“ERISA, you’ll need a lawyer for that.” Our practice group’s tagline is meant to be a shorthand for the alphabet soup of laws that apply to employee benefits, including the Employee Retirement Income Security Act (ERISA). Employee benefits compliance has many traps for the unwary and is ever evolving. Below, we have provided a primer on current issues of importance in the employee benefits area to help in-house attorneys identify potential risks, mitigate them, and know when to call an outside ERISA lawyer.
1. What Is Old Is New: Get Your Health Plan Governance in Order
Employers that sponsor self-funded health plans have a host of complicated obligations. There are greater potential legal, regulatory, and fiduciary risks than in years past with managing health plans because of increased congressional legislation, increased Department of Labor (DOL) focus on group health plan compliance, and increased group health plan litigation, often by the same plaintiffs’ firms that have been suing 401(k) plans in fee litigation the past 20 years or more.
Employers and health plans should be aware that two recent federal decisions have recognized that the non-discrimination provision in the Affordable Care Act prohibits discrimination on the basis of gender identity. Plans cannot categorically exclude coverage for procedures to treat gender dysphoria.
In Boyden v. Conlin, the U.S. District Court for the Western District of Wisconsin found that the state’s exclusion of gender reassignment-related procedures from the state employees’ health insurance coverage constitutes sex discrimination in violation of Section 1557 ...
This is part 4 of 7 in the Medicare Secondary Payer Compliance series. All titles in this series can be viewed below. Subscribe to our blog to receive these future updates. Prior installments of this series can be accessed using the links provided.
- Medicare Secondary Payer Compliance: An Introduction (Part I)
- Medicare Secondary Payer Compliance: Conditional Payments (Part II)
- Medicare Secondary Payer Compliance: Group Health Plans (Part III)
- Medicare Secondary Payer Compliance: Non-Group Health Plans (NGHPs) (Part IV)
- Medicare Secondary Payer Compliance: Providers (Part V)
This is part 3 of 7 in the Medicare Secondary Payer Compliance series. All titles in this series can be viewed below. Subscribe to our blog to receive these future updates. Prior installments of this series can be accessed using the links provided.
- Medicare Secondary Payer Compliance: An Introduction (Part I)
- Medicare Secondary Payer Compliance: Conditional Payments (Part II)
- Medicare Secondary Payer Compliance: Group Health Plans (Part III)
- Medicare Secondary Payer Compliance: Non-Group Health Plans (NGHPs) (Part IV)
- Medicare Secondary Payer Compliance: Providers (Part V)
All titles in this series can be viewed below. Subscribe to our blog to receive these future updates. Prior installments of this series can be accessed using the links provided.
- Medicare Secondary Payer Compliance: An Introduction (Part I)
- Medicare Secondary Payer Compliance: Conditional Payments (Part II)
- Medicare Secondary Payer Compliance: Group Health Plans (Part III)
- Medicare Secondary Payer Compliance: Non-Group Health Plans (NGHPs) (Part IV)
- Medicare Secondary Payer Compliance: Providers (Part V)
- Medicare Secondary Payer Compliance: The False Claims Act (FCA) for ...
Recent Updates
- Comment Period Closes on California OHCA’s Proposed Emergency Regulations Expanding Private Equity, Hedge Fund, and MSO Reporting in Health Care Transactions
- DOJ Revises Justice Manual on Non-Binding Guidance and Qui Tam Dismissals: Practical Considerations
- Additional SBA Crackdown on Pandemic-Era Fraud Leads to Program and Loan Suspensions, Possible FCA Enforcement
- Federal Regulatory Views on Cybersecurity and AI Amidst a Growing Threat Landscape
- Remote Monitoring Services Under the 2027 PFS Proposed Rule: Epstein Becker Green Submits Comments to CMS