EBIA Weekly Archives - HIPAA - Court Cases
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Results (53 articles found)
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- Prescription Drugs Prescribed Prior to Six-Month Waiting Period, But Taken During the Waiting Period, Constituted "Treatment" Under Plan's Preexisting Condition Clause
- From the March 16, 2000 EBIA Weekly
- This is a pre-HIPAA case. Mr. Davolt, who was hired in 1995, suffered from diabetes. The employer (O'Reilly Automotive) had a self-funded health plan that excluded coverage for preexisting conditions "that were diagnosed or treated in the ...
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- Fourth Circuit Upholds Broad Preexisting Condition Clause
- From the February 17, 2000 EBIA Weekly
- In another recently-issued pre-HIPAA case addressing a preexisting condition exclusion (PCE), the court upheld a plan administrator's interpretation of a medical plan's PCE. In this case, a Wal-Mart employee (Ms. Booth) incurred expenses for a ...
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- Court Construes Definition of Preexisting Condition Clause Against the Plan
- From the February 10, 2000 EBIA Weekly
- This pre-HIPAA case is instructive on the type of ambiguity and court review that should exist under HIPAA's required definition of a "preexisting condition." The pertinent facts of the case are as follows. An Emerson employee (Mr. Weaver) ...
