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In the United States, ERISA reimbursement refers to the efforts of an ERISA Plan administrator (an insurer) to obtain repayment from an insured person who had previously received payments for personal injury medical bills. When an insurer pays an injury claim to someone, the insurer can seize cash settlements from whoever caused the injury.
The Employee Retirement Income Security Act of 1974 ( ERISA) ( Pub. L. 93–406, 88 Stat. 829, enacted September 2, 1974, codified in part at 29 U.S.C. ch. 18) is a U.S. federal tax and labor law that establishes minimum standards for pension plans in private industry. It contains rules on the federal income tax effects of transactions ...
Self-funded health care, also known as Administrative Services Only ( ASO ), is a self insurance arrangement in the United States whereby an employer provides health or disability benefits to employees using the company's own funds. [1] This is different from fully insured plans where the employer contracts an insurance company to cover the ...
Pharmacy benefit management. In the United States, a pharmacy benefit manager ( PBM) is a third-party administrator of prescription drug programs for commercial health plans, self-insured employer plans, Medicare Part D plans, the Federal Employees Health Benefits Program, and state government employee plans.
29 U.S.C. § 1132 (a) (3) ( ERISA § 502 (a) (3)) Sereboff v. Mid Atlantic Medical Services, Inc., 547 U.S. 356 (2006), was a case decided by the Supreme Court of the United States involving the ability of an Employee Retirement Income Security Act (ERISA) plan fiduciary to recover medical costs from a beneficiary who has been reimbursed for ...
e. In the United States, a health maintenance organization ( HMO) is a medical insurance group that provides health services for a fixed annual fee. [1] It is an organization that provides or arranges managed care for health insurance, self-funded health care benefit plans, individuals, and other entities, acting as a liaison with health care ...
This rule updated the definition of an investment advice fiduciary under the Employee Retirement Income Security Act and the Internal Revenue Code, according to an announcement.
American Hospital Association v. Becerra, No. 20-1114, 596 U.S. ___ (2022) The Medicare Prescription Drug, Improvement, and Modernization Act, [1] also called the Medicare Modernization Act or MMA, is a federal law of the United States, enacted in 2003. [2] It produced the largest overhaul of Medicare in the public health program's 38-year history.