Medical Benefits Law
-
New Changes Made to HIPAA Privacy and Security Rules
Health and Human Services has issued final regulations that address recent legislative changes to the HIPAA privacy and date security rules. Compliance by employers will be required by Sept. 23, according to a press release.
-
Worker's Inability to Speak English Appropriately Considered in Disability Ruling: Court
The case of Merivic Inc. and Zurich North America v. Enrique Gutierrez involved a workers' comp claimant who had a ninth-grade education and a 'limited working knowledge' of English despite having lived in the United States for 34 years, according to the opinion.
-
Supreme Court to Hear Title VII, Class-Action Cases in 2012-13 Term
As Littler Mendelson's Garry Mathiason says, 'There are always some surprises from the Supreme Court.'
-
Medicare Heats Up Biden-Ryan Debate
The Medicare segment of the debate included some of the most frequent interruptions by both Vice President Joe Biden and Republican vice presidential candidate Rep. Paul Ryan (R-Wisconsin) in a testy debate as each took turns bashing the other side's impacts on the program.
-
Contraceptive Coverage Legal Battle Looms for Missouri
Missouri lawmakers on Sept. 12 overrode Gov. Jay Nixon's veto of legislation that would allow employers and insurers to deny contraceptive coverage, setting the stage for yet another legal battle over contraceptive coverage.
-
Michigan Teacher Funding of Retiree Health Benefits Violates Employment Rights: Court
The law ran afoul of protections against impairment of government contracts because teachers received three percent less in pay by paying into a fund than the amount the teachers and their employers agreed upon as part of teachers' contracts.
-
Mid-Market Companies Face Health Benefits Enrollment Challenges
One challenge for middle-market companies is the U.S. Department of Labor has yet to finalize the regulations implementing the mandate in Section 1511 of the Patient Protection and Affordable Care Act.
-
Former Wells Fargo Employee Says Company Fired Him Over Daughter's Cancer Costs
According to a lawsuit filed Aug.
-
Paul Ryan a Longtime Supporter of Health Savings Accounts
In 2006, Rep. Ryan, along with Rep. Eric Cantor, R-Virginia, now the House Majority Leader, introduced legislation that boosted the appeal of health savings accounts.
-
Willis Makes Additions to Health Care Reform Impact Analysis Calculator
The proprietary tool allows companies to examine health plan possibilities within the Patient Protection and Affordable Care Act of 2010.
-
Retailers and Hospitality Industry Employers Face Big Health Care Reform Law Related Cost Increases in 2014
Forty-six percent of employers in the retail and hospitality industries and 40 percent of employers in the health care services industry expect health care cost increases of at least 3 percent due to health care reform law requirements.
-
Supreme Court Medicaid Ruling to Leave 36 Million Uninsured in 2016: CBO
A smaller reduction in the number of uninsured could negatively affect employers as the amount of uncompensated care—a cost that health care providers now try to shift in the form of higher charges to patients with health insurance—will not decline as much as providers had initially...
-
Kentucky Establishes Health Benefit Exchange
Kentucky Gov. Steve Beshear has issued an executive order to establish the Kentucky Health Benefit Exchange as required by the federal Patient Protection and Affordable Care Act, the governor's office announced July 17.
-
House of Representatives Votes to Repeal Health Care Reform Law
With Democrats controlling the Senate, the bill is unlikely to advance further. In addition, if a repeal measure cleared Congress, President Barack Obama would veto it, the White House said this week.
-
House to Vote on Bill to Repeal Health Care Reform Law
The Senate did not take up the repeal bill and it is unlikely that the Senate, where Democrats are in the majority, would do so this time.
-
HR Leaders Scrambling After Supreme Court's Health Care Reform Ruling
From the individual mandate provision to 'pay or play' rule, companies find it's time to deal with the bottom line.
-
Officer Hit By Car While Walking to Get Coffee Due Workers' Comp
An Oregon appellate court said that Carolyn McDermed was still at work during her coffee run, since she was expected to perform community policing duties while not in her office.
-
Study: Obesity Affects Duration of Workers' Compensation Benefits
The study's findings on the effect of obesity on indemnity duration are close to those reported in a 2007 Duke University Medical School study that found that obese workers file more claims, have higher medical costs, and miss more days due to job-related injuries than do their nonobese...
-
PTSD of Employee Who Witnessed Deaths at Work Is Compensable
The man was diagnosed with post-traumatic stress disorder in June 2008 after experiencing anxiety and crying spells on various occasions, and he filed for workers' comp benefits in June 2009.
