Health Net to Pay $250,000 to Settle First-Ever State HIPAA Privacy Suit
Excerpt: "The Health Information Technology for Economic and Clinical Health (HITECH) Act of 2009 amended HIPAA to give state attorneys general the power to bring a civil action on behalf of state residents when the attorney general believes they have been victims of a HIPAA violation."
(Thompson Publishing Group Inc.)
Provider Payment for Emergency Services under New Plan Rules
Excerpt: "Section 10101(h) of the Affordable Care Act health reform legislation requires that health plans and insurers provide coverage for all emergency services without regard to whether the provider is in- or out-of-network, without requiring preauthorization, without imposing administrative requirements more burdensome than those applicable to emergency care provided in-network, and without imposing higher cost-sharing burdens on patients."
(Proskauer Rose LLP)
Proposed HHS Rulemaking Expands HIPAA Privacy and Security Rules
Excerpt: "The Rule modifies the Privacy Rule, the Security Rule and the Enforcement Rule. It will broaden the applicability of the Privacy and Security Rules requirements to business associates, and apply the Privacy and Security Rules to electronic protected health information."
(Nixon Peabody LLP)
Final Application and FAQs for Early Retiree Reinsurance Program (PDF)
4 pages. Excerpt: "Buck Comment. In identifying the plan for purposes of the application, a plan sponsor will need to coordinate carefully any actions that are being considered in implementing 'retiree-only plans' to avoid health reform market mandates."
If You Lose Grandfathered Status of Your Health Insurance Plan, What Do You Avoid? (PDF)
Excerpt: "If you lose grandfathering, you will not have to, among other things: Include a notice with your plan communication material which implies you are depriving employees of certain benefits; Maintain documentation of your plan as it existed on 3/23/2010 for perpetuity; Calculate the impact of certain benefit changes (increasing copayments, increase cost sharing using a formulae contained in the regulations); Postpone or rework plan changes for the coming year."
Ninth Circuit Issues Ruling in Standard Insurance Co. v. Morrison on Discretionary Clause Issue
Excerpt: "The Ninth Circuit held that Morrison's practice of disapproving discriminatory clauses is specifically directed toward entities engaged in insurance and substantially affects the risk pooling arrangement between insured and insurer, more so than other laws that have been upheld by the U.S. Supreme Court; thus, the practice is saved from ERISA preemption."
(Passion for Subro!)
Boosting Wellness Participation Without Excessive Costs
Excerpt: "Successful employers share a common commitment in their wellness strategy. They provide broad-based and targeted communication to their workforce and develop a healthy workplace culture with strong support from senior leadership."
When Choosing a Health Insurance Plan, Know What You'll Owe
Excerpt: "Many group policies provide limits on annual out-of-pocket expenditures, including co-insurance, deductibles and co-pays. With these plans, once you pay, say, $5,000 or $6,000 for a single person in approved medical bills, your insurer will cover 100 percent of additional treatment. The new health care law will limit all cost-sharing, including co-insurance payments, beginning in 2014."
(The New York Times; free registration required)
Companies Adding End-of-Life Support Services to Their Life-Event Employee Programs
Excerpt: "With more baby boomers either caring for parents who are nearing death or suffering from life-ending diseases themselves, HR has a mounting responsibility to help workers make those final plans. Issues include wills, advanced directives about medical treatment, financial advice and grief counseling."
(Human Resource Executive Online)
Washington, D.C.'s Effort to Regulate Pharmacy Benefit Managers Ruled Invalid
Excerpt: "The District of Columbia Council passed the AccessRx Act in 2004 in response to rising prescription drug prices. Title II of the act had sought to regulate PBMs by imposing fiduciary duties on the companies and requiring them to disclose certain financial information including rebates, discounts and similar payments."
District Court Rules for Retirees on Health Benefits
Excerpt: "The SPD stated that the company 'hoped' to continue the benefits indefinitely but reserved the right to change the payments at any time. Jonker declared in his ruling: 'This language is not an unqualified statement that the employer retained the unilateral right to amend and terminate the plan.'"
Will Having More Insurers Control Health Care Costs Better?
Excerpt: "A common theme among health reformers has been that the small-group and individual markets for health insurance are too concentrated and thus inadequately competitive. The proposed remedy is to have more independent insurers compete within local markets."
The nation's workforce and health care system are constantly evolving and so are the legal issues. Law Journal Press helps you handle any benefits law question with up-to-date, authoritative books on all aspects of the field. Get legal and practical advice from leading experts on everything from COBRA to ERISA, "contingent" employees to family and medical leave, and more. Browse our product listings for detailed information and special offers.
Benefits in General; Executive Compensation
Hewitt Associates, Inc. to Merge with Aon Corporation
Excerpt: "This morning Aon Corporation and Hewitt Associates, Inc. announced that the boards of directors of both companies have approved a definitive agreement under which Hewitt will merge with a subsidiary of Aon."
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