June 13, 2019

Special Considerations for Excess and Surplus Lines Brokers

By: Cynthia Borrelli and Michael J. Morris , Bressler Amery & Ross, P.C. This article addresses special considerations about surplus lines (SL) brokers like the surplus lines agent’s (SLA) license status, due diligence searches by agents of admitted marketplace prior to a SL placement, and broker disclosure of status of excess and surplus (E&S) insurers as unauthorized. Audit recordkeeping reports and...

April 21, 2019

Wellness Program Design and Compliance

By: Emily D. Zimmer and Lynne S. Wakefield , K&L Gates LLP EMPLOYER-SPONSORED WELLNESS PROGRAMS HAVE become increasingly common as employers attempt to control rising healthcare costs and improve employees’ overall health and productivity. Designing and operating a wellness program requires careful consideration of compliance obligations under a number of different laws including, but not limited to, the...

April 20, 2019

Association Health Plans

Brian W. Berglund and Sarah L. Bhagwandin , Bryan Cave Leighton Paisner LLP This article discusses the requirements for Association Health Plans (AHPs) under the Employee Retirement and Income Security Act of 1974 (ERISA) and describes how the final rule issued by the U.S. Department of Labor (DOL) may shape how you advise clients wishing to either establish a new AHP or reevaluate the operations of an existing AHP...

April 20, 2019

Wellness Programs Design and Implementation Checklist

These guidelines will assist you in implementing a wellness program that complies with the Health Insurance Portability and Accountability Act of 1996 (HIPAA), the Patient Protection and Affordable Care Act of 2010 (ACA), the Americans with Disabilities Act of 1990 (ADA), the Genetic Information Nondiscrimination Act of 2009 (GINA), the Consolidated Omnibus Budget Reconciliation Act of 1985 (COBRA), the Employee Retirement...

April 20, 2019

Health Plan Provider Agreement Essentials Checklist

This checklist is designed for attorneys representing health plans who are asked to draft or review an agreement with healthcare providers who will be part of the plan’s provider network. It highlights key legal and business points for you to consider when preparing a provider agreement for use by a plan. Assemble Your Project Team . Identify someone at the health plan to connect you with appropriate stakeholders...

April 20, 2019

Health Plan Network Provider Agreement Essentials

By: Jason Brocks , Lexis Practice Advisor This article discusses provisions for agreements between health plans and doctors, dentists, and other healthcare professionals who provide healthcare services to plan members. It is intended as a guide for attorneys representing health plans who are asked to draft, review, or negotiate a provider agreement with providers who wish to participate in the health plan’s provider...

April 20, 2019

Healthcare Providers and Insurers: FTC Approach to Provider Mergers and Acquisitions

By: Alexis J. Gilman, Joseph M. Miller, and Angel Prado, Crowell & Moring LLP This article explains how antitrust enforcers, primarily the Federal Trade Commission (FTC), analyze healthcare provider mergers, including hospital, outpatient, and physician-group mergers. AFTER FEDERAL AND STATE ANTITRUST ENFORCERS LOST seven straight hospital-merger challenges in the 1990s, which put their hospital-enforcement approach...

April 19, 2019

Physician Practice Acquisitions: Avoiding Legal Pitfalls

By: William B. Eck, Seyfarth Shaw LLP This article focuses on the special merger and acquisition considerations applicable to physician practice acquisitions. The past couple of years have seen a resurgence in the acquisition of physician practices, both by hospitals and by private equity firms. Hospitals and health systems are increasingly looking for clinical integration. Private equity firms see the advantages that...

April 18, 2019

Ambulatory Surgical Center Lease Agreements

By: Alan B. Gordon, Paul A. Kiehl, and Timothy R. Loveland , McGuireWoods LLP WHILE NEGOTIATION OF LEASE AGREEMENTS FOR MOST healthcare providers involves the same issues presented by most commercial lease agreements, this article deals with leases for ambulatory surgical centers (ASCs), which present unique issues that must be identified and negotiated by the attorneys representing the landlord and the ASC tenant....

April 18, 2019

Current Updates and Legal Developments Healthcare SE 2019

EEOC LEAVES WORKPLACE WELLNESS PROGRAMS IN LIMBO EFFECTIVE JANUARY 1, 2019, REGULATIONS ISSUED by the Equal Employment Opportunity Commission (EEOC) concerning incentive-based workplace wellness programs are rescinded, leaving employers without guidance until at least June. By way of background, in May 2016, the EEOC had finalized regulations explaining how employers could provide financial and other incentives to...

March 01, 2019

AI Can Create Art, but Can It Own Copyright in It, or Infringe?

By: Sarah Ligon Pattishall, Mcauliffe, Newbury, Hilliard & Geraldson LLP A 17-year-old bet his high school programming club that artificial intelligence (AI) could outperform human beings. To prove it, Robbie Barrat developed a program that could write its own rap lyrics using 6,000... A 17-year-old bet his high school programming club that artificial intelligence (AI) could outperform human beings. To prove it...

February 22, 2019

Biosimilars and The Biologics Price Competition and Innovation Act (BPCIA)

By: Michael Furrow , DLA Piper, and Whitney Meier , Venable LLP The Biologics Price Competition and Innovation Act (BPCIA) provides an abbreviated pathway for companies to bring biologic drugs to market that are biosimilar to previously approved branded reference products by relying on clinical studies that were performed by the reference product sponsor (RPS). THIS ARTICLE INTRODUCES BIOSIMILARS AND THE LITIGATION...