-
Q&A With Jay Krueger: Evaluating Medical Marijuana Policies
Jay Krueger is chief strategy and client services officer at PMSI Inc., providing overall strategic direction for the Tampa, Florida-based provider of pharmacy benefit management services, medical equipment, home health care and case settlement services.
-
Massive Master Complaint Filed Against NFL Over Concussion-Related Injuries
The 86-page document, filed in U.S. District Court in Philadelphia, seeks financial compensation, injunctive relief and medical monitoring for former NFL players who claim the league misled them about the dangers of concussions.
-
Benefit Execs Say Supreme Court Will Strike Down Individual Mandate
Some 66 percent of the respondents' predictions about the fate of the mandate reflect what they heard the justices say during oral arguments, says one expert.
-
House Panel OKs Bill to Ease FSA ‘Use-It-or-Lose-It' Rule
The bill approved by the House panel would eliminate over-the-counter restrictions in the health care reform law.
-
Employee's Off-Duty Car-Crash Injuries Compensable: Court
The Kentucky Supreme Court said Adan Mandujano's car accident was compensable because he was performing the 'necessary and inevitable' act of returning from a trip that Gaines-Gentry and Eaton had requested him to take.
-
Medical Marijuana Use Not Protected by ADA: Appeals Court
The lawsuit was brought by severely disabled plaintiffs who said conventional medications had not alleviated the pain caused by their impairments
-
Pregnancy Discrimination Act Violated When School Fires Teacher for Premarital Pregnancy
According to the May 16 ruling in Jarretta P. Hamilton vs. Southland Christian School Inc., Hamilton, who began teaching at the St. Cloud, Florida-based school in January 2008, conceived a child with her then-fiancé in January 2009. The couple got married the next month.
-
Health Care Reform Law Ruling Likely Complicated: WorldatWork Executive
If the high court were to strike down the individual mandate that requires most U.S.
-
Washington Redskins' Workers' Comp Cases Head to Maryland Court
The Redskins practice at the team's Virginia headquarters, but play home games at FedExField in Landover, Maryland.
-
Woman Injured Having Sex During Work Trip Can Collect Workers' Comp
Her workers' comp claim for facial and psychological injuries initially was rejected, the reports state. But her attorney argued that sex is an ordinary life activity, similar to showering in a motel room.
-
Injured Worker's Depression not Compensable Because She did not Return to Work
A doctor found that Delores Roxbury's depression was caused directly by her 2004 work accident, and prevented her from returning to her former position. However, an independent medical expert contended that Roxbury suffered from mild depression, and was not totally disabled by her mental condition.
-
Supreme Court Divided if Health Care Law Can Survive Without Mandate
At issue in the final day of oral arguments on health care reform was whether the individual mandate, which requires most U.S.
-
Health Care Reform on Trial: Read the Supreme Court Oral Arguments
In addition to our web news and analysis coverage, we've posted transcripts of the arguments from all three days.
-
White House Suggestions on Funding Contraception Coverage Called 'Unworkable'
Under one administration suggestion, TPAs could fund the coverage through rebates they receive from drug manufacturers that the TPA is not contractually liable to forward to the affiliates.
-
Health Exchanges Must Notify Employers About Employees Eligible for Subsidies: HHS
Among other things, exchanges will have to provide a notice to employers that identifies by name the employees who have applied for and have been determined by exchange administrators as eligible for premium subsidies.
-
Consumerism Coming to Companies' Health Care Plans
Large employers at the annual National Business Group on Health conference held last week grappled with uncertainty around health care, but one thing was clear: Employees will be asked to do more to keep costs down by staying healthy and becoming savvier consumers.
-
Lines Drawn as Individual Mandate Heads to High Court
The Supreme Court is expected to rule by June on whether the individual mandate is constitutional. And if not, can it be severed from the rest of the Patient Protection and Affordable Care Act?
-
Despite Potential Prohibition, Matter of ‘Mini-Med' Insurance Plans Persists Via Waivers
The plans are attractive because they typically have low premiums—sometimes just $10 per month. But coverage limits can be as low as $1,000 annually, and some plans pay for just four doctor's visits per year.
-
Massachusetts' Medical Menu
The Massachusetts Division of Health Care Finance & Policy published cost figures of procedues last year, part of a blitzkrieg of data that officials have released as they strive to better understand what's driving the state's high health costs.
-
Mass Overhaul
With national health care reform looming, Workforce Management examines Massachusetts' reforms, which went into effect in 2006.
-
Bye, Bye 'Dr. Beloved'?
More consumers in limited networks seem to be comfortable leaving a favorite doctor or hospital.
