News & Analysis as of

Discrimination Medicare

Discrimination is prejudicial treatment related to (or inappropriate consideration of) an individual's actual or perceived membership in a particular class, group or category, such as an individual's... more +
Discrimination is prejudicial treatment related to (or inappropriate consideration of) an individual's actual or perceived membership in a particular class, group or category, such as an individual's race, religion, gender, age, to name a few.  less -
Rivkin Radler LLP

FCA Case Against Insurers Alleges Kickbacks and Discriminatory Practices

Rivkin Radler LLP on

On May 1, a whistleblower filed a complaint under the federal False Claims Act (FCA) against Aetna, Elevance Health (formerly Anthem) and Humana alleging that the insurers paid hundreds of millions of dollars in illegal...more

Ballard Spahr LLP

Section 1557: Deadlines Approach, But Long-Term Prognosis Unclear Under Executive Orders

Ballard Spahr LLP on

Section 1557 of the Affordable Care Act mandates nondiscrimination in health care programs managed or funded by the Department of Health and Human Services (HHS), with upcoming deadlines for compliance set for May and July...more

Jackson Lewis P.C.

“Final” Section 1557 Nondiscrimination Regulations – Round 3: Impact on Employer Health Plans

Jackson Lewis P.C. on

Section 1557 is the non-discrimination provision of the Affordable Care Act (ACA). Section 1557, which has been in effect since 2010, is intended to prevent discrimination in certain health programs or activities that...more

Whiteford

New CMS Guidance on Use of Algorithms and AI in Prior Authorizations and Utilization Management

Whiteford on

Use of algorithms and artificial intelligence (AI) in prior authorization and utilization management is facing growing criticism and litigation. Notable lawsuits include alleged automatic authorization denials for tests that...more

Cozen O'Connor

The State AG Report – 4.28.2023

Cozen O'Connor on

Here are curated AG and federal regulatory news stories highlighting key areas in which state and federal regulators’ decisions are having an impact across the US: •FTC Targets Optometrists, Ophthalmologists Suspected of...more

Sheppard Mullin Richter & Hampton LLP

2023 Payment Rule’s Nondiscrimination Provisions and Anticipation of New Section 1557 Rules

On January 5, 2022, we discussed the Notice of Benefit and Payment Parameters for 2023 proposed rule released by the Centers for Medicare & Medicaid Services (CMS). On April 28, 2022, CMS issued the NBPP 2023 Final Rule. CMS...more

Michigan Auto Law

The Risks of Older Drivers Using Medicare instead of Michigan No-Fault Auto Insurance

Michigan Auto Law on

By allowing seniors to opt out of No Fault for Medicare, SB 787 jeopardizes seniors’ medical and financial health after a car crash - It sounds good, at first. Allowing senior and elderly drivers to opt out of Michigan auto...more

Fisher Phillips

The Patient Is Not Always Right: Discriminatory Staffing Requests Can Create Legal Exposure

Fisher Phillips on

Employer reports of bigoted or inappropriate comments made by customers to employees or other patrons have become increasingly common for employers in all industries. In the healthcare industry, this often takes the form of a...more

FordHarrison

Texas Court Enjoins Enforcement of Regulation that Would Forbid Discrimination in Healthcare on the Basis of Gender Identity and...

FordHarrison on

As LGBTQ rights have taken center stage in political and social issues, FordHarrison has been following ground-breaking litigation related to LGBTQ rights and providing updates. In the latest decision, a federal judge in...more

Tucker Arensberg, P.C.

Telehealth News

Tucker Arensberg, P.C. on

Iowa Supreme Court Rejects Ban on Telemedicine Abortions - An Iowa Board of Medicine rule requires the presence of a physician when abortion inducing drugs are provided....more

Proskauer - Employee Benefits & Executive...

Eighth Circuit Says That Considerations Of Health Care Cost Savings Could Be Proxy For Age In ADEA Suits

The Eighth Circuit recently concluded that an employer may violate the ADEA by terminating an older employee in order to reduce its health care premiums. Tramp v. Associated Underwriters, Inc., 2014 WL 4977396 (8th Cir....more

Winstead PC

U.S. Supreme Court Ruling: Defense of Marriage Act ("DOMA")

Winstead PC on

While the U.S. Supreme Court(the “Court”) ruled section 3 of the Defense of Marriage Act (“DOMA”) unconstitutional, that does not mean that the changes for human resources departments and employee benefits plans can be...more

Ervin Cohen & Jessup LLP

In Case You Were Confused, Medicare is for the Benefit of Employees, not Employers

Most employers these days know that they cannot set a mandatory retirement age for employees. This arcane practice runs directly afoul of the Age Discrimination in Employment Act (ADEA)....more

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