Health Law Advisor

We recently wrote about the many failures of health insurance co-ops created under the Affordable Care Act ("ACA"), and the impact of those failures on providers and other creditors, consumers, and taxpayers.

As we described, nonprofit co-op insurers were intended to increase competition and provide less expensive coverage to consumers; however, low prices, lack of adequate government funding, restrictions on the use of federal loans for marketing, and low risk corridor payments from the Centers for Medicare & Medicaid Services created financial challenges for these ...

The top story on Employment Law This Week is the unfolding Zika virus crisis.

For the fourth time in history, the World Health Organization has declared a global public health emergency, following the spread of the Zika virus throughout Latin America and the Caribbean. The disease can have harmful effects on fetuses, and the CDC has warned against travel for pregnant women and their partners. The Zika crisis has important implications for employers. Workers who travel for their jobs may request accommodations, and employers should make them aware of the risks if they aren’t ...

The top story on Employment Law This Week is the unfolding Zika virus crisis.

For the fourth time in history, the World Health Organization has declared a global public health emergency, following the spread of the Zika virus throughout Latin America and the Caribbean. The disease can have harmful effects on fetuses, and the CDC has warned against travel for pregnant women and their partners. The Zika crisis has important implications for employers. Workers who travel for their jobs may request accommodations, and employers should make them aware of the risks if they aren't ...

Epstein Becker Green's Peter M. Panken and Frank C. Morris, Jr. have authored a post on the Hospitality Labor and Employment Law blog entitled, "Loose Lips Sink Ships: New Liabilities Under The Affordable Care Act."

Following is an excerpt:

The Affordable Care Act ("ACA") requires larger employers (50 or more full time equivalents) to offer "affordable" "minimum value" health care to employees working thirty (30) or more hours per week or face the possibility of significant penalties in some cases.  Thus the cost of staffing with part time employees may be far less than paying for ...

[caption id="" align="alignright" width="110"] John M. O'Connnor[/caption]

Who knew that “Don’t Tell Me You Love Me,” the iconic rock anthem of 80’s hairband Night Ranger (YouTube video) is actually a rally song protesting religious discrimination??  On January 27, 2016, the EEOC filed a summary judgment motion in EEOC v. United Health Programs of America, No. 14-cv-3673 (E.D.N.Y. filed June 11, 2014), asking the Court to find that certain team building policies and practices implemented by the defendant employer, including a requirement that its employees tell one ...

One of the featured stories on Employment Law This Week is the EEOC's recent release of two different guides on the rights of HIV-positive employees.

The first guide outlines employees’ rights under the ADA. The second guide is for health care providers with HIV-positive patients. It encourages them to advocate for their patients' rights in the workplace. These documents are also valuable resources employers. Among other takeaways, they break down the process involved in a request for reasonable accommodation from an HIV positive employee.

View the episode below or read more ...

In a matter emphasizing the importance of neutral hiring policies, the U.S. Court of Appeals for the Sixth Circuit has affirmed summary judgment in favor of a Kentucky hospital system that refused to hire two nurses who had restrictions on their professional licenses after they participated in a state-approved drug rehabilitation program.  The nurses alleged the refusal to hire decisions violated the Americans with Disabilities Act, but the Sixth Circuit held that the evidence showed the hospital had a neutral practice of denying employment to nurses with current or previous ...

[caption id="attachment_2360" align="alignright" width="206"] Nathaniel M. Glasser and Daniel C. Fundakowski[/caption]

Last month, in United States ex rel. Helfer v. Associated Anesthesiologists of Springfield, Ltd., No. 3:10-cv-03076 (N.D. Ill. Jan. 14, 2016), the U.S. District Court for the Central District of Illinois held that the retaliation provision of the False Claims Act (“FCA”) requires a whistleblower to show that protected activity was the “but-for” cause of the alleged adverse action.

The FCA’s retaliation provision entitles an employee to ...

On Monday, the World Health Organization ("WHO") declared the rise in birth defects linked to the Zika virus outbreak a public health emergency, marking only the fourth time that the WHO has made such a declaration. This announcement by the WHO underscores the seriousness of the Zika virus outbreak and, hopefully, will pave way for a coordinated and well-funded global response to this serious public health problem that may include intensified mosquito control efforts, expedited creation of a more rigorous diagnostic test to detect the virus, and development of a preventive ...

2016 is poised to be a major year in network adequacy developments across public and private insurance markets.  Changes are ahead in the Medicare and Medicaid managed care programs, the Exchange markets and the state-regulated group and individual markets, including state-run Exchanges.  The developing standards and enforcement will vary significantly across these markets.

Through 2014 and 2015, major news stories discussed concerns over the growing use of narrow provider networks by issuers on the Affordable Care Act's insurance exchanges ("Exchanges").  Others reported on ...