-
Oklahoma Bills Would Allow Employers to Opt Out of State Workers' Comp System
If approved, Oklahoma would become the second state to adopt an alternative workers comp system. Texas has operated a similar opt-out system since 1913.
-
Back Injuries Account for 26 Percent of Workers' Comp Payments in California
Back injuries reportedly comprised 26.3 percent of workers' comp payments in California between 2001 and 2011—the highest percentage of any injury type.
-
EEOC Approves Strategic Plan Through 2016
The agency 'is taking a significant step toward realizing the commission's vision of ending employment discrimination and promoting equal opportunity' in the workplace, EEOC Chair Jacqueline A. Berrien said in the statement.
-
Staffing a Chief Worry for Health Care IT
A Healthcare Information and Management Systems Society survey found that almost 90 percent of respondents plan to complete their conversion to the new federally mandated ICD-10 medical codes used to report medical diagnoses and inpatient procedures by the Oct. 31, 2013, deadline.
-
Employer Guidance Urged for Pregnancy Discrimination Act
Testimony during the hearing showcased an employer's confusion over some of the act's rules.
-
Lactation Discrimination Is not Sex Discrimination: Judge
The Pregnancy Discrimination Act of 1978 amends Title VII of the Civil Rights Act of 1964 to say discrimination on the basis of pregnancy, childbirth or related medical conditions constitutes unlawful sex discrimination under Title VII, according to the EEOC.
-
Aetna Accuses New York Doctors of Overcharging Patients
The insurance company's lawsuit takes aim at the practice called 'balance billing,' which wallops some customers with fees big enough to buy a house.
-
NFL Concussion Lawsuits May Turn on Workers' Comp Rules
The pro football league is named as a defendant in 21 suits that allege the league negligently misled at least several hundred players about the dangers of concussions and other head injuries.
-
Amendments to FMLA's Military Leave Provisions Proposed
The Labor Department said the proposal released Jan. 30 implements amendments to the military leave provisions of the FMLA made by the National Defense Authorization Act of 2010.
-
Employer Must Pay Workers' Compensation for Concurrent Job: Court
William Thomas worked as a light equipment operator for the Warren County Department of Public Works when he was injured in 2009. Court records show that Thomas also was employed by a janitorial service at that time.
-
Massachusetts Residents Lacking Health Insurance to Face Higher Penalty
Massachusetts residents who do not have health insurance will face a higher financial penalty in 2012 under newly finalized rules.
-
Pregnant Worker Protected by FMLA Despite Timing of Leave Request: Court
Although the woman had previously been considered a 'top employee,' after learning of her pregnancy 'Brookdale began harassing her, causing stress and other complications in her pregnancy.'
-
Top 5 Workplace Injury Causes Make Up 72 Percent of Direct Workers' Comp Costs: Analysis
Overexertion—or injuries caused by lifting, pushing, pulling, holding and carrying—costs businesses $12.5 billon in direct annual expenses and accounts for more than 25 percent of the national burden, according to Liberty Mutual's Workplace Safety Index.
-
Court: Comp Benefits Due to Restaurant Manager Despite Being Smoker
Edmondo Bemis—who smoked for 30 years according to the appellate court's ruling—eventually filed for workers' comp benefits, claiming that his work injury worsened until he needed the surgery and that he was totally disabled.
-
Law Barring Legal Immigrants from Massachusetts Health Care Program Unconstitutional
The U.S. Census Bureau reported in September that at 5 percent—averaged over 2009 and 2010—Massachusetts had the lowest uninsured rate of any U.S. state.
-
Study Notes Medical Malpractice Insurance Market to Evolve with Health Care Changes
Changes in health care delivery will drive changes in the marketplace, including an ongoing shift from physicians practicing alone or in small groups toward practicing in multispecialty and multistate physician networks, or physicians working in practices purchased and operated by hospitals and...
-
Recreational Boatmakers Excluded From Workers' Comp Act
Under new federal regulations, laborers who build, repair or dismantle any recreational water vessel will no longer be covered by the Longshore Act, so long as they are covered under a state's workers comp law.
-
IRS Issues Guidance on Reporting Health Cover Costs on Employees' W-2s
The latest information makes clear that employers can—but are not required to—report contributions to health reimbursement arrangements in calculating health care costs.
-
Women Less Likely to Receive Employer Health Coverage as Employees: Analysis
Last year, 35 percent of women age 18 through 64 had coverage through their employer, down from 38 percent in 2008, the Kaiser Family Foundation analysis released Dec. 19 found.
-
Supreme Court Sets Oral Arguments on Health Care Reform Law
On March 26, the justices will hear arguments on whether a challenge to the law's individual mandate that requires individuals to enroll in a qualified plan or pay a financial penalty can be imposed before the provision's January 2014 effective date.
