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On the Docket: Benefits

Case Name: Association for Community Affiliated Plans (ACAP) v. U.S. Dep't of Treasury

Court: U.S. Ct. App. D.C. Cir. Docket: 19-5212

Decided: 7/17/2020

Read AARP's Amicus Brief (PDF)  and Opinion (PDF)

Case Result: The Court of Appeals for the District of Columbia, by a 2-1 vote, held that the Departments’ rule defining short-term, limited-duration insurance (STLDI) does not violate the Administrative Procedure Act. 


Case Name: ACAP v. U.S. Dep't of Treasury

Court: U.S. Dist. Ct. D.C.  Docket: 18-2133 (RJL)

Read AARP's Amicus Brief (PDF) and Press Release 

Case Result: The court held that the defendant agencies did not exceed the authority granted them by Congress in issuing the 2018 STLDI rule, and that defining STLDI as no longer than 365 days, and automatically renewable for 36 months is permissible under the law, and not inconsistent with the ACA.


Case Name:  Bagnall v. Cochran 

Court: U.S. Ct. App. 2d Circuit Docket: 20-1642

Filed: 3/5/2021

Read AARP Amicus Brief (PDF) and Article

Case Issue: Does the Secretary of the U.S. Department of Health and Human Services violate the Due Process Clause of the Fifth Amendment by denying hospitalized Medicare beneficiaries, initially classified as inpatients and later designated as outpatients under observation, an expedited due process hearing to challenge the hospital’s classification of their stay?


Case Name: Brown v. Becerra

Court: U.S. Dist. Ct. CD Cal. Docket: 21-00511

Filed: 1/19/2021 Motion for Summary Judgment: 7/20/2021, Decision 11/17/2021

Read Complaint (PDF), Press ReleaseMotion for Summary Judgment (PDF), Decision (PDF)

Case Issue: Did the Center for Medicaid and Medicare Services err when it approved provider rate cuts and bureaucratic hurdles to California’s Medicaid Plan?


Case Name: California Advocates for Nursing Home Reform (CANHRv. Smith

Court: Ct. App. State of Cal., First Appellate Div. Docket: A147987

Read AARP's Amicus Brief (PDF) and Decision (PDF)

Case Result: Court upheld California statute that permits nursing facilities to administer antipsychotic drugs to people who lack capacity, based only on what treatment team deems is appropriate. 


Case Name:  Carr v. Saul (Low-income benefits)

Court: U.S. Supreme Court Docket: 19-1442, 20-105

Decided: 4/21/2021

Read AARP Amicus Brief (PDF) and Decision (PDF)

Case Result:  Social Security disability claimants can raise constitutional challenges to the appointment of the administrative judge who heard their case in federal district court even when that issue was not raised in an administrative hearing. The result will help future claimants raise other constitutional issues in federal district court as well.


Case Name: Carroll v. City and County of San Francisco

Court: Cal. Supreme Court Docket: S259558

Decided: 1/29/2020

Read AARP's Amicus Letter (PDF)  

Case Issue: Can a public entity be held liable for age discrimination in disability retirement benefits under the California Fair Employment and Housing Act (FEHA), where the discrimination is mandated by a facially discriminatory legislative provision requiring payment of reduced retirement benefits to persons hired after age 40?

Case Result: Sought relief was achieved. California Supreme Court was urged not to review an appellate court decision favorable to the economic security of California state retirees and the Court denied review.


Case Name: California Advocates for Nursing Home Reform (CANHRv. Smith

Court: Ct. App. State of Cal., First Appellate Div. Docket: A147987

Read AARP's Amicus Brief (PDF) and Decision (PDF)

Case Result: Court upheld California statute that permits nursing facilities to administer antipsychotic drugs to people who lack capacity, based only on what treatment team deems is appropriate. 

 


Case Name:  Cochran v. Gresham; Arkansas v. Gresham

Court: U.S. Supreme Court Docket: 20-37; 20-38

Filed: 2/25/2021

Read AARP Amicus Brief (PDF) 

Case Issue: Was the Secretary of the U.S. Department of Health and Human Service’s approval of Medicaid demonstration projects in Arkansas and New Hampshire, that condition health insurance coverage on satisfying work requirements, arbitrary and capricious in violation of the Administrative Procedure Act?

