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Regulatory Requirements › Insurance Industry › Enforcement Actions

McDermott Will & Schulte

CMS to enforce MMSEA 111 reporting compliance beginning October 2025

McDermott Will & Schulte on

Beginning October 11, 2025, failure to comply with the statutory obligation that most insurers of medical claims (including self-insured entities) have to report claims under Section 111 of the Medicare, Medicaid and SCHIP...more

Rivkin Radler LLP

NY Insurer Fined $250,000 for Mental Health “Ghost Network”

Rivkin Radler LLP on

The New York Attorney General’s office recently announced an agreement with MVP Health Care under which the insurer will pay $250,000 in penalties, fees, and costs to the state for maintaining an inaccurate mental health...more

Cozen O'Connor

NY AG Puts Mental Health Ghost Network to Rest

Cozen O'Connor on

New York AG Letitia James has announced an agreement with MVP Health Plan (MVP) following an investigation that found systemic problems with the insurer’s mental health provider network. The investigation revealed that MVP’s...more

Paul Hastings LLP

You’ve Got Mail: NYDFS Enforcement Action Highlights Cybersecurity Risk of Over-Retention and Other Risks

Paul Hastings LLP on

On Aug. 14, 2025, the New York Department of Financial Services (NYDFS) issued a Consent Decree announcing that Healthplex, Inc. (Healthplex) has agreed to pay a $2 million fine, as a result of an investigation into a 2021...more

Foley & Lardner LLP

CMS Finalizes Rule Change Applying Preponderance of the Evidence Standard to Agent, Broker, and Web-Broker Exchange Agreement...

Foley & Lardner LLP on

In its recently issued Final Rule (CMS-9884-F; 90 FR 27074-01; the Final Rule), the Centers for Medicare and Medicaid Services (CMS) finalized revisions to 45 C.F.R. § 155.220(g)(2) to specify a standard of proof for...more

Husch Blackwell LLP

MHPAEA July 2025 Update: What Employers and Plans Need to Know about Federal Non-Enforcement

Husch Blackwell LLP on

The Mental Health Parity and Addiction Equity Act of 2008 (MHPAEA) was enacted to ensure that group health plans and health insurance issuers offering mental health and substance use disorder (MH/SUD) benefits do not impose...more

Littler

The Parity Paradox: MHPAEA Compliance for Employers and Insurers During the 2024 Enforcement Pause

Littler on

The U.S. Departments of Labor, Health and Human Services, and Treasury have announced that they will pause enforcement of the 2024 Mental Health Parity and Addiction Equity Act (MHPAEA) Final Rule (the “2024 Final Rule”) for...more

Mayer Brown

Brasília em Pauta – Edição Nº 188

Mayer Brown on

PAUTAS: STF – CONTROLE CONCENTRADO E REPERCUSSÃO GERAL | STJ – REPETITIVOS | TCU – PLENÁRIO | CÂMARA DOS DEPUTADOS | SENADO FEDERAL - Prezados e prezadas, O - “Brasília em Pauta” é um boletim semanal preparado pela...more

Conyers

Economic Substance Enforcement Regime Overview - Applicable to Insurance Entities

Conyers on

It has now been over a year since the updated Enforcement Guidelines: Economic Substance (the “Guidelines”) were issued on 31 March 2023, outlining the enforcement powers and processes of the Cayman Islands Tax Information...more

Polsinelli

Kansas Regulatory Action: A Reminder That Insurers Must Maintain Oversight of Third Party Administrators

Polsinelli on

The Kansas Insurance Department (“Department”) recently took regulatory action against an insurer which allegedly violated Kansas insurance laws. Specifically, the Department initiated a Market Conduct inquiry of accident and...more

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