
Industry Updates
- Hurricane Preparedness: Essential Legal Topics for North Carolina Business Ownersby Ward and Smith, P.A. on July 26, 2025 at 2:06 am
Hurricane season presents significant legal and operational challenges for North Carolina businesses. Whether it's a hurricane hammering your business, floodwaters threatening your property, hail damaging crops, or ice storms causing an extended power outage and disrupting your company, you've suffered harm from the worst that North Carolina weather has to offer. During the last five years, government shutdowns, supply chain disruptions, material price increases, and substantial and......By: Ward and Smith, P.A.
- The One Big Beautiful Bill Act Explained: A Detailed Review of Key Changes for the Healthcare Industryby King & Spalding on July 25, 2025 at 10:05 pm
To offset the cost of other provisions in the bill, the One Big Beautiful Bill Act (OBBBA) includes significant reforms to Medicaid, Medicare, and Affordable Care Act (ACA) premium tax credits that are expected to result in millions of people losing federal healthcare coverage and reduced expenditures by more than $ 1 trillion over a decade. Collectively, the OBBBA’s healthcare provisions amount to the largest changes to healthcare programs since the ACA....By: King & Spalding
- What the MultiPlan MDL Tells Us About Rebrands During Litigationby Napoli Shkolnik on July 25, 2025 at 8:43 pm
When a company faces mounting public scrutiny, especially in high-stakes litigation, it sometimes does what any crisis playbook might suggest: change the name. It’s not a financial reset. It’s a reputational one, and a strategy frequently used to deflect public ire even if the underlying legal claims remain unchanged....By: Napoli Shkolnik
- CPPA Board to Discuss Draft CCPA Regulations, DROP Requirementsby Alston & Bird on July 25, 2025 at 7:53 pm
The California Privacy Protection Agency (“CPPA”) Board will meet on Thursday, July 24 to discuss the California Consumer Privacy Act (“CCPA”) draft regulations on cybersecurity audits, risk assessments, automatic decisionmaking technology (“ADMT”), the CCPA’s application to insurance companies, and updates to the existing CCPA regulations....By: Alston & Bird
- Five Things to Know About the Owner’s Affidavit in Real Estate Transactionsby Kerr Russell on July 25, 2025 at 6:32 pm
In real estate transactions, one of the most important documents a seller will execute is the “Owner’s Affidavit” (also sometimes called a “Seller’s Affidavit” or “Affidavit of Title”). Often, purchase agreements require the Seller to provide an Owner’s Affidavit at closing....By: Kerr Russell
- FDIC Rethinks Industrial Banks—Againby Davis Wright Tremaine LLP on July 25, 2025 at 5:44 pm
Industrial banks or industrial loan companies (ILCs)—FDIC-insured banks chartered by certain states, notably Utah—have long been a niche component of the U.S. financial system. These institutions may be owned by commercial entities because, while they are essentially insured banks in many respects, they are not "banks" under the Bank Holding Company Act......By: Davis Wright Tremaine LLP
- Q&A: Essential Questions to Ask When Preparing Your Commercial Property’s Hurricane Insurance Policyby Bracewell LLP on July 25, 2025 at 5:42 pm
Commercial property hurricane insurance presents complex challenges that require careful consideration and strategic planning. Business owners must understand critical coverage elements, policy limitations and claim procedures to protect their operations effectively....By: Bracewell LLP
- Ep. 71 – Good Faith Estimates for Uninsured and Self-Pay Patientsby Dentons on July 25, 2025 at 2:23 am
Make sure you’re providing good faith estimates to uninsured & self-pay patients - Under the No Surprises Act, healthcare providers are required to offer Good Faith Estimates (GFEs) to self-pay and uninsured patients before services are rendered. These estimates promote price transparency and empower patients to make informed decisions....By: Dentons
- Massachusetts Paid Family and Medical Leave—Updates from the Department - July 2025by Mintz - Employment Viewpoints on July 25, 2025 at 12:40 am
