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Benefits
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October 30, 2024
5th Circ. Keeps Most No Surprises Act Provisions Intact
The Fifth Circuit on Wednesday upheld several provisions for calculating qualifying payments under a federal law aimed at protecting Americans from surprise medical bills, saying in a published opinion that the provisions were neither inconsistent with the law nor arbitrary and capricious.
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October 30, 2024
Class Asks Court To Revive Claims Against Florida Blue
A proposed class of Florida state employees enrolled in a Blue Cross and Blue Shield of Florida healthcare plan asked an appeals court Wednesday to revive their suit claiming the insurer designed a claims process to obstruct approval and payment of claims for mental health care.
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October 30, 2024
Cigna Wants $16.1M, Florida Labs Seek $5.1M In Benefits Feud
Cigna should pay $5.1 million for harming three Florida laboratories by wrongfully declaring thousands of substance abuse treatment tests medically unnecessary, the labs told a Connecticut jury Wednesday, while Cigna asked to recoup $16.1 million in payouts to the labs for what it called "wasteful" tests.
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October 30, 2024
Ohio PBM Case Will Wait For High Court Ruling
The Sixth Circuit agreed to pause a case from Ohio state enforcers accusing Express Scripts and Prime Therapeutics of driving up prescription drug prices while the U.S. Supreme Court decides another case dealing with federal versus state jurisdiction.
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October 30, 2024
Southwest Seeks To Dismantle Military Leave Class
Southwest Airlines urged a California federal judge to disassemble a nearly 3,000-member class of workers who say the company violated federal law by failing to pay them for short stints of military leave, saying new evidence shows there are too many individualized issues to warrant class treatment.
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October 30, 2024
Texas Sues Another Doc For Violating Trans Care Ban
The state of Texas announced Wednesday it launched another lawsuit accusing a physician of violating a state law barring healthcare providers from offering gender transition services to minors.
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October 29, 2024
Beyond Abortion, 7 Ballot Questions Set To Shape Care
While reproductive rights have led the healthcare debate this election season, voters across the country will shape state policies on a number of other hot issues, including a Medicaid work requirement and coverage for IVF. Law360 Healthcare Authority looks at seven ballot measures that go beyond abortion.
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October 29, 2024
Argent Strikes Symbria ESOP Suit Settlement Deal
A class of Symbria Inc. workers alleging mismanagement of their employee stock ownership plan told an Illinois federal court they had reached a settlement with ESOP trustee Argent Trust Co. to end their federal benefits lawsuit.
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October 29, 2024
NYC Pet Leave Bill Marks 'Radical Departure' In Sick Time Use
Legislation proposed by two New York City Council members that would require letting workers use sick leave to care for pets and service animals is an unprecedented move and an acknowledgment of the rising importance employees place on mental health, experts say.
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October 29, 2024
2 Firms Tapped To Lead Five Below Investor Suit
Berger Montague PC and Bernstein Litowitz Berger & Grossmann LLP will represent a proposed class of investors in a suit alleging that teen-focused retail chain Five Below overstated its growth prospects, then saw trading prices crater when it announced that its sales expectations fell short.
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October 29, 2024
Senate Panel Targets 'Clever' Pharma Pricing
The Senate Judiciary Committee on Tuesday railed against drugmakers and pharmacy benefit managers for allegedly causing the high cost of prescription drugs, arguing that "Big Pharma" has used anticompetitive tactics through patenting to fleece American patients.
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October 29, 2024
Alibaba's $433.5M Investor Suit Deal Gets Initial OK
A New York federal judge granted preliminary approval to a $433.5 million deal settling a suit between Alibaba Group and investors alleging the company made misstatements about its exclusivity practices and the planned $34 billion initial public offering of a fintech affiliate.
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October 29, 2024
Military Reservist Not Exempt From Extra Pay, Justices Told
Military reservists are owed top-up pay if they're called to serve during a war or national emergency, regardless of whether they're directly serving in those events, a U.S. Coast Guard reservist told the U.S. Supreme Court.
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October 28, 2024
Surge In Nicotine Fee Suits Shows Wellness Program Risks
A recent crop of suits accusing large employers of violating nondiscrimination provisions in federal benefits law by making workers who use nicotine pay more for health insurance underscore the risk of using fees to offset healthcare costs, attorneys say. Here are five nicotine surcharge suits to keep an eye on.
