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Employees' claims for unpaid medical benefits not "loss" under company's fiduciary liability policy

  • Wiley Rein LLP
  • -
  • USA
  • -
  • January 19 2012

The United States District Court for the Southern District of West Virginia has held that employees’ claims for unpaid medical benefits arising from the mismanagement of a company’s benefits plan constituted “benefits due” and therefore were carved out from the definition of “loss” in the entity’s fiduciary liability policy

CMS town hall adds to confusion over Section 111 reporting obligations of accident and health insurers; controversy emerges over insurer's "duty to protect medicare's interests"

  • Wiley Rein LLP
  • -
  • USA
  • -
  • April 8 2011

On April 6, 2011, the Centers for Medicare & Medicaid Services (CMS) held a Town Hall teleconference focusing on policy issues related to Non-Group Health Plan (NGHP) mandatory insurer reporting under Section 111 of the Medicare, Medicaid and SCHIP Extension Act of 2007

March 16, 2010 town hall teleconference overview: CMS takes stock of its to-do list

  • Wiley Rein LLP
  • -
  • USA
  • -
  • March 17 2010

On March 16, 2010, the Centers for Medicare & Medicaid Services (CMS) held its monthly teleconference for non-group health plans (NGHPs) that focuses on policy issues related to the implementation of Section 111 of the Medicare, Medicaid, and SCHIP Extension Act of 2007

Legislative fix introduced in Congress to Section 111 reporting hurdles; bill also seeks broader MSP reforms

  • Wiley Rein LLP
  • -
  • USA
  • -
  • March 12 2010

The Medicare Secondary Payer Enhancement Act of 2010 (H.R. 4796) was introduced in the House of Representatives on March 9, 2010 by Congressmen Patrick Murphy (D. Pennsylvania) and Tim Murphy (R. Pennsylvania

Court applies exclusion for claims involving receivership of a healthcare benefit plan

  • Wiley Rein LLP
  • -
  • USA
  • -
  • June 16 2008

The United States District Court for the Middle District of Florida, applying Florida law, has held that exclusions for claims involving the receivership of a healthcare benefit plan and claims involving Multiple Employer Welfare Arrangements (MEWA) barred coverage for claims brought by a receiver of a healthcare benefit plan alleging that brokers sold coverage under a benefit plan that was a MEWA