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Medicare › Discrimination › Health Insurance

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

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

Sheppard Mullin Richter & Hampton LLP

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

Sheppard Mullin Richter & Hampton LLP on

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

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

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

Ervin Cohen & Jessup LLP on

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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