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1 week ago | 
jdsupra.com | Steven L. Imber |Justin Liby |Jennifer Osborn
Key Takeaways The Delaware Department of Insurance (Department) is conducting targeted market conduct exams of Third Party Administrators (TPAs) for compliance with state insurance laws and regulations. Reviews will cover areas such as claims handling, premium collection, disclosures, audits and operational practices, following NAIC guidelines. The Department will consider each TPAs specific business activities in Delaware and nationally when determining examination requirements.
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Jan 8, 2025 | 
natlawreview.com | Steven L. Imber
Skip to main content January 08, 2025 Volume XV, Number 8 Legal Analysis. Expertly Written. Quickly Found.
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Jul 29, 2024 | 
natlawreview.com | Steven L. Imber
The Centers for Medicare and Medicaid Services (“CMS”) announced on July 19, 2024 that it is taking action to help stop unauthorized changes by agents and brokers to Federally Facilitated Marketplace (“FFM”) enrollments.
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May 22, 2024 | 
natlawreview.com | Steven L. Imber
Skip to main content May 22, 2024 Volume XIV, Number 143 Legal Analysis. Expertly Written. Quickly Found.
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May 7, 2024 | 
natlawreview.com | Steven L. Imber
The Florida Office of Insurance Regulation (“Florida OIR”) recently took regulatory action against a New York-based company (“Company”) regarding its alleged unlicensed activities in Florida. According to the Florida OIR, the Company had been administering business on behalf of admitted insurers in Florida without a Certificate of Authority as an Insurance Administrator in Florida, in violation of Section 626.8805(1), Florida Statutes.
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Jan 25, 2024 | 
natlawreview.com | Steven L. Imber
The U.S. Department of Labor (“DOL”) recently entered into a settlement agreement with a New York-based insurer and third-party administrator (“Company”) of employer group health plans governed by the Employee Retirement Income Security Act (“ERISA”).
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Nov 20, 2023 | 
natlawreview.com | Steven L. Imber
The U.S. Department of Labor (“DOL”) recently filed a lawsuit against UMR, Inc., a third-party administrator and UnitedHealth Group, Inc. subsidiary. The lawsuit alleges that UMR denied thousands of claims based on diagnosis codes and allegedly failed to comply with the requirements of the Patient Protection and Affordable Care Act, as amended (“ACA”) and the DOL’s claims procedures regulation.
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Nov 16, 2023 | 
natlawreview.com | Andrew H. DeVoogd |Kate Stewart |Steven L. Imber |Jennifer Osborn
Skip to main contentNovember 16, 2023Volume XIII, Number 320Legal Analysis. Expertly Written. Quickly Found. Trending NewsEpisode 50: The Economic Cost of the Green Card Backlog [Podcast] PrintMailDownloadiLawmakers reach a deal to avert a government shutdown. The government publishes a regulation on additional H-2B visas. And a new report estimates the economic cost of the U.S. green card backlog.
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Nov 16, 2023 | 
natlawreview.com | Steven L. Imber
The Louisiana Insurance Department (“Department”) recently fined Express Scripts Administrators, LLC (“ESA”) $275,000 and MedImpact Healthcare Systems, Inc. (“MedImpact”) $250,000 for allegedly failing to pay electronically adjudicated insurance claims to pharmacies in a timely manner on behalf of the Louisiana Office of Group Benefits (“OGB”).
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Nov 15, 2023 | 
natlawreview.com | Steven L. Imber
On September 18, 2023, the Florida Office of Insurance Regulation (“OIR”) published proposed rules to implement provisions of the Prescription Drug Reform Act (Florida Senate Bill 1550) governing Pharmacy Benefit Managers (“PBMs”). The Prescription Drug Reform Act requires all PBMs to become licensed as an Administrator with the OIR in order to continue operating legally in Florida after December 31, 2023.
