Court Nixes Health Plan’s Subrogation Claim

Posted December 22, 2015, 3:11 P.M. ET By Carmen Castro-Pagan A health plan isn’t entitled to reimbursement of $48,000 in medical expenses it paid on behalf of a minor beneficiary who was injured in an all-terrain vehicle accident, the U.S. District Court for the District of Ari
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The Supreme Court Seeks Solutions to the Latest Challenges to Subrogation Rights in Montanile Case

By Catherine Dowie The facts of the latest healthcare subrogation challenge on the SupremeCourt’s docket (Montanile v. Board of Trustees of the National Elevator Industry Health Benefit Plan) will be familiar to many. As you may recall from the June 2015 article,“TheRoad to Recovery:
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FEHBA Preempts Kansas Anti-Subrogation Regulation

By Carmen Castro-Pagan The Federal Employees Health Benefits Act preempts a Kansas administrative regulation prohibiting subrogation and reimbursement clauses in health insurance contracts of federal government employees, the U.S. Court of Appeals for the Tenth Circuit ruled . The app
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Size Doesn’t Matter But the Regulators Do

By Adam V. Russo, Esq. (As published in Thompson Information Services’ Employer’s Guide to Self-Insuring Health Benefits)  What is the perfect size for a self-funded plan?  This is one of my favorite questions and I love to ask it at any conference at which I happen to hav
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The Road to Recovery: Subrogation Gets Its Day In Court … Again

By Christopher M. Aguiar, Esq. (As published within The Self-Insurer)  In a country with a seemingly infinite amount of regulation and concerns regarding benefit plan compliance following the passage of the Affordable Care Act in 2010, one would expect much attention from courts in th
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Be Smart When Self-Funding

By Adam V. Russo, Esq. (As published in Thompson Information Services’ Employer’s Guide to Self-Insuring Health Benefits)   Introduction While we are seeing record growth across the country, self-funding is a topic that few are familiar with, even though many participate i
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Cost containment: The Golden Oldies

By Andrew R. Silverio, Esq. (As published within ECI Users Group Spring Newsletter)  It’s no secret that America devotes more of its gross domestic product to healthcare expenses than any other country.  Runners up, including Canada, the Netherlands, France, Germany, and Switzerland,
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New York Governor Signs Legislation Prohibiting ERISA Liens on Settlement Proceeds

McGivney & Kluger, P.C. On November 13, 2013, the Governor of New York signed legislation which clarifies the scope of General Obligations Law (“GOL”) Section 5-335. As a result of this amendment, ERISA plans are prohibited from asserting liens against settlement proc
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New York’s Attempt to Preempt ERISA

Jonathan A. Jablon, Esq. Though New York’s legislature is trying to legislate away the rights of self-funded employee benefit plans, to the extent that ERISA explicitly preempts application of a conflicting state law such as this one, that state law is invalidated. ERISA’s “savings cl
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Amicus Update: New York Governor signs into law anti-subrogation bill

November 15, 2013 Kammy Poff, Amicus Committee Chair Joseph Willis, Legislative Affairs Committee Chair On November 13, 2013, Governor Andrew Cuomo signed into law New York Assembly Bill 7828 whose purpose was to tighten perceived loopholes in NY Gen. Obl. 5-535, which was enacted in
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