-
Designer Can Sue Firm for Tapping Social Media Accounts While She was Injured
The woman alleges the accounts were accessed while she was recovering from a brain injury she sustained after being hit by a car while running an errand for work.
-
Employment-Based Coverage Fell Sharply During Great Recession: Analysis
The drop in employment-based coverage is directly linked to the slump in the economy, according to the analysis, which is based on U.S. Census Bureau data.
-
EEOC Sues Wal-Mart for Disability Discrimination
Despite a 10-year-old settlement involving disability discrimination with the federal Equal Employment Opportunity Commission, the agency has filed another lawsuit charging Wal-Mart Stores Inc.
-
HHS: Health Care Reform Law Adds Coverage for 2.5M Young Adults
An earlier National Center for Health Statistics study found that about 1 million young adults gained coverage in the first quarter this year.
-
Supreme Court Sets Briefing Schedule for Health Care Reform Law Litigation
Among other things, the high court will hear whether the law's individual mandate is constitutional. That mandate, effective in January 2014, requires individuals to enroll in a qualified health care plan or pay a financial penalty.
-
Employer Health Care Reform Law Communication Mandate Delayed
The proposed rules would require employers to provide employees with an 'easy-to-understand' summary of benefits and coverage and, upon request, a glossary of commonly used health care coverage terms, such as deductible and copay.
-
Supreme Court to Review Health Care Reform Law
Observers have said that decisions for cases argued in the court's spring term would likely by published by June, which could thrust the case into the national run-up to the November 2012 presidential election.
-
Half of Working Women Who Gave Birth did not Receive Paid Maternity Leave: Census
Two-thirds of women who were given maternity leave were able to return to work within a year of their first pregnancy, according to the U.S. Census Bureau in Washington.
-
Court: Workers' Comp Is Exclusive Fix for Construction Injury
Charles DeFrates sought to sue Robert Clark, sole owner of R.G. Clark Construction Inc. in Calpella, California, for personal injury after he slipped and fell while working on the roof of Clark's new duplex, court records show.
-
Court Rules Video Can Be Used as Evidence to Discontinue Disability Benefits
In a unanimous decision, the Pennsylvania Commonwealth Court said Brian Soja was required to prove that he had a continuing disability when he filed for a reinstatement of his benefits in 2006. It also said a video from employer Hillis-Carnes Engineering Associates Inc.
-
Wellness Programs Adapted for Workers' Comp
One consultant adds that employers also should optimize employee use of established wellness offerings, such as weight-loss or smoking-cessation programs that otherwise may be underutilized.
-
Appeals Court Allows FMLA Suit Against American Medical Association
According to the decision, because of the economic downturn, the AMA decided to eliminate the position of Peter Friedman, the communications campaign manager, because his responsibilities had drastically changed.
-
Employers Challenge Lump-Sum Payments in Certain Comp Disability Situations
The case the New York court heard includes four workers who were injured before a March 2007 deadline that allowed them to receive unlimited benefit weeks.
-
Poll Says Overweight Workers Miss Millions More Days of Work
Their missed work results in about $153 billion in lost productivity annually, according to data collected this year by Washington-based Gallup.
-
Health Reform May Outweigh Supreme Court's Light Employment Law Docket
The high court, which went back to work Oct. 3, has so far received petitions to review four separate health reform cases, and the Justice Department is expected to ask the court to overturn an August decision in which the 11th Circuit Court of Appeals struck down the law's individual mandate.
-
Bill Requiring Coverage for Autism Treatment Becomes Law in California
If the autism coverage mandate laid down by the California measure is not included in what federal regulators decide is essential benefits, the mandate automatically will expire.
-
Insurers Contend Medical Marijuana Should not get Workers’ Comp Funding
Last week, legislation that would prohibit auto insurers from funding claims for medical marijuana was passed by Michigan’s Senate Judiciary Committee and is expected to go before the full state Senate, an Insurance Institute of Michigan spokeswoman said.
-
Court: Prior-Approval Rule Does not Require Payment for Claims Unrelated to Workers' Comp
Georgia's State Board of Workers' Compensation says insurers and self-insurers must notify medical providers of whether they will pay for a procedure within five days of receiving a pre-approval request. If the deadline is missed, payment is considered to be approved automatically by the insurer.
-
Senate Backs Higher Tax Credit for Certain Health Insurance Premiums
The tax credit can be used to offset the cost of a variety of health insurance plans, including COBRA continuation coverage and individual plans offered by commercial insurers. Nearly 60 percent of beneficiaries use the credit to pay COBRA premiums.
