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Supreme Court to resolve circuit split in health care reform cases

  • Proskauer Rose LLP
  • -
  • USA
  • -
  • December 2 2013

The Supreme Court will review two of the numerous lawsuits challenging the Affordable Care Act's (ACA) requirement that group health plans and

The Affordable Care Act and its coverage mandates for employers: a potent recipe for ERISA class actions

  • Proskauer Rose LLP
  • -
  • USA
  • -
  • August 20 2012

Although the Patient Protection and Affordable Care Act (ACA) has engendered much controversy (pro and con) in the business community, one area that has received less discussion is whether ACA may increase employers’ exposure to high-stakes class action litigation

Third Circuit limits relief available to ERISA welfare plans seeking reimbursement of medical expenses

  • Proskauer Rose LLP
  • -
  • USA
  • -
  • November 17 2011

In a case of significant importance for plan sponsors and fiduciaries, the U.S. Court of Appeals for the Third Circuit held in US Airways, Inc. v. McCutchen, No. 10-3836 (3d Cir. Nov. 16, 2011), that an employee benefit plan was not entitled to full reimbursement of medical expenses it paid to a participant even though the plan provided that the participant was required to reimburse the plan for all amounts paid "out of any monies recovered from a third party."

Second Circuit holds Taft-Hartley funds are inherently conflicted, potentially affects outcome and scope of future benefit claims litigation

  • Proskauer Rose LLP
  • -
  • USA
  • -
  • June 29 2010

On June 24, 2010, the U.S. Court of Appeals for the Second Circuit held, in Durakovic v. Building Service 32 BJ Pension Fund, 2010 WL 2519645 (2d Cir. 2010), that Taft-Hartley funds (administered by boards of trustees consisting of an equal number of union and employer representatives) are inherently conflicted when making benefit determinations, and that this conflict needs to be considered by federal district courts when reviewing plan determinations under an arbitrary and capricious standard of review

Rulings, filings and settlements of interest

  • Proskauer Rose LLP
  • -
  • USA
  • -
  • June 7 2010

In Golden Gate Restaurant Assoc. v. City and County of San Francisco, No. 08-1515 (U.S.), the U.S. Solicitor General requested that the Supreme Court deny certiorari in light of the recent enactment of the Patient Protection and Affordable Care Act (PPACA

Rulings, filings and settlements of interest

  • Proskauer Rose LLP
  • -
  • USA
  • -
  • February 3 2010

In Pollitt v. Health Care Serv. Corp., 558 F.3d 615 (7th Cir. Mar. 10, 2009), cert. granted (Oct. 13, 2009), the Seventh Circuit vacated and remanded the district court’s finding that the Federal Employees Health Benefits Act (“FEHBA”) preempted a participant’s claim that Health Cares Services Corporation (“HCSC”) acted in bad faith by terminating her son’s coverage and seeking reimbursement of benefits previously provided