Passion for Subro

Health Plan TPA Breached its ERISA Fiduciary Duties by Overpaying Medical Claims

Adam V. Russo — Tue, 09 Mar 2010 13:35:47 +0000

Haynes and Boone’s Newsroom – E-Benefits Newsletter, March 2, 2010 A U.S. District Court held that a health plan’s third-party administrator breached its fiduciary duties under ERISA by failing to exercise due care and by failing to administer the plan in accordance with plan documents when it overpaid medical claims. Notwithstanding the fact that the TPA [...]

Unchecked Provider Clout In California Foreshadows Challenges To Health Reform

Adam V. Russo — Tue, 09 Mar 2010 13:33:48 +0000

Robert A. Berenson, Paul B. Ginsburg and Nicole Kemper3 Faced with declining payment rates, California providers have implemented various strategies that have strengthened their leverage in negotiating prices with private health plans. When negotiating together, hospitals and physicians enhance their already significant bargaining clout. California’s experience is a cautionary tale for national health reform: It suggests [...]

WellPoint, UnitedHealth To Obama: We Are Innocent Victims

Adam V. Russo — Fri, 05 Mar 2010 21:36:08 +0000

David Whelan The White House continues to demonize the insurance industry for big rate increases as it pushes for health reform. It called the CEOs of five big HMOs on the carpet today in a White House meeting with Health Secretary Kathleen Sebelius. Afterwards, two of the participants–UnitedHealth chief Stephen Hemsley and WellPoint honcho Angela Braly–held [...]

SIIA Legislative Update – Healthcare Reform, March 3, 2010

Adam V. Russo — Thu, 04 Mar 2010 13:47:15 +0000

President Obama Calls on Congress to Move Forward with Reform Moments ago, President Obama gave a public statement urging Congress to move forward with its healthcare reform effort. The President stated that reform has been debated for over a year and that any more debate would not do any more good. Republicans have contended that the [...]

Ohio Bar Associate/ New Subrogation Committee

Adam V. Russo — Wed, 03 Mar 2010 15:19:02 +0000

The Ohio Bar Association’s new Subrogation Committee held its first meeting today to try to formulate what the purpose of this committee is. The committee developed a working statement which states as follows: “Parties injured by a wrongdoer often are not receiving full or fair compensation in part because of subrogation laws of Ohio.” The [...]

Colorado HB 1168/ Amended & Passed by Judiciary Committee

Adam V. Russo — Wed, 03 Mar 2010 15:17:37 +0000

President-Elect Kenneth Levine and Amicus Committee Chair Daran Kiefer spent Monday February 22nd in Colorado with several NASP members and industry lobbyists testifying in opposition to House bill 1168. During the eight hours at the Capital, the parties supporting this bill agreed to several amendments. First, the bill was amended to eliminate property, workers’ compensation [...]

SD S 169/ Passed and Moves to the House/ Affects All Subrogation Rights

Adam V. Russo — Wed, 03 Mar 2010 15:15:04 +0000

The South Dakota bill would prohibit a subrogated insurer from participating in any recovery for “bodily injury” or “property damage” unless or until the injured party is “made whole”. S.D. Senate bill 169 failed to pass the Senate on February 22, 2010. However, the Senate reconsidered the bill on February 23rd, 2010 which resulted in [...]

New Hampshire House Bill 1259/ Attorney Fees & Expenses in Medical Subrogation

Adam V. Russo — Wed, 03 Mar 2010 15:13:18 +0000

The New Hampshire House Judiciary Committee reviewed and recommended a bill recently pertaining to contract, Medicaid or statutory subrogation rights of subrogation for “”reimbursement of medical expenses” against plaintiff’s recovery. The proposed bill requires these subrogated entities to pay costs and attorney fees to the injured party “as justice requires”. The bill does not give [...]

Will employers offer health care in future?

Adam V. Russo — Wed, 03 Mar 2010 14:21:06 +0000

Economy, rising costs raise concerns about future affordability Joanne Wojcik Employers’ inability to control health care costs and uncertainty about the effects of federal health reform have many rethinking their commitment to providing health care benefits, a survey concludes. Forty-three percent of employers responding to the National Business Group on Health and Towers Watson & Co. survey released [...]

Democrats renew health reform push

Adam V. Russo — Wed, 03 Mar 2010 14:05:25 +0000

After regrouping, lawmakers seek new path to passage Jerry Geisel WASHINGTON—President Barack Obama and top congressional Democrats are preparing to mount a new and perhaps final drive to pass health care reform legislation. Last week, the president signaled that he has not given up on the reform drive and is prepared to play a commanding role as Democrats [...]