 


Case Name: Divane v. Northwestern University

Court: U.S. Ct. App. 7th Cir.   Docket: 18-2569

Decided: 3/25/2020

Read AARP's Amicus Brief  and Opinion (PDF)

Case Result: The court held that fiduciaries did not breach their duties, the fees for the Plaintiffs’ investments were not too high, and offering over 200 investment options was not unreasonable. 

 


Case Name: Dorman v. Charles Schwab Corp.

Court: U.S. Ct. App. 9th Cir. Docket: 18-15281

Read AARP's Amicus Brief (PDF)

Case Issue: Should the Ninth Circuit grant rehearing en banc of its panel's ruling that employers, via arbitration contract, can strip individual 401(k) retirement plan participants of their right under ERISA to bring federal court actions for fiduciary breach on behalf of the entire plan, see 29 U.C.S. §§ 1132(a)(2) and 1109(a).


Case Name:  Driggs v. Saul

Court: U.S. Ct. App. 9th Cir. Docket: 20-16426

Decided: 11/1/2021

Read AARP Amicus Brief (PDF) 

Case Issue: Was the district court correct in holding that the nine-month marriage duration requirement could not constitutionally be applied to deny Social Security survivors benefits to a spouse when the sole reason the couple had not yet been married nine months before the wage earner’s death was that the state they lived in unconstitutionally barred same-sex marriage?

Case Result:  Defendants-Appellants voluntarily dismissed their appeal.


Case Name:  Ely v. Saul

Court: U.S. Ct. App. 9th Cir. Docket: 20-16427

Decided: 11/1/2021

Read AARP Amicus Brief (PDF) 

Case Issue:  Was the district court correct in holding that the nine-month marriage duration requirement could not constitutionally be applied to deny Social Security survivors benefits to a spouse when the sole reason the couple had not yet been married nine months before the wage earner’s death was that the state they lived in unconstitutionally barred same-sex marriage?

Case Result: Defendants-Appellants voluntarily dismissed their appeal.


Case Name: Express Scripts/Anthem ERISA Litig (In re)

Court: U.S. Ct. App. 2d Cir. Docket: 18-346

Decided: 12/7/2020

Read AARP's Amicus Brief (PDF)

Case Result: In a summary, nonprecedential order, the Second Circuit held that Anthem, as an insurance provider, and Express Scripts, as a pharmacy benefit manager, were not acting as fiduciaries  under ERISA when they negotiated prescription drug prices, even though the agreements affected an ERISA plan.


Case Name: Graff v. Heritage Manor of Slidell

Court: U.S. Dist. Ct. ED La.    Docket: 17-cv-06812

Read Article and Press Release

Case Result Comment: The parties jointly dismissed the case because the client died; however,  the lawsuit as initiated by AARP Foundation was instrumental in the enactment of the legislation on the placement of video cameras in nursing facility residents' rooms. 


Case Name:  Haley v. TIAA

Court: U.S. Ct. App. 2d Cir. Docket: 21-805

Filed: 10/18/2021

Read AARP Amicus Brief (PDF) 

Case Issue: Can an exploitative loan program used by many employee benefit plans be challenged on a classwide basis?


Case Name: Hartshorne  v. The Roman Catholic Diocese of Albany, New York

Court: New York Supreme Ct., Schenectady County   Docket: 2019-1989

Watch Video and Read Complaint (PDF), Press ReleaseCorp Opposition Brief (PDF), Church Opposition Brief (PDF) Decision/Order (PDF) and Press Release

Case Issue: Did the Defendants, including the Roman Catholic Diocese of Albany, violate New York state laws concerning contracts, promises, and fiduciaries when they either stopped paying or drastically reduced the pensions of former employees of St. Clare's Hospital?


Case Name:  Howard Jarvis Taxpayers' Ass'n v. California Secure Choice Retirement Sav. Prog.

Court: U.S. Ct. App. 9th Cir. Docket: 20-15591

Read AARP Brief (PDF),  Article, and Opinion (PDF)

Decided: 5/7/2021

Case Result: The Ninth Circuit panel unanimously held that ERISA does not preempt the CalSavers program because the program does not relate to an employee benefit plan, but is a state-established and maintained savings program.


Case Name: Hughes v. Northwestern Univ. 

