LexisNexis® Legal Newsroom
Williams Mullen: For H-1B Employers: How Even a Single Employee’s H-1B Complaint Could Incite a Comprehensive DOL Investigation of Your H-1B Practices

By Mary E. Pivec and Reba M. Mendoza In Greater Missouri Medical Pro-Care Providers, Inc. , ARB Case No. 12-015, ALJ Case No. 2008-LCA-26 (2014), a divided U.S. Department of Labor (“DOL”) Administrative Review Board (the “Board”) partially reversed the decision of the Administrative...

Williams Mullen: OIG Scrutiny of Hospital Outpatient Evaluation/Management Claims Billed to Medicare

By Marcus C. Hewitt H.H.S’s Office of Inspector General’s yearly work plan was issued on January 31, 2014, which included numerous new and ongoing reviews and activities by OIG for the coming year. Among the new projects, OIG will review Medicare payments to hospitals for outpatient evaluation...

Williams Mullen: Employer Healthcare Mandate Transition Relief Announced

By Brydon M. DeWitt This week, the Treasury Department announced transition rules that delay implementation of the Affordable Care Act (ACA) employer health insurance mandate for some employers and modify it for others. The ACA requires employers with at least 50 full-time employees to offer affordable...

Williams Mullen: OIG 2014 Work Plan Focuses On Compounded Pharmaceuticals Reimbursed By Medicare

By Brian C. Vick The Office of Inspector General for the U.S. Department of Health and Human Services (“OIG”) included two items in its recently-released 2014 Work Plan indicating a new focus on the quality and safety of compounded pharmaceuticals reimbursed by Medicare. Pharmaceutical...

Williams Mullen: Court Holds ERISA Plaintiff Can’t Claim Equitable Remedies When They Have Adequate Remedies to Recover Plan Benefits, Notwithstanding the Expansion of the Kinds of Equitable Relief in CIGNA Corp. v. Amara

By Mark S. Thomas and Robert W. Shaw A federal court has ruled that, although a recent U. S. Supreme Court decision expanded the kinds of equitable remedies available to a plaintiff under ERISA § 502(a)(3), those remedies are still unavailable when the ERISA plaintiff has an adequate remedy to...

Williams Mullen: New COBRA and CHIP Notices Highlight Affordable Care Act Marketplaces

B y Brydon M. DeWitt The Department of Labor recently issued updated model COBRA continuation coverage and Childrens’ Health Insurance Program (“CHIP”) notices. Plan administrators should begin using the new notices immediately. The revised model COBRA notices address the availability...

Williams Mullen: ‘You Can’t Bend It That Way, Beckham’: Federal Court Dismisses Plaintiff’s Attempted Claims For Equitable Relief

By Mark S. Thomas and Robert W. Shaw Following the U. S. Supreme Court’s decision in CIGNA Corp. v. Amara , 131 S. Ct. 1866 (2011) [ enhanced opinion available to lexis.com subscribers ] [lexis.com subscribers may access Supreme Court briefs for this case ] , the federal courts have wrestled with...

Williams Mullen: 7th Circuit Interprets ERISA’s Statute of Limitations for Fiduciary Breach: Fish v. GreatBanc Trust Company

By Mark S. Thomas and Robert W. Shaw The Seventh Circuit Court of Appeals in Fish v. GreatBanc Trust Company , No. 12-3330 (7th Cir. May 14, 2014) [ enhanced opinion available to lexis.com subscribers ], has issued a decision that clarifies the rules for suits for fiduciary breach under ERISA. The decision...

Williams Mullen: CMS Proposes Rule That Would Expand Its Authority To Audit Medicare Advantage Plans

By Brian C. Vick O n April 30, 2014, the Centers for Medicare and Medicaid Services (“CMS”) issued a proposed rule to update payment policies and rates for inpatient hospitals (the “Proposed Rule”) that includes a provision with significant future implications for sponsors...

Williams Mullen: OIG 2014 Compendium Highlights Need For Improved Controls For Pharmacy Claims Submitted To Medicare Part D Plans For Payment

By Brian C. Vick and C. Elizabeth Hall In its March 2014 Compendium of Priority Recommendations (the “Compendium”), the Office of the Inspector General of the United States Department of Health and Human Services (“OIG”) identified a number of prescription drug-related priorities...

Williams Mullen: D.C. Circuit Rules That ‘Exhaustion of Administrative Remedies’ Is Not Required For Violations of ERISA’S Statutory Guarantees: Stephens v. Pension Benefit Guaranty Corporation

By Mark S. Thomas and Robert W. Shaw The U. S. Court of Appeals for the District of Columbia Circuit has joined five other federal circuits to rule that pension plan participants need not exhaust a plan’s internal remedial procedures before they file suit in federal court to assert violations...

