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New final regulations and FAQs provide guidance on preventive services coverage
  • Proskauer Rose LLP
  • USA
  • August 17 2015

Through new FAQs and final regulations, the U.S. Departments of Labor ("DOL"), Health and Human Services ("HHS") and the Treasury (the "Departments"


First federal appellate court holds a noncash reverse payment subject to antitrust scrutiny: is the Third Circuit's decision in King Drug a turning point?
  • Proskauer Rose LLP
  • USA
  • July 9 2015

Recently, the Third Circuit issued the first federal appellate decision interpreting the Supreme Court's landmark decision in FTC v. Actavis, Inc


Claims administrator not liable under ERISA for alleged failure to follow ACA’s enhanced benefit claim procedures
  • Proskauer Rose LLP
  • USA
  • November 25 2013

A federal court in New York appears to have issued the first published decision addressing alleged violations of the enhanced benefit claim


Third Circuit holds that the ADA can obligate an employer to reasonably accommodate an employee’s disability-related difficulties in getting to work
  • Proskauer Rose LLP
  • USA
  • May 26 2010

In a recent ADA case, Colwell v. Rite Aid Corporation, No. 08-4675, 2010 U.S. App. LEXIS 7249 (3d Cir. Apr. 8, 2010), the U.S. Court of Appeals for the Third Circuit reversed summary judgment for the employer and held that employers may need to make reasonable shift changes, allowing an employee with a visual impairment to work the day shift only in order to accommodate the employee’s disability-related difficulties in getting to work


Health care reform litigation risks the intersection of ERISA Section 510 and the Affordable Care Act’s whistleblower provisions
  • Proskauer Rose LLP
  • USA
  • May 31 2013

The Affordable Care Act (ACA) is significantly changing employer health care obligations under the Employee Retirement Income Security Act (ERISA


District court permits ERISA claim for benefits of IRO review, holding such review is not an arbitration
  • Proskauer Rose LLP
  • USA
  • March 19 2013

In Yox v. Providence Health Plan, No. 12-cv-01348, 2013 WL 865968 (D. Or. Mar. 8, 2013), a federal district court held that the review of benefit


OIG approves "per-click" payments for transmission of referral information as part of integrated electronic health record and physician office support service
  • Proskauer Rose LLP
  • USA
  • December 9 2011

On November 30, 2011, the U.S. Department of Health and Human Services, Office of Inspector General, issued a favorable Advisory Opinion relating to a set of services that includes the preparation and transmission of referral orders between health care providers in which part of the service fees, including fees paid by referral recipients, are determined on a "click-fee" basis



New IRS guidance on 40 excise tax previews future regulatory complexity
  • Proskauer Rose LLP
  • USA
  • August 3 2015

Although public opposition to the 40 excise tax on high-cost health care is rapidly growing, the IRS continued to develop a regulatory framework for


HIPAA Certificates are no longer required as of January 1, 2015
  • Proskauer Rose LLP
  • USA
  • December 12 2014

Effective January 1, 2015, group health plans and insurers are no longer required to issue a certificate of creditable coverage ("HIPAA Certificate"