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October 28, 2024
Yellow Corp. Says Failing Biz Excuses WARN Act Duty
Bankrupt trucking firm Yellow Corp. told a Delaware judge Monday that it should get early wins in suits brought by laid off employees, saying that because the company had ceased most business operations, it was excused from notification obligations surrounding the firing of thousands of workers.
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October 28, 2024
Labor Dept.'s Proposed ESOP Rule Moves Toward Release
The White House Office of Management and Budget is reviewing the U.S. Department of Labor's proposal for a rule related to how employee stock ownership valuations are conducted, the last step before the long-awaited proposed regulation is released to the public for comment.
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October 28, 2024
DOD Settles Bias Suit Over 'Don't Ask, Don't Tell' Discharges
The U.S. Department of Defense has reached a settlement in principle with a group of LGBTQ+ service members who sued the U.S. military in California federal court claiming veterans discharged under the former Don't Ask, Don't Tell policy, which banned non-heterosexual service members, continued to face discrimination.
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October 28, 2024
Pierson Ferdinand Hires Ex-Morris Manning L&E Atty
Pierson Ferdinand LLP announced Monday that a former Morris Manning & Martin LLP attorney whose practice spans litigation, human resources counseling and transactional work is the latest addition to its employment, labor and benefits practice.
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October 25, 2024
Alibaba Agrees To $433.5M Deal In Nearly 4-Year Investor Suit
Alibaba Group has agreed to shell out $433.5 million to resolve a proposed class of investors' allegations it made misstatements about its exclusivity practices and the planned $34 billion initial public offering of a fintech affiliate, the Chinese e-commerce company said in a U.S. Securities and Exchange Commission filing on Friday.
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October 25, 2024
Ex-Venture Global Exec Says Co. Lowballed, Then Fired Her
A former Venture Global executive has sued the U.S. natural gas company in Virginia federal court for allegedly breaching a decades-old stock option agreement, claiming the company's co-founders refused to let her exercise millions of dollars' worth of soon-to-expire options, then fired her for complaining.
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October 25, 2024
Premera Rejection Seems Sparse, 9th Circ. Judges Say
A Ninth Circuit judge pressed Premera Blue Cross on Friday to defend refusing coverage for a Washington teen's lengthy mental health residential treatment, questioning if the insurer engaged in a meaningful dialogue as required with the youth's family in letters explaining why the treatment was medically unnecessary.
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October 25, 2024
Judge Won't Rethink $750K For P&G Worker's Ex-Girlfriend
A Pennsylvania judge won't reconsider her decision to let the estranged ex-girlfriend of a deceased Procter & Gamble employee claim more than $754,000 he had in an investment account, ruling that the employee's estate hadn't cited any new evidence or changes in law to overcome the beneficiary form he'd left untouched since the late 1980s.
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October 25, 2024
Mass. Panel Flips Teacher's Tenure Denial Over Family Leave
Massachusetts' intermediate-level appeals court on Friday invalidated an arbitrator's denial of tenure to a teacher who took maternity leave during one of her first three years of teaching, ruling that the decision had wrongly penalized her for taking the protected time away from work.
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October 25, 2024
High Court Bar's Future: Mitchell Law's Jonathan F. Mitchell
The pantheon of U.S. solicitors general doesn't include many lawyers who've openly challenged the U.S. Supreme Court's authority or sought to undermine its landmark precedents. But there aren't many lawyers like Jonathan F. Mitchell, a crusading conservative who rescued former President Donald Trump's reelection run — and in the process positioned himself to become the government's top oral advocate.
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October 25, 2024
Ga. Woman Gets 12 Years For $30M COVID Fraud Scheme
A Georgia woman was sentenced to 12 years in prison Thursday for her role in filing more than 5,000 fraudulent COVID-19 unemployment insurance claims with the Georgia Department of Labor, which resulted in at least $30 million in stolen benefits.
Expert Analysis
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Opinion
DOL's Impending Mental Health Act Regs Should Be Simplified
The U.S. Department of Labor should consider revising these six issues in its forthcoming Mental Health Parity and Addiction Equity Act regulations to ease the significant compliance hurdles for group health plan sponsors, says Alden Bianchi at McDermott.
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Opinion
Texas Judges Ignored ERISA's Core To Stall Fiduciary Rule
Two recent rulings from Texas federal courts, which rely on a plainly wrong reading of the Employee Retirement Income Security Act to effectively strike a forthcoming rule that would impose functional fiduciary duties onto sellers of investment services, may expose financially unsophisticated 401(k) participants to peddlers of misleading advice, says Mark DeBofsky at DeBofsky Law.