In its quarterly briefing, the Massachusetts Department of Family and Medical Leave (the “Department”) recently updated its Employer Portal, issued a reminder for the private plan reporting deadline of August 31, 2025, and summarized tax guidance concerning the Massachusetts Paid Family and Medical Leave law (“MAPFML”). We explore each of these updates in more detail below......By: Mintz - Employment Viewpoints
- Anthem's New Chargemaster-Based Claim Edits: Which Charges and Providers Will Anthem's New Process Target and How Will It Impact Reimbursement Rates?by Davis Wright Tremaine LLP on July 24, 2025 at 10:21 pm
Effective August 1, 2025, Anthem will implement a new claims-editing process that adjusts payments for Medicare Advantage (MA) claims based on an undisclosed, customized chargemaster table. The announcement identifies claims for emergency room evaluation and management (ED E/M) services as subject to additional review and "ER leveling … for consistency with submitted claim elements."......By: Davis Wright Tremaine LLP
- WISeR Model Will Test the Use of Artificial Intelligence for Prior Authorization in Medicare: Key Considerations for Health Care Providers and Suppliersby Mintz - Health Care Viewpoints on July 24, 2025 at 9:18 pm
The Center for Medicare and Medicaid Innovation (CMMI) recently announced a six-year payment model for 2026-2031 called the Wasteful and Inappropriate Service Reduction (WISeR) Model. WISeR will test the use of artificial intelligence and machine learning (AI/ML) for prior authorization and pre-payment review processes for certain items and services provided to beneficiaries in Medicare Fee-for-Service (Medicare FFS) (otherwise known as Original Medicare). According to CMMI, WISeR is intended to...By: Mintz - Health Care Viewpoints
- Signed, Sealed…but Contaminated: Mitigating Environmental Risks in M&Aby Woodruff Sawyer on July 24, 2025 at 6:51 pm
Environmental-related risks in merger and acquisition (M&A) transactions shouldn’t just be a technical concern for legal and compliance teams—they should also be a board-level consideration. Whether stemming from legacy contamination, pending regulatory scrutiny, or stakeholder pressure, these risks have the potential to derail deals, trigger shareholder litigation, and be the catalyst for breach of fiduciary duty suits against directors and officers....By: Woodruff Sawyer
- North Carolina Ruling Confirms Insurer’s Autonomy in Settlement Negotiationsby Phelps Dunbar on July 24, 2025 at 6:50 pm
In a recent opinion issued this month, the United States District Court for the Eastern District of North Carolina confirmed that an insurer may consider its own interests, as well as those of its insured, when entering into settlement agreements....By: Phelps Dunbar
- No Surprises Here! Payers Push Back on IDR Submissions, Opening New Front in NSA Implementation Landscapeby Proskauer - Health Care Law Brief on July 24, 2025 at 6:21 pm
On May 27, 2025, Blue Cross Blue Shield Healthcare Plan of Georgia (“BCBSGA”) sued several emergency physician groups and their billing agent, Halo MD, alleging abuse of the No Surprises Act’s (“NSA”) independent dispute resolution (“IDR”) process. The complaint claims the providers submitted ineligible claims, made false attestations, and inundated the system with high volumes of disputes to secure inflated arbitration awards......By: Proskauer - Health Care Law Brief
- Idaho Federal Court Grants Motion to Compel Discovery of Reinsurance Information for Employee Benefit ERISA Planby Carlton Fields on July 24, 2025 at 5:02 pm
In THC–Orange County LLC v. Regence BlueShield of Idaho Inc., the U.S. District Court for the District of Idaho addressed a motion by plaintiff THC–Orange County LLC, doing business as Kindred Hospital Ontario, to conduct limited discovery from the defendants, including whether defendant WinCo Holdings Employee Benefit Plan “has reinsurance and, if so, who the reinsurer is and whether the reinsurer has any input into benefit decisions.”...By: Carlton Fields
- Benefits Catch-Up - Q2 2025by Eversheds Sutherland (US) LLP on July 24, 2025 at 4:57 pm
