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Articles by Marlee Waxelbaum
Tenth Circuit Develops New ERISA Rule in Ellis v. Liberty Assurance Company of Boston
The Tenth Circuit developed a new rule under the Employee Retirement Income Security Act of 1974 (ERISA) in Ellis v. Liberty Assurance Company of Boston (case number 19-1074), holding last week that courts should adhere to choice-of-law provisions in ERISA health benefits plans.
6th Circ. Ruling Jeopardizes ERISA Exhaustion Defense - Law360
Law360 (April 16, 2020, 4:53 PM EDT) -- In a potentially impactful decision for Employee Retirement Income Security Act precedent, the U.S. Court of Appeals for the Sixth Circuit in Wallace v. Oakwood Healthcare Inc.[1] held that for a plan fiduciary to avail itself of the exhaustion of administrative remedies doctrine, its plan documents must, at minimum, detail the required internal appeal procedures.
FCC Says “Think Twice” Before Assuming COVID-19 Calls Qualify Under the Emergency Purpose Exception to the TCPA
On March 20, 2020 the FCC issued a Declaratory Ruling specifically outlining how calls and messages will be treated under the Telephone Consumer Protection Act (“TCPA”) with regard to the novel coronavirus (“COVID-19”). In its sua sponte Declaratory Ruling, The FCC exempted certain calls related to the COVID-19 pandemic from TCPA requirements – but only calls made by certain callers regarding certain topics.
Calling Consumers During COVID-19: Call Me Maybe? UPDATE: FCC Says Maybe Not
In light of the coronavirus (“COVID-19”) and its impact on business operations, it is important to be aware that Telephone Consumer Protection Act restrictions on calling or texting consumers for a commercial purpose still apply. These national restrictions include rules governing consent to contact cellular telephones and rules regarding revocation of consent. Moreover, certain state public health emergency declarations also place additional restrictions on texting or calling consumers.
New York’s Extended Protections Against Surprise Medical Bills Set Stage for National Regulation
Furthering his state’s historic consumer protections against surprise medical bills, New York Governor Andrew Cuomo signed into law this past October the Patient Protection Act, adding additional protections for emergency room visits. New York was already a bellwether in the field, passing the historic Surprise Medical Bill Act in 2014 to prevent unexpected medical bills from emergency room visits.
Troutman Sanders Attorneys Publish Law360 Piece on Pretrial Defenses For Payors Facing Quasi-Contract Claims
Here’s the problem: In the managed care litigation space, noncontracted medical providers are suing payors as part of their business-collections strategy, utilizing quasi-contract theories of recovery in their attempt to justify ever growing bills. In the traditional contracted-provider/ payor relationship, the network agreement, of course, governs rates of reimbursement.
Pretrial Defenses For Payors Facing Quasi-Contract Claims - Law360
Law360 (November 15, 2019, 5:58 PM EST) -- Here’s the problem: In the managed care litigation space, noncontracted medical providers are suing payors as part of their business-collections strategy, utilizing quasi-contract theories of recovery in their attempt to justify ever growing bills. In the traditional contracted-provider/payor relationship, the network agreement, of course, governs rates of reimbursement.
Strategies To Defeat Quasi-Contract Claims At The Outset
Law360 (November 15, 2019, 5:15 PM EST) -- Here’s the problem: In the managed care litigation space, noncontracted medical providers are suing payors as part of their business collections strategy, utilizing quasi-contract theories of recovery in their attempt to justify ever growing bills. In the traditional contracted-provider/payor relationship, the network agreement, of course, governs rates of reimbursement.
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