Williams Mullen: 4th Circuit Adopts More Demanding Test For Exercise Of Objective Prudence By Retirement Plan Fiduciaries

By Mark S. Thomas and Robert W. Shaw In the latest ruling in a long-running battle arising from company stock fund divestments, the U. S. Court of Appeals for the Fourth Circuit has underscored the importance of procedural prudence in the management of plan assets. In Tatum v. RJR Pension Investment...

Williams Mullen: Defeating Class Certification: Halliburton II Ruling Impacts Securities Class Action Issues

By Turner A. Broughton and Lauren M. Wheeling In its June 23, 2014 opinion in Halliburton Co. v. Erica P. John Fund, Inc. (“ Halliburton II ”), the United States Supreme Court addressed two securities class action issues[ enhanced opinion available to lexis.com subscribers. : lexis.com...

Williams Mullen: Cybersecurity -- Mitigating the Legal Risks of On-Line Banking With Business Customers

By Robert D. Perrow and & J.P. McGuire Boyd Jr. On-line or electronic banking (“e-banking”) offers many well-known advantages to financial institutions engaged in banking and to their business customers. A significant risk of on-line bank accounts for both financial institutions and...

Williams Mullen: Preparing for a Data Breach – What to Know about Breach Notification

By Kelsey S. Farbotko Data breaches are at the forefront of the news, and many companies, including those dominant in the health care industry, have found themselves front and center in the headlines. Although recent news stories have focused their attention on attacks on major, nationwide companies...

Williams Mullen: Supreme Court Upholds ACA Premium Assistance Nationwide

By: Brydon M. DeWitt This morning [June 25], the Supreme Court ruled that Affordable Care Act (ACA) premium tax credits will remain available to individuals residing in states that did not establish their own health insurance marketplaces. In King v. Burwell , the Supreme Court analyzed ACA statutory...

Williams Mullen: Cybersecurity Standards Apply To Thee, Not Me

By J.P. McGuire Boyd, Jr. & Robert C. Van Arnam “If there is anyone to blame, it is the perpetrators,” said Katherine Archuleta, Director of the federal Office of Personnel Management (“OPM”), to a Senate panel investigating the causes of the recent OPM cyberattack. During...

Williams Mullen: Supreme Court Ruling on EPA Mercury Rule: Utilities Win the Battle, But Lose the War

By Jessica J.O. King The Clean Air Act requires EPA to regulate emissions of hazardous air pollutants from coal-fired power plants if the agency determines that such “regulation is appropriate and necessary” after studying the hazards the emissions pose to human health. EPA conducted the...

Williams Mullen: Clean Water Rule Opens Litigation Floodgates

By A. Keith "Kip" McAlister, Jr. | With much fanfare, EPA and the Army Corps of Engineers (“Corps”) recently issued a final rule clarifying which bodies of water are “waters of the United States” protected under the Clean Water Act (“CWA”). Coming in the...

Williams Mullen: Health Care Providers Lacked Standing to Sue as ERISA Beneficiaries: Rojas v. Cigna Health and Life Insurance Company

By Mark S. Thomas The U. S. Court of Appeals for the Second Circuit has affirmed a dismissal of claims by two physicians and their medical practice asserting standing under ERISA to enjoin an insurer from removing them from its coverage network. Rojas v. Cigna Health and Life Insurance Company , Case...

Williams Mullen: Affirming the Need to Fix the Medicare Appeals Backlog: The AFIRM Act of 2015

By: Kelsey S. Farbotko If you are one of the many health care providers wanting to appeal a Medicare contractor’s reimbursement decision, you may need to be prepared for a long wait. Over the last few years, the backlog of appeals to the administrative hearing level has grown into an untenable...

Williams Mullen: Federal Government Continues to Target Big Coal

By: Jessica J.O. King The United States Department of Interior’s (DOI) Office of Surface Mining Reclamation and Enforcement has proposed new regulations requiring coal mining companies to protect and restore streams impacted by nearby mining activities. DOI’s draft Stream Protection Rule...

Williams Mullen: EPA Finalizes Clean Power Plan: Now What?

By: Channing J. Martin President Obama unveiled on August 3 what has been billed as the Administration’s biggest initiative yet to regulate carbon emissions. Although the final regulations that form the Clean Power Plan are ostensibly aimed at reducing emissions from existing fossil fuel-fired...

Williams Mullen: The Definition of Identify: The 60-Day Rule

By Ruth Levy & Patrick C. Devine, Jr. | The Patient Protection and Affordable Care Act (“PPACA”) established that any person who receives an overpayment from the Medicare or Medicaid programs and who does not report and return the overpayment within 60 days after it is identified will...

Williams Mullen: FERC Urged To Revise Generator Interconnection Procedures and Agreement

By Robert F. Riley It has been over twelve years since the Federal Energy Regulatory Commission (FERC) issued the pro forma Large Generator Interconnection Procedures (LGIP) and pro forma Large Generator Interconnection Agreement (LGIA) for generators larger than 20 megawatts. [1] In addition, it...