EBIA Weekly Archives - HIPAA - Court Cases
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Results (53 articles found)
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- PCE Clause in LTD Policy Does Not Apply When Treatment During Exclusionary Period Was Not Linked to Later Diagnosis
- From the October 24, 2002 EBIA Weekly
- In this pre-HIPAA case involving long-term disability (LTD) benefits, the Third Circuit affirmed the trial court's decision in favor of a disabled employee. The LTD plan in the case had a 12-month exclusion for "preexisting conditions," ...
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- Court Dismisses Lawsuit by Physician Group Claiming That HIPAA Privacy Regulations Exceed Statutory Authority and Violate Constitution
- From the June 20, 2002 EBIA Weekly
- Pursuant to HIPAA Section 264, the Department of Health and Human Services (DHHS) developed privacy regulations, which were issued in final form in April 2001. These privacy regulations must be implemented by "covered entities"--defined as health plans (including insurers), ...
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- Court Refuses to Dismiss Claim of Fiduciary Breach for Violation of HIPAA Nondiscrimination Rules
- From the May 02, 2002 EBIA Weekly
- This case--one of the first reported decisions involving HIPAA's nondiscrimination rules--involves a benefit dispute in which the insurer of an employer-provided group health plan refused to pay claims submitted by a covered spouse and then terminated ...
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- Implied Consent by Spouse Defeats Claim for Breach of Physician-Patient Confidentiality
- From the December 13, 2001 EBIA Weekly
- This case involves a state law claim for breach of physician-patient confidentiality. The patient sought medical treatment twice after experiencing pain with intercourse. Each time, her husband made the appointment with the physician and was in the room during ...
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- Preexisting Condition Clause in LTD Policy Does Not Apply When Treatment During Exclusionary Period Was Not Linked to Later Diagnosis
- From the November 29, 2001 EBIA Weekly
- In this pre-HIPAA case involving long-term disability benefits, the court found in favor of a disabled former employee who claimed long-term disability benefits for a severe urinary condition called interstitial cystitis. The long-term disability plan had ...
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- Beneficiary of Individual Health Insurance Policy May Not Sue for Violation of HIPAA
- From the November 29, 2001 EBIA Weekly
- Ms. O'Donnell obtained an individual policy of medical insurance in 1994. She agreed with the insurer that a 1991 back injury would be a preexisting condition for which any medical care would be excluded from coverage. But in 1997, ...
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- Claims to Enforce WHCRA Must Be Brought Under ERISA's General Enforcement Provisions
- From the November 01, 2001 EBIA Weekly
- The plaintiff in this case had continuing medical difficulties with the tissue expanders and saline implants placed in her chest following a double mastectomy. After she became covered by the ERISA health plan at issue here, the insurance company providing ...
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- Applying HIPAA Privacy Rules as Guidance, Court Requires Notice to Patients Prior to Disclosure of Records
- From the June 28, 2001 EBIA Weekly
- In this criminal case involving a doctor accused of unlawful distribution and dispensing of controlled substances, the court considered a government subpoena of the medical records of the doctor's patients. The hospital that maintained the records resisted disclosure, arguing ...
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- Medicare Secondary Payer Statute Does Not Operate to Reorder COB Priorities Between Two ERISA Plans
- From the June 14, 2001 EBIA Weekly
- This case involves a coordination of benefits dispute between two ERISA plans, in which one of the plans, the Harris plan, attempted to use the ordering provisions of the Medicare Secondary Payer ("MSP") statute to make the other plan, the ...
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- Sex Discrimination Case Involving Health Plan's Failure to Cover Contraceptives is Permitted to Proceed
- From the May 24, 2001 EBIA Weekly
- This case was brought by the EEOC on behalf of employees of United Parcel Service (UPS). The EEOC alleged that UPS discriminated on the basis of sex in violation of Title VII of the Civil Rights Act of 1964 when ...