With so much happening in the employee benefits world over the last few months, we bring you Benefits Catch-Up, our catch-up contribution to help you keep up with recent developments. Eversheds Sutherland’s US Employee Benefits and Executive Compensation team – equipped with a deep knowledge of the nuances of retirement plans, health and welfare benefits, and executive compensation issues – actively monitors industry trends, regulatory changes, and best practices to provide the updates you need...By: Eversheds Sutherland (US) LLP
- Personal Liability Risks for Insurance Liquidators: Navigating Federal Super Priority in Insolvency Proceedingsby Husch Blackwell LLP on July 24, 2025 at 4:35 pm
Insurance commissioners serving as liquidators of insolvent insurance companies should be mindful of the potential for personal liability arising under the Federal Priority Act (FPA) and potential solutions through model legislation under development by the National Association of Insurance Commissioners (NAIC)....By: Husch Blackwell LLP
- Client Alert: It Ends With Us Having No Coverage? – What Corporate Insureds Need to Know About Prior Knowledge Exclusions in Their Liability Policiesby Shumaker, Loop & Kendrick, LLP on July 24, 2025 at 10:30 am
On July 21, 2025, Harco National Insurance Company filed suit against its insureds, Justin Baldoni and his production company, Wayfarer Studios, seeking a declaration from the U.S. District Court for the Southern District of New York that it has no duty to defend or indemnify against a sexual harassment lawsuit, citing the policies' Prior Knowledge Exclusion....By: Shumaker, Loop & Kendrick, LLP
- Healthcare Authority Newsletter - July 2025 #2by Arnall Golden Gregory LLP on July 23, 2025 at 10:52 pm
News Briefs - Tariffs May Impact Hospice Mergers and Acquisitions Activity - Tariffs being implemented by the Trump administration could have a dampening effect on an already slumping hospice mergers and acquisitions market. These uncertainties arise at a time when hospice M&A is undergoing a slowdown....By: Arnall Golden Gregory LLP
- SNF Off-Cycle CMS-855A Reporting Delayed to January 1, 2026by Arnall Golden Gregory LLP on July 23, 2025 at 10:42 pm
The Centers for Medicare & Medicaid Services (“CMS”) has extended the window for skilled nursing facilities (“SNFs”) to file off-cycle Medicare revalidation documents until January 1, 2026. This marks CMS’ third deadline extension for the reporting requirement....By: Arnall Golden Gregory LLP
- Purdue Prohibition of Nonconsensual Third-Party Chapter 11 Plan Releases Does Not Apply to Bankruptcy Asset Salesby Jones Day on July 23, 2025 at 8:58 pm
The U.S. Supreme Court's 2024 ruling in the Purdue Pharma bankruptcy cases generally prohibiting nonconsensual releases of non-debtors in chapter 11 plans sent shockwaves through the restructuring community. With one fell swoop, it appeared to upend long-standing practice facilitating successful chapter 11 cases premised upon releases of third parties in exchange for funding to pay creditor claims and achieve confirmation of restructuring or liquidation plans....By: Jones Day
- Appellate Court of Illinois decision reminds insurers to communicate with insureds or face potential consequences: Estoppel of coverage defensesby Kennedys on July 23, 2025 at 7:03 pm
The Appellate Court of Illinois recently reminded insurers that they may be estopped from raising coverage defenses through their misleading acts or statements, including silence. In Monroy-Perez v. Sentry Select Ins. Co., 2025 IL App (1st) 241711, the Court held that the insurer was estopped from asserting that the insured failed to bring suit within the policy’s two-year limitation period when the insurer withheld the policy from the insured until after the limitations period expired, despite...By: Kennedys
- Insurer Has No Duty to Interplead Policy Limits Under Montana Law When Faced with Multiple Claimants and Potentially Insufficient Limitsby Wiley Rein LLP on July 23, 2025 at 5:42 pm
Applying Montana state law, the United States District Court for the District of Montana has held that an insurer has no duty to interplead its policy limits to satisfy claims by multiple competing claimants and did not violate Montana’s Unfair Trade Practices Act (“UTPA”) when successively settling claims of multiple plaintiffs....By: Wiley Rein LLP
