This week, two critical matters came under the deliberation of the Ninth Circuit Court of Appeals: the issue of insurance coverage for COVID business losses and the constitutionality of Guam’s in-person informed consent requirement for abortion. At the center of the first issue was a claim by The Oregon Clinic against the Fireman’s Fund Insurance…
The Centers for Medicare & Medicaid Services (CMS) has recently released the Skilled Nursing Facilities (SNF) and Inpatient Prospective Payment System (IPPS) final rules, signaling new alterations to healthcare regulations. This action by CMS is part of a broader initiative to review and modify health care rules to accommodate evolving health scenarios and market needs….
The Cayman Islands, as an international offshore financial center, have been under the global magnifying glass in the realm of financial regulation. Consideration of recent enforcement actions by local regulatory bodies can offer valuable insights into future expectations for financial services providers (FSPs) worldwide. As highlighted by Lucy Frew and Ian Mason, regulatory partners at…
On July 25, 2023, the U.S. Department of Health and Human Services (HHS), the Department of Labor, and the Department of the Treasury (collectively referred to as “the Departments”) collectively issued a set of proposed rules regarding the compliance of health plans and issuers with mental health parity requirements. The Departments also published a related…
The U.S. Attorney’s Office for New Jersey recently unveiled that Alexander Schleider, a resident of Lakewood, has admitted to wire fraud and conspiracy to commit healthcare fraud. The fraudulent scheme was centered on durable medical equipment (DME). Schleider pleaded guilty to his actions as part of a large-scale kickback plot, which resulted in massive losses…
On July 27, 2023, a significant regulatory proposal was issued by the Board of Governors of the Federal Reserve System (FRB), the Office of the Comptroller of the Currency, and the Federal Deposit Insurance Corporation. Collectively known as the Federal Banking Agencies (FBAs), they proposed the amendment of the banking regulatory capital rules that impact…
In the rapidly evolving era of digital health, many medical practitioners and healthcare providers are turning to artificial intelligence tools to streamline their operations and enhance patient care. Among these AI developments, ChatGPT, an advanced conversational AI developed by OpenAI, has been gaining attention for its potential application in the healthcare sector. ChatGPT’s impressive ability…
The Occupational Safety and Health Administration (OSHA) has implemented a new standard, forcing employers in high-risk industries to turn over more detailed reports regarding on-site injuries and illness instances. Specifically, this regulation demands certain employers to electronically submit not only 300A data but also 300 log and 301 information for some locations, thereby expanding the…
In an unfolding legal dispute, Brooks Sports Inc. is asserting its own insurance provider and agent in Washington State court concealing their roles in neglecting to cover counterclaims filed by suit brand Brooks Brothers Group Inc. The sportswear company has implicated the named entities in this lawsuit for copyright infringement, as reported by Law360 ….
A consortium of trade groups has recently reached out to the Consumer Financial Protection Bureau (CFPB), urging them to extend the relief granted by a Texas federal district court’s stay of compliance dates for the CFPB’s final small business lending rules (the Rule). This push is to include all entities that the Rule would cover,…
On August 3, 2023, Unum Group – a Fortune 500 insurance company – became yet another target of cyber criminals as it revealed a data breach on its subsidiary- Starmount Life Insurance Company, Inc. The company posted a notice of data breach on its website, alerting users about unauthorized access to its MOVEit server. According…
In its August 4, 2023 report, McDermottPlus Consulting updated on a variety of regulatory developments. Among the highlights, we see initiatives from Centers for Medicare & Medicaid Services (CMS) including the final FY 2024 Inpatient Prospective Payment System (IPPS) rule, a newly proposed Medicare Dementia Care Model, as well as the latest 2024 Medicare Part…
The Federal Trade Commission (FTC) has submitted a notice of proposed rulemaking, with the objective of expanding the Health Breach Notification Rule (HBNR) to include most health apps and similar technologies that are not governed by HIPAA (Health Insurance Portability and Accountability Act). The HBNR amendment proposition follows an effort to formalize the FTC’s Statement…
In an effort to combat biodiversity loss and promote environmentally conscientious practices within the industry, the Association of British Insurers (ABI) has released guidance for its members, referred to as the Action on Nature Guide. The aim of this material is to encourage insurers and long-term savings providers to become more “nature positive.” This recent…
In an intriguing development on the legal horizon with regards to insurance claims, a Florida condominium association is mandated by law for utilizing its utmost efforts to source and retain ample property insurance. This insurance scheme aims to shield the association, the associated property, the shared elements, and the condominium property, which must be indemnified…
On July 27, 2023, the Federal Reserve, Federal Deposit Insurance Corporation (FDIC), and the Office of the Comptroller of the Currency (OCC) issued a notice of proposed rulemaking, calling for comment on a proposal to exercise the final components of the Basel III Capital Accords, often referred to as the Basel III endgame. This initiative…
The recent legislative focus on mental health has been receiving substantial attention in the legal community, as federal regulators increase scrutiny for corporate compliance with the Mental Health Parity and Addiction Equity Act of 2008 (MHPAEA). The act aims to prevent health insurance providers from imposing less favorable benefit limitations on mental health and substance…
Operating as a trustee brings with it an array of responsibilities and potential hazards. One unexpected area of risk, often overlooked, lies in the realm of trustee liability insurance. Recently, one client shared a conversation with an institutional co-trustee who was resisting the approval of a trustee liability policy. The institutional co-trustee’s argument? Most of…
The US Department of Labor (DOL) has undertaken an investigatory initiative centered around the serious issue of “insurability” under life insurance benefits, as highlighted in a recent news release. The problem herein lies in the failure to complete the process of confirming the evidence of insurability. The evidence of insurability can be described as the…
Understanding the typical commercial property claims process can be a daunting task, especially in the midst of an already stressful situation. Such circumstances often arise from a convergence of natural, human, or mechanical errors. It goes without saying that swift action is crucial not only to alleviate dangers posed to your employees and customers, but…
Artificial Intelligence (AI) has sparked significant interest and witnessed rapid growth, thereby becoming a vital focus of technology transactions. Remarkably, the inherent standard acquisition agreement seems not to have matched the pace and demand of AI companies. These modern tech entities pose unique risks to potential buyers, risks that a standard transaction approach may fail…
In a high-profile case concluded in July 2023, the Court of Québec ruled against the Régie de l’assurance maladie du Québec (the Quebec Health Insurance Board, RAMQ), citing “serious” and “systemic” violations of the Canadian Charter of Rights and Freedoms. As a result of the ruling, evidence against medical specialists was excluded due their rights…
In a significant regulatory development on July 27, 2023, U.S. federal prudential bank regulators – namely, the Federal Deposit Insurance Corporation, the Federal Reserve Board (FRB), and the Office of the Comptroller of the Currency – have proposed new capital requirements focused on the larger banking organizations. The proposal pertains to Risk-Based Capital, Capital Relief…
The U.S. Department of Labor recently filed a lawsuit against UnitedHealth Group subsidiary, UMR, for alleged wrongful denials of claims regarding emergency room services and urinary drug screenings that date back to 2015. According to the complaint filed by the Labor Department, it was charged that UMR denied these claims “based solely on diagnosis codes…
The legal world continues to be a dynamic landscape, wherein corporations, as much as their individual employees, are called out into court for settlement of various disputes. As such, there are significant developments that may be of interest to legal professionals in the corporate sector. Consider the case of President Trump, who continues to assert…