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Expert Analysis

• What ACA Preventive Care Ruling Means For Employers

  

  Though a Texas federal court's recent ruling in Braidwood v. Becerra paves the way for employers to reimpose cost-sharing requirements on preventive care, companies considering making these changes to their group health and welfare plans should first analyze the financial and social impacts, says Rachel Shim at Holland & Knight.

• Seeking IRS Accountability For Faulty Microcaptive Notice

  

  Like the taxpayers in Standard Insurances v. U.S. seeking to expand earlier wins in microcaptive insurance cases that limit IRS use of improperly obtained information, others should consider ways to hold the agency accountable and provide incentive for it to follow the law going forward, says Joshua Smeltzer at Gray Reed.

• AmEx Ruling Proves A Double-Edged Sword In Labor Antitrust

  

  Though the U.S. Supreme Court's 2018 decision in Ohio v. American Express was a defense victory, both the plaintiff and defense bars have learned to use the case's holdings to their advantage, with particularly uncertain implications for labor antitrust cases, say Lauren Weinstein and Robert Chen at MoloLamken.

• Ch. 11 Ruling Stresses 5th Circ. Courts' Asset Sale Deference

  

  A Texas federal court recently rejected a challenge to Fieldwood Energy’s Chapter 11 plan by several surety bond companies, serving as a reminder that courts within the Fifth Circuit give deference to the finality of asset sales where a stay of the applicable order has not been obtained, say Jonathan Lozano and Mark Dendinger at Bracewell.

• The Important Role Of Contra Proferentem In ERISA Cases

  

  A Pennsylvania federal court's recent decision in Stein v. Paul Revere Life Insurance illustrates what happens when ERISA plan terms are unclear, and why the contra proferentem principle should be applied uniformly in all ERISA cases, says Mark DeBofsky at DeBofsky Law.

• No Surprises Act Gives Plan Sponsors Savings Opportunities

  

  Under the No Surprises Act, the potential savings for an ERISA group health plan and its participants are significant, and sponsors should focus on the negotiation of third-party administrator service agreements to avoid exposure to breach of fiduciary claims for payment of excessive fees, say attorneys at Hall Benefits.

• HHS Advisory Opinion Serves As Free Drug Program Guide

  

  A careful review of the U.S. Department of Health and Human Services' recent advisory opinion and track record on free drug programs provides a rubric for manufacturers to ensure that similar programs are viewed favorably under the Anti-Kickback Statute, say Dominick DiSabatino and Cortney Inman at Sheppard Mullin.

• ACA Anti-Discrimination Rules May Apply To 3rd-Party Admin

  

  A Washington federal court's recent ruling in C.P. v. Blue Cross Blue Shield, where a third-party administrator applied plan rules that excluded gender-affirming care, potentially expands the scope of covered entities under the Affordable Care Act's anti-discrimination rule, say Kara Backus and Allison Jacobsen at Lane Powell.

• Courts Should Follow 8th Circ. On ERISA Procedure Rules

  

  Other courts should take note of the Eighth Circuit's refusal to view Yates v. Symetra Life Insurance as an administrative law claim and join the growing effort to restore regular civil procedure to Employee Retirement Income Security Act cases, says Mark DeBofsky at DeBofsky Law.

• High Court Ax Of Atty-Client Privilege Case Deepens Split

  

  The U.S. Supreme Court's recent dismissal of In re: Grand Jury as improvidently granted maintains a three-way circuit split on the application of attorney-client privilege to multipurpose communications, although the justices have at least shown a desire to address it, say Trey Bourn and Thomas DiStanislao at Butler Snow.

• Biden Admin.'s Anti-Merger Stance Is Leading To Bad Policies

  

  A U.S. Department of Justice Antitrust Division speech reflects the Biden administration's goal to move enforcement in a markedly anti-merger direction, an approach that is leading to bad policies and enforcement decisions, says Cleary attorney David Gelfand, a former DOJ Antitrust Division official.

• 9th Circ. Should Rethink Inadequate UBH Ruling

  

  The Ninth Circuit should seriously consider rehearing Wit v. United Behavioral Health en banc because its recent claims reprocessing decision in the case raises troubling questions about the future of Employee Retirement Income Security Act's class actions, says Mark DeBofsky at DeBofsky Law.

• Hertz Ruling Could Help Debtors Avoid Make-Whole Premiums

  

  A Delaware bankruptcy court’s recent ruling in Hertz, disallowing claims for make-whole premiums and post-petition interest at the contract rate, could be relied upon by debtors to sidestep those provisions, and potentially provide higher recoveries for equity holders, say Theresa Foudy and Alexander Severance at MoFo.