- CMS CY 2026 proposed rules: 340B in PFS and OPPSby McDermott Will & Emery on July 23, 2025 at 4:45 pm
On July 15, 2025, the Centers for Medicare & Medicaid Services (CMS) released the CY 2026 Outpatient Prospective Payment System (OPPS) proposed rule. The proposed rule includes a provision that would increase the reduction in OPPS payment rates to offset the lump sum payments previously paid to 340B hospitals from 0.5% to 2% and would accelerate the period of the reductions from 16 years to six years......By: McDermott Will & Emery
- July 2025 Insurance Updateby Rivkin Radler LLP on July 23, 2025 at 4:27 pm
We cover a broad range of topics in this month’s insurance update. The Supreme Court of Vermont considers how to measure a boat’s capacity under a watercraft exclusion. The Sixth Circuit decides whether an equipment designer’s omission in its insurance application voided its professional services coverage. The North Carolina Supreme Court considers whether a homeowner has a negligence claim against his insurance agent who improperly filled out an insurance application that the homeowner...By: Rivkin Radler LLP
- FCA, PRA and HM Treasury Consult on SMCR Reformby Ropes & Gray LLP on July 23, 2025 at 3:12 pm
On 15 July 2025, HM Treasury, the Financial Conduct Authority (FCA), and the Prudential Regulation Authority (PRA) published consultation papers proposing possibly significant reforms to the Senior Managers and Certification Regime (SMCR). The proposals are intended to streamline regulatory processes, reduce administrative burdens, and enhance the proportionality and flexibility of the regime, while maintaining robust standards of accountability in the financial sector....By: Ropes & Gray LLP
- Ninth Circuit Applies EKRA to Marketing Intermediaries in Lab Operator’s Allergy Testing Schemeby Epstein Becker & Green on July 23, 2025 at 4:14 am
The U.S. Court of Appeals for the Ninth Circuit has held that a laboratory owner’s payments to marketing intermediaries violated the Eliminating Kickbacks in Recovery Act (EKRA)—in its first interpretation of the statute since it was enacted in 2018....By: Epstein Becker & Green
- Federal Reserve Proposes Changes to Rating System for Large Financial Institutionsby Mayer Brown on July 23, 2025 at 1:16 am
On July 10, 2025, the Board of Governors of the Federal Reserve System (“Board”) proposed changes to its supervisory rating systems for large financial institutions (“LFIs”) and supervised insurance organizations (the “Proposal”). The changes address the meaning of “well managed” and are intended to more accurately reflect the strength of large Board-supervised financial institutions and the banking system as a whole....By: Mayer Brown
- SCOTUS Allows Enforcement of ACA’s Preventive-Care Mandates But Opens Door for Political Influence: Key Points for Group Health Plansby Fisher Phillips on July 22, 2025 at 8:25 pm
The federal government may continue to enforce the Affordable Care Act’s preventive-care mandates, thanks to the Supreme Court’s recent decision in Kennedy v. Braidwood Management. In a 6-3 bipartisan opinion written by Justice Brett Kavanaugh, SCOTUS rejected constitutional challenges brought by a Texas business and others to the structure of a federal health task force that, as SCOTUS put it, issues “preventive-service recommendations of critical importance to patients, doctors, insurers,...By: Fisher Phillips
- Indiana Appellate Court Rejects Known Loss and Deemer Clause Defenses for the Second of Two Connected Class Actions Over Toxic Exposuresby Wiley Rein LLP on July 22, 2025 at 5:57 pm
The Indiana Court of Appeals, applying Indiana law, affirmed a trial court decision finding coverage for attorneys’ fees related to defending the second of two Taiwanese class actions relating to the same underlying toxic exposures. Allianz Global Risks US Ins. Co. v. Technicolor USA, Inc., 2025 WL 1921809 (Ind. Ct. App. July 14, 2025). The Court of Appeals affirmed that neither the known-loss doctrine nor the policies’ deemer clause barred coverage for the second Taiwanese class action....By: Wiley Rein LLP