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NAIC adopts model regulation for final medical loss ratios
  • Locke Lord LLP
  • USA
  • November 4 2010

On October 21, 2010, the Executive and Plenary committees of the National Association of Insurance Commissioners ("NAIC") voted to adopt a model regulation containing the definitions and methodologies for calculating medical loss ratios as stipulated under the Patient Protection and Affordable Care Act ("PPACA"


Lawmakers agree on year-long "doc fix"
  • Locke Lord LLP
  • USA
  • December 20 2010

Following the enactment of a one-month fix in order to prevent looming Medicare cuts to physicians for the month of December, Congress moved swiftly to clear a longer-term solution


Federal Court calls "individual mandate" unconstitutional
  • Locke Lord LLP
  • USA
  • December 16 2010

A Federal Court in Virginia ruled on December 13 that the provision of the Patient Protection and Affordable Care Act requiring most Americans to carry insurance or pay a fine is unconstitutional


Healthcare law faces legal challenges
  • Locke Lord LLP
  • USA
  • December 20 2010

On December 13, U.S. District Court Judge Henry E. Hudson struck down a key component of the new healthcare reform law (Public Laws 111-148 and 111-152) the individual mandate that all Americans have health insurance coverage


Federal government issues final medical loss ratio regulations
  • Locke Lord LLP
  • USA
  • November 24 2010

On November 22, 2010, the U.S. Department of Health and Human Services (HHS) issued final regulations on the medical loss ratio requirements provided for in the Patient Protection and Affordable Care Act (PPACA


Last week in DC: the healthcare reform debate March 29, 2010
  • Locke Lord LLP
  • USA
  • March 29 2010

Healthcare reform's long and often bumpy journey through Congress came to a close last week, as President Obama signed into law the 2,000 page legislation that will overhaul the nation's healthcare system


Massachusetts health insurers sue over rejected rate increases
  • Locke Lord LLP
  • USA
  • April 6 2010

Blue Cross Blue Shield of Massachusetts and the Massachusetts Association of Health Plans have sued the Massachusetts Division of Insurance (DOI) after the DOI's decision last week to reject most proposed rate increases for small businesses for the current calendar quarter


Supreme Court of Canada considers the meaning of 'accident' under a group policy
  • Locke Lord LLP
  • Canada
  • January 22 2010

In the case of Co-operators Life Insurance v Gibbens, 2009 SCC 59, the insured contracted herpes through unprotected sex and, as a result, developed transverse myelitis, a rare complication of herpes, which left him paralysed from the waist down


Last week in DC: the healthcare reform debate February 1, 2010
  • Locke Lord LLP
  • USA
  • February 1 2010

Healthcare reform efforts remained in flux last week, as President Obama sought to repackage his party's priorities in the wake of the shocking Republican victory in Massachusetts on January 19


Ninth Circuit: automobile insurer did not engage in bad faith by refusing to pre-authorize treatment under PIP coverage
  • Locke Lord LLP
  • USA
  • February 2 2010

In Sadler v. State Farm Mutual Automobile Insurance Company, No. 08-35859 (9th Cir. Nov. 4, 2009), the insureds sued their insurer for bad faith, among other claims, arising from their insurer’s refusal to pre-authorize surgery under the personal injury protection (“PIP”) provision of the automobile insurance policy