Medical autonomy not violated by ACA’s individual health insurance mandate: Court

By Jerry Geisel A key health care reform law provision that requires individuals to purchase coverage or pay a financial penalty does not violate their constitutional right to make their own medical decisions, a federal appeals court panel ruled. Read more…
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Idaho antitrust case puts healthcare pricing ‘trade secrets’ in spotlight

By Joe Carlson A nationally watched case in Idaho is casting light on a familiar irony in healthcare antitrust enforcement: Prices are officially considered proprietary trade secrets, even though it is the risk of rising prices that motivates the need for action. Read more…
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Adding Another Weapon to the Subrogation Arsenal

By: Sean Donnelly and Jon Jablon It may only be October, but Christmas has come early for self-insured health plans.  A recent court decision out of Washington affirms a self-insured plan’s right to offset claims as part of its subrogation and reimbursement rights – that is, to deny f
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AMICUS UPDATE

In a victory for healthcare subrogation, the United States Supreme Court reversed the Third Circuit’s holding in US Airways, Inc. v. McCutchen.  In stunning fashion, the Justices of the Supreme Court ruled 9-0 that equitable principles (such as the made whole and common fund doctrines
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Second Circuit: Deferential Standard Applies Without Notice To Participants & Reimbursement Claims Are Equitable Relief

Yesterday, the Second Circuit ruled on two important issues of note for ERISA plan sponsors and plan fiduciaries. In Thurber v. Aetna Life Insurance Co., 2013 WL 950704 (2d Cir. Mar. 13, 2013), the Court ruled that participants and beneficiaries are not required to be put on notice th
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Ninth Circuit Breathes New Life Into Retirees’ Claim for Lifetime Healthcare Benefits

Employers may unwittingly create implied vested contractual rights to retirement and healthcare benefits for their employees in perpetuity. In Sonoma County Ass’n of Retired Employees v. Sonoma County, No. 10-17873 (February 26, 2013), the Ninth Circuit vacated a district court’s dism
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Choice of Law In ERISA Disputes – How State Law May Affect Outcomes On Judicial Review

Here, the Policy contained a valid choice of law provision, which indicates that the parties intended for the Policy to be governed by Texas law to the extent that it is not preempted by ERISA. Thus, in order to decide this issue, we must ascertain how to determine whether or not to e
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