February 22, 2019

Ohio Law Provides Legal Safe Harbor for Compliant Cybersecurity Programs

By: Chad Perlov - LEXIS PRACTICE ADVISOR THIS ARTICLE DISCUSSES THE OHIO DATA PROTECTION Act’s (ODPA) new legal safe harbor against data breach claims and how to comply with the requirements set out in the statute. Effective November 2, 2018, businesses and nonprofit entities that create and maintain a cybersecurity program in accordance with the ODPA’s requirements can assert their compliance as an affirmative...

February 22, 2019

Considerations when Marketing Alternative Investment Funds if a “Hard Brexit” Occurs

By: Winston Penhall , Reed Smith LLP This article addresses common questions and concerns regarding the marketing of alternative investment funds in the European Economic Area (EEA), should a “hard Brexit” occur. Hard Brexit is a scenario in which the United Kingdom (UK) fully exits the single market and leaves full access to the customs union along with its membership in the European Union (EU). In contrast...

February 22, 2019

Data Analytics in the Insurance Industry

Data analytics is at work every time Amazon tells a customer he or she may want to buy a product, each time Facebook recommends a resource page, and when a life insurance company assesses risk and set rates for potential policyholders. It’s an area governed by layers of laws and rules that are impacting the highly regulated insurance industry in a significant way. THIS ARTICLE PROVIDES PRACTICAL GUIDANCE FOR ATTORNEYS...

February 22, 2019

Managing Data Analytics Checklist

This checklist will help insurance companies manage data analytics related to complaints, claims, call centers, privacy, and security. Insurers should outline policies and include definitions in each of these areas. A data analyst proficient in Structured Query Language should categorize, collect, and analyze data. Other units must help the analyst understand the business to ensure that the categories, collection, and...

February 22, 2019

Updates and Legal Development - Spring 2019

STATE ATTORNEYS GENERAL FILE APPEAL FROM RULING INVALIDATING AFFORDABLE CARE ACT ATTORNEYS GENERAL FROM 16 STATES AND THE DISTRICT of Columbia have filed a notice of appeal with the U.S. Court of Appeals for the Fifth Circuit following a ruling by a Texas federal judge striking down the Patient Protection and Affordable Care Act (ACA) (111 P.L. 148) in its entirety. U.S. Judge Reed O’Connor of the Northern District...

February 22, 2019

The Misunderstood but Critically Important Merger Clause

By: Timothy Murray , Murray Hogue & Lannis ONE TIME IN AN ARBITRATION, THE PLAINTIFF CLAIMED that my client, the defendant, breached an alleged oral agreement that my client denied entering into. It was undisputed that after the alleged oral agreement, the parties entered into a written contract that dealt with the same subject matter but that omitted the rights and obligations of the supposed oral agreement. The...

February 22, 2019

Restrictive Covenant and Trade Secret Misappropriation Claims: Key Initial Considerations and Tips for Seeking TROs and Preliminary Injunctions

By: Daniel Turinsky , Evan D. Parness , and Britt C. Hamilton , DLA Piper LLP (US) This article provides guidance on substantive and procedural considerations involved in pursuing temporary restraining orders (TROs) and preliminary injunctive relief to help protect employer trade secrets and enforce restrictive covenants against former employees. FOR EMPLOYERS, RESTRICTIVE COVENANTS HAVE BECOME a vital tool for protecting...

February 22, 2019

Extraterritorial Reach of U.S. Antitrust Laws

By: Abram Ellis , John Terzaken , and Jonathan Myers , Simpson Thacher & Bartlett LLP This article addresses the extraterritorial reach of U.S. antitrust laws—that is, their application to international trade or commerce—specifically discussing the interplay between the Sherman Act, which prohibits anticompetitive conduct, and the Foreign Trade Antitrust Improvements Act (FTAIA), which defines the Sherman...

February 21, 2019

Restrictions on Bank Affiliate Transactions: Federal Reserve Act §§ 23A and 23B and Regulation W

By: Eric S. Yoon , K&L Gates LLP This article covers Sections 23A and 23B of the Federal Reserve Act (FRA), which establish certain quantitative limits and other prudential requirements for loans, purchases of assets, and certain other transactions between a member bank and its affiliates. Regulation W, promulgated by the Board of Governors of the Federal Reserve System (Federal Reserve), implements Sections 23A...

February 21, 2019

Market Trends: Employee Stock Ownership Plans

By: Rebecca G. DiStefano and Jeffrey S. Kahn , Greenbert Traurig, P.A. This market trends article covers employee stock ownership plans (ESOPs), which are a combination of a tax-qualified retirement plan and a corporate finance tool, and addresses recent trends in ESOPs relating to the design and structuring of the transaction, setting the price of the ESOP shares, and governing the post-ESOP company. Although sometimes...

February 20, 2019

Seven Summary Judgment Survival Skills

By: Jim Wagstaffe and the Wagstaffe Group In federal and state court cases, the litigator’s survival kit frequently has as its principal tool motions for summary judgment. For defendants, the winning case strategy frequently involves executing the summary judgment escape plan to survive the costs and risks of litigation. Conversely, for plaintiffs, staying alive for settlement and trial is quite often all about...

December 19, 2018

Securities Regulation and Enforcement

By: David L. Kornblau and Gerald W. Hodgkins Overview The enforcement and regulatory priorities of the Securities and Exchange Commission (SEC) have begun to come into focus now that SEC Chairman Jay Clayton has been in office for nearly a year and a half. Courts have also issued decisions that will significantly affect future securities enforcement moving forward. This article discusses the U.S. Supreme Court’s...

December 19, 2018

Freedom of Information Act

By: Christine N. Walz, Cynthia A. Gierhart, and Madelaine J. Harrington The Freedom of Information Act (FOIA) is a federal statute that mandates public access to certain U.S. government and administrative agency records upon submission of a request to the appropriate federal agency. Under FOIA, any person is afforded access to federal agency records unless such records are exempt or protected from disclosure. Each federal...