-
Prescription Drugs Make Up 19 Percent of Workers’ Comp Claims: Report
That amount, however, is only “slightly higher” than its 2010 estimate, a workers’ compensation rating and research organization said in the report, Workers’ Compensation Prescription Drug Study: 2011 Update.
-
Health Plan Administrator Seeks to Exempt HRAs from Health Reform Law Research Fees
That fee—to be used to fund research on medical outcomes as part of the federal health care reform law—will be $1 per plan participant for the first plan year ending after Sept. 30, 2012, and $2 per participant in succeeding years.
-
The Courts Weigh In
As of mid-August, of the more than 12 lawsuits brought against the Patient Protection and Affordable Care Act four are of any significance, legal experts say.
-
HSA Changes Add More to Consider When Picking Plans
Two elements of federal health care reform legislation passed last year that could affect HSAs’ growth. Over-the-counter medications had been HSA-eligible, but now only those prescribed by a physician will be allowed.
-
Ruling in Bipolar-Threat Case Brings Mixed Legal Opinions
Lawyers for employers say a court decision that upheld the termination of a bipolar employee balances the legal obligation of employers to accommodate a worker’s disability with their responsibility to provide a safe workplace.
-
Appeals Court Strikes Down Individual Mandate in Reform Law
Although the ruling technically only strikes out the individual mandate, legal observers have said that it’s not clear whether the law is workable from a practical perspective without the provision.
-
Drugs Increase Employer Pain
As the over-prescription of narcotic pain relievers to injured workers grows to near epidemic proportions, applying medical guidelines would help eliminate unnecessary consumption and the problems it drives, the occupational medical experts say.
-
Court Says Injured Wal-Mart Worker Can Pursue Retaliation Claim
After the fall, Cox returned to work in May 2007 and Wal-Mart afforded her several accommodations, court records state. But she alleges that Wal-Mart disciplined and fired her after she invoked her rights under Oregon’s workers’ compensation law.
-
How to Spot, Stop and Prevent On-the-Job Drug Abuse
Unlike pre-hire testing, random testing is performed on an unannounced, unpredictable basis on existing employees. As such, it is a powerful long-term deterrent for curbing on-the-job substance abuse, since it poses a much higher threat of detection than pre-hire testing.
-
Genetic Shake-Up
You must make the Genetic Information Nondiscrimination Act part of your company's DNA.
-
The Skinny: Genes Pocket Data on Bad Drugs, Best Sex
Here’s the fun and exciting side of genetic information. It’s not all federal rules and regulations—although the Food and Drug Administration is expected to jump in soon and start regulating the burgeoning new genomics industry.
-
Complying With GINA
Follow these tips to stay in compliance with the Genetic Information Nondiscrimination Act.
-
New Health Care Reform Law Regulations Ease Previous Rules
One change involves the amount of time health care plan enrollees have to be notified of an urgent-care coverage decision. Last year, regulators said enrollees would have to be notified of an urgent care decision within 24 hours of receipt of a claim.
-
New EEOC Guidelines Shift Legal Rules for Disability Discrimination
The new regulations on implementing the ADAAA include several changes that HR professionals should keep in mind when dealing with disability issues.
-
Urgent Care Coverage Notification Requirement to Stay at 72 Hours
Federal regulators in 2010 said enrollees would have to be notified of an urgent care coverage decision within 24 hours of receipt of a claim.
-
EEOC Issues Final Regulations for ADA Amendments Act
Employers need to understand and abide by these major changes set forth in the EEOC’s final regulations.
-
Off-the-Job Medical Marijuana Use Does Not Bar Firing
A trial court and a state appellate court found that Medical Use of Marijuana Act provides a defense only against criminal prosecution and does not address civil actions.
-
Survey Says 30 Percent of Employers May Drop Health Care Coverage After 2014
Employers that drop coverage would pay an annual penalty of $2,000 for each full-time employee, a fraction of the typical cost of group plans
-
EEOC Proposes Records Rule on Genetic Information Nondiscrimination Act
The 2008 law prohibits employment discrimination based on genetic information. The EEOC said that employers already have this record-keeping requirement with respect to Title VII of the Civil Rights Act of 1964 and the Americans with Disabilities Act.
-
OSHA Wins Workers Compensation Case Fight
Insurer is ordered to release reports after fatal accident.
-
Hiring Ban After Failed Drug Test and the ADA
A rule that bars hiring or rehiring employees who have tested positive for drugs, even if it affects an employee who may otherwise be protected under the ADA or similar state statutes, does not violate those acts.
