The Departments of Health and Human Services, Labor, and the Treasury, as well as the Office of Personnel Management (Departments) recently finalized the Independent Dispute Resolution (IDR) Operations rule under the No Surprises Act (NSA). Although many self-funded group health plan fiduciaries won’t have to deal directly with the operational changes to the federal IDR
Imagine you’re a plan administrator who receives an angry letter from an out-of-network provider. The letter explains that before treating a plan participant, the provider called to confirm the participant’s eligibility for out-of-network coverage and to authorize treatments at certain rates under the plan. Now that treatment has been rendered, the provider is demanding payment
In a prior post, we commented on the growing trend of fiduciaries making non-monetary concessions to settle ERISA fee litigation cases. We observed that certain “onerus” non-monetary settlement features – such as obligating fiduciaries to provide plaintiffs’ counsel with customized reports on plan operations and performance during a years-long “monitoring” period — are significant
Court filings made this week show that Johns Hopkins has settled its ERISA fee case on proposed terms that include making a $14.5 million settlement payment, the second highest settlement in a 403(b) fee case, behind Vanderbilt ($14.5 million), and ahead of Duke ($10.65 million), U. Chicago ($6.5 million) and Brown ($3.5 million). The most
The University of Pennsylvania suffered a setback in the first ERISA fee case against a university to be decided by a U.S. Court of Appeals. In Sweda v. the University of Pennsylvania, a divided panel of the Third Circuit ruled 2-1 that the district court had erred in granting the university’s motion to dismiss.