Popular, Insurance Industry, Health Insurance

Alive and (Anti)Kicking: EKRA Prosecutions on the Rise in California with Multiple Recent Indictments

BakerHostetler on 8/19/2025

In the past few months, federal prosecutors in California have brought multiple indictments under the Eliminating Kickbacks in Recovery Act (EKRA) charging the owners of substance abuse treatment facilities and their...more

Health Headlines: May 2025

Goodwin on 5/30/2025

On May 14, 2025, Pennsylvania State Sen. Tim Kearney and State Rep. Lisa Borowski introduced legislation addressing private equity and corporate interests in healthcare. Pennsylvania Gov. Josh Shapiro is touting the companion...more

Massachusetts Enacts Drug Pricing Legislation: Introducing PBM Licensure, Mandatory Cost Reporting, and Consumer Cost-Sharing...

ArentFox Schiff on 2/28/2025

On January 8, Massachusetts Governor Maura Healy signed into law “An Act Relative To Pharmaceutical Access, Costs And Transparency.” The Act will have a profound impact on all parties involved in setting and applying drug...more

California Implements New AI and Software Regulations for Insurers

DLA Piper on 10/4/2024

On September 28, 2024, California enacted SB 1120, which regulates the use of artificial intelligence (AI), an algorithm, or “other software tool” in utilization review and utilization management (UR/UM) functions by...more

Regs, Regs and More Regs: The Biden Administration Releases Spring 2024 Unified Agenda

McDermott+ on 7/11/2024

We are in the midst of a storm of regulations that are being released by the Centers for Medicare & Medicaid Services (CMS) and the US Department of Health and Human Services (HHS), including the Calendar Year (CY) 2025...more

New York Department of Financial Services Provides Guidance in the Face of the Change Healthcare Cyber Incident

Bressler, Amery & Ross, P.C. on 3/15/2024

On February 21, 2024, Change Healthcare, a platform that provides certain technology solutions for the health care industry, experienced a nationwide network interruption related to a cybersecurity issue (cyber incident) and...more

Google Mandates Licensure for Health Insurance Advertisers / Lead-Gens

Clark Hill PLC on 5/4/2021

Starting on June 2, 2021, Google will restrict who can advertise health insurance to just government exchanges, first-party providers and licensed insurance producers. Promoters such as lead generators will need to obtain...more

[Webinar] Around The Corner: Digital Health at Scale: The Payor's Perspective - July 29th, 12:00 pm - 1:15 pm EDT

McDermott Will & Schulte on 7/15/2020

The COVID-19 pandemic has catalyzed efforts by health insurers to expand reimbursement for telehealth services and digital health tools, and develop and invest in their own digital health tools. Health insurers, who...more

Attorney General Yost announces multistate data breach settlement with Premera

Bricker Graydon LLP on 8/16/2019

Ohio Attorney General Dave Yost recently announced a multistate settlement that will require health insurance company Premera Blue Cross to pay $10 million following a breach of protected health information (PHI). According...more

DOJ Antitrust Division Grants Approval to Proposed Cigna/Express Scripts Merger

Akerman LLP - Health Law Rx on 9/24/2018

On September 17, the United States Department of Justice (DOJ) Antitrust Division issued a “closing statement” in which it announced that it was closing its investigation into Cigna’s proposed acquisition of Express Scripts,...more

Clawbacks: Recent Litigation Targeting Insurers and Pharmacy Benefit Managers

Proskauer - Employee Benefits & Executive... on 5/3/2018

While the term “co-pay” might suggest a sharing of costs between patients and their health plans, a recent study by the University of Southern California Schaeffer Center found that almost a quarter of patients are paying...more

Ninth Circuit Holds that ERISA Preempts State Insurance Law Bans on Discretionary Clauses for Self-Funded ERISA Plans

Seyfarth Shaw LLP on 9/11/2017

Seyfarth Synopsis: The Ninth Circuit Court of Appeals recently confirmed that ERISA preempts state insurance law bans on discretionary clauses for self-funded ERISA plans....more

Aetna and its Vendor Face Class Action Lawsuit over HIV Disclosure

Patterson Belknap Webb & Tyler LLP on 8/29/2017

A Pennsylvania man has filed a class action lawsuit against Aetna Inc., accusing it of violating his privacy rights when the insurer mailed him prescription information in an envelope with a large, clear window that disclosed...more

Anthem and Aetna Merger Trials Begin

Baker Donelson on 1/4/2017

While the election of Donald Trump as the nation's next president is clearly the biggest news in Washington over the last two months, for the insurance industry, big news has also been made at the federal district courthouse....more

Judge Rejects Joint Defense Privilege Claim; Orders Would-be Merger Partners to Produce Sensitive Emails to DOJ

K&L Gates LLP on 12/8/2016

On October 14, 2016, a federal judge in Washington, D.C., ruled that two companies could not claim a joint defense privilege for certain sensitive emails they had exchanged in connection with their proposed merger. ...more

Anthem and Aetna Prepare for Merger Trials Against the DOJ Antitrust Division

Baker Donelson on 11/3/2016

In late July, the DOJ Antitrust Division filed actions in federal district court seeking to derail both the Anthem/Cigna and Aetna/Humana mergers. In each case, the DOJ contended that consumers would face higher insurance...more

DOJ and States Challenge Health Insurer Mergers

Baker Donelson on 9/12/2016

Following more than a year of regulatory review, in late July 2016 the Department of Justice (DOJ) Antitrust Division and a number of states filed actions seeking to derail both the Anthem/Cigna and Aetna/Humana mergers. In...more

Rules of the (International) Road, Brexit, PPP as a New Tool for Argentina, and Keeping Non-U.S. Companies Safe from Suit (Expect...

Carlton Fields on 8/26/2016

- Post-Daimler: Are Non-U.S. Companies Safe from Suit in U.S. Courts? What if the Non-U.S. Parent Registers to Do Business in a State? - Rules of the (International) Road: Choosing and Appointing a Distributor ...more

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