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Mirror, Mirror On The Wall, Is My Counterclaim Bound To Fall?
A Pennsylvania federal court’s recent dismissal of the defendants’ counterclaims in Morgan v. Noss should remind attorneys to avoid the temptation to repackage a claim’s facts and law into a mirror-image counterclaim, as this approach will often result in a waste of time and resources, says Matthew Selmasska at Kaufman Dolowich.
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Series
Playing Dungeons & Dragons Makes Me A Better Lawyer
Playing Dungeons & Dragons – a tabletop role-playing game – helped pave the way for my legal career by providing me with foundational skills such as persuasion and team building, says Derrick Carman at Robins Kaplan.
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Del. Dispatch: Director Caremark Claims Need Extreme Facts
The Delaware Court of Chancery recently dismissed Caremark claims against the directors of Centene in Bricklayers Pension Fund of Western Pennsylvania v. Brinkley, indicating a high bar for a finding of the required element of bad faith for Caremark liability, and stressing the need to resist hindsight bias, say attorneys at Fried Frank.
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Parsing NJ Court's Rationale For Denying Lipitor Class Cert.
A New Jersey federal court's recent Lipitor rulings granting summary judgment and denying motions for class certification for two plaintiff classes offer insight into the level of rigorous analysis required by both parties and their experts to satisfy the requirements of class certification, says Catia Twal at Edgeworth Economics.
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Series
After Chevron: Challenges Loom For PBGC Actions
After Loper Bright, two recent actions taken by the Pension Benefit Guaranty Corp. already under scrutiny seem destined to be challenged and resolved under the new standard of judicial deference, which will greatly affect employers with potential withdrawal liability exposure, say Robert Perry and David Pixley at Jackson Lewis.
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3 Leadership Practices For A More Supportive Firm Culture
Traditional leadership styles frequently amplify the inherent pressures of legal work, but a few simple, time-neutral strategies can strengthen the skills and confidence of employees and foster a more collaborative culture, while supporting individual growth and contribution to organizational goals, says Benjamin Grimes at BKG Leadership.
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E-Discovery Quarterly: Rulings On Hyperlinked Documents
Recent rulings show that counsel should engage in early discussions with clients regarding the potential of hyperlinked documents in electronically stored information, which will allow for more deliberate negotiation of any agreements regarding the scope of discovery, say attorneys at Sidley.
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Loper Bright Limits Federal Agencies' Ability To Alter Course
The U.S. Supreme Court's recent decision to dismantle Chevron deference also effectively overrules its 2005 decision in National Cable & Telecommunications Association v. Brand X, greatly diminishing agencies' ability to change regulatory course from one administration to the next, says Steven Gordon at Holland & Knight.
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Series
Teaching Scuba Diving Makes Me A Better Lawyer
As a master scuba instructor, I’ve learned how to prepare for the unexpected, overcome fears and practice patience, and each of these skills – among the many others I’ve developed – has profoundly enhanced my work as a lawyer, says Ron Raether at Troutman Pepper.
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A Guide To Long-Term, Part-Time Employee Determinations
With final regulations under the Secure Act requiring 401(k) retirement benefits for long-term, part-time employees expected soon, Amy Sheridan and David Guadagnoli at Sullivan & Worcester look at how the proposed rules would shift the risk-reward calculus on excluding categories of employees, and what plan sponsors would need to consider when designing retirement plans.
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Lawyers Can Take Action To Honor The Voting Rights Act
As the Voting Rights Act reaches its 59th anniversary Tuesday, it must urgently be reinforced against recent efforts to dismantle voter protections, and lawyers can pitch in immediately by volunteering and taking on pro bono work to directly help safeguard the right to vote, says Anna Chu at We The Action.
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Series
After Chevron: ERISA Challenges To Watch
The end of Chevron deference makes the outcome of Employee Retirement Income Security Act regulatory challenges more uncertain as courts become final arbiters of pending lawsuits about ESG investments, the definition of a fiduciary, unallocated pension forfeitures and discrimination in healthcare plans, says Evelyn Haralampu at Burns & Levinson.
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Justices' Intent Witness Ruling May Be Useful For Defense Bar
At first glance, the U.S. Supreme Court’s recent Diaz v. U.S. decision, allowing experts to testify to the mental state of criminal defendants in federal court, gives prosecutors a new tool, but creative white collar defense counsel may be able to use the same tool to their own advantage, say Jack Sharman and Rachel Bragg at Lightfoot Franklin.