Court: U.S. Supreme Court Docket: 19-1401

Read AARP Amicus Brief (PDF)

Filed: 9/10/2021

Case Issue: Is including a fund with excessively high fees a breach of fiduciary duty in an employee benefit plan?


Case Name: Indep. Insur. Agents and Brokers v. N.Y.

Court: New York Supreme Court Appellate Division—Third Department Docket: 530047

Read AARP Brief (PDF)

Filed: 8/10/2020

Case Issue: Is New York’s Suitability and Best Interest Rule, which requires insurance agents and brokers to act in the best interests of consumers, a valid regulation?


Case Name: Intel v. Sulyma

Court: U.S. Supreme Court Docket: 18-1116

Decided: 2/26/2020

Read AARP's Amicus Brief (PDF)  

Case Result: The Court, per Justice Alito, held that receiving ERISA disclosures did not automatically mean that the participant had "actual knowledge" of a breach of fiduciary duty, so the three-year statute of limitations did not apply. 


Case Name: Jammal v. Am. Family Insurance

Court: U.S. Ct. App. 6th Cir.  Docket: 20-3226

Filed: 6/10/2020

Read Amicus Brief (PDF)  

Case Issue: Was the district court correct in its initial finding that American Family treated its insurance agents as employees?


Case Name: Jammal v. Am. Family Ins. 

Court: U.S. Ct. App. 6th Cir.     Docket: 17-4125

Read AARP's Amicus Brief (PDF)

Case Issue: Was the district court correct in finding that American Family treated its insurance agents as employees?


Case Name: Lake v. State Health Plan

Court: North Carolina Supreme Court Docket: 436 PA 13-4

Filed: 6/29/2020

Read AARP's Amicus Brief (PDF) 

Case Issue: Is the health insurance benefit North Carolina promised to state and municipal retirees a form of deferred compensation?


Case Name: National Consumer Voice  v. Becerra, U.S. Dep't Health and Human Services 

Court: U.S. Dist. Ct. D.C. Docket: 21-162

Filed: 1/18/2021

Read Complaint (PDF), Opening Press ReleaseArticle, NYT: Abelson ArticlePress Release (7/28/2021, CMS reversal on penalties)

Case Issue: Can CMS and HHS change the structure of enforcement by imposing only per instance fines instead of per day fines for nursing facilities who violate the Nursing Home Reform Act but correct that noncompliance prior to state survey agencies reviewing their compliance?


Case NameStephanie Price v. Shibinette

Court: U.S. Dist. Ct. New Hampshire Docket: 21-00025

Filed: 1/11/2021

Read Complaint (PDF), Press ReleaseArticleDecision on Motion to Dismiss (PDF), Press Release on Motion to Dismiss, Article on Motion

Case Issue: Does the failure of the New Hampshire Department of Health and Human Services to provide personal care and other services to people with disabilities under the state’s Choices for Independence Waiver program, that puts them at risk of needing to be institutionalized, violate the Americans with Disabilities Act or other federal law?


Case Name: Rutledge v. Pharmacy Care Management Assn.

Court: U.S. Supreme Ct.  Docket: 18-450

Decided: 12/10/2020

Read AARP's Amicus Brief  (PDF) and Opinion (PDF)

Case Result:  The Supreme Court unanimously ruled that ERISA does not preempt Arkansas’ PBM transparency law.

Case Issue: Many states have passed laws regulating health care market players to address rising health care costs. Does ERISA, the federal law that protects employee benefits, say that states can't do this because the state laws could potentially affect employee benefit plans in some remote way?


Case Name:  Schmoll v. Saul

Court: U.S. Ct. App. 9th Cir. Docket: 20-16445

Decided: 11/1/2021

Read AARP Amicus Brief (PDF) 

Case Issue:  Was the district court correct in holding that the nine-month marriage duration requirement could not constitutionally be applied to deny Social Security survivors benefits to a spouse when the sole reason the couple had not yet been married nine months before the wage earner’s death was that the state they lived in unconstitutionally barred same-sex marriage?

Case Result: Defendants-Appellants voluntarily dismissed their appeal.


Case Name: Single v. Catholic Pioneer Church Homes

Court: Superior Ct., State of Cal., County of Sacramento    Docket: 2017-00220058

Read Decision Ruling (4/15/2021), Press Release, Original Press Release, and Complaint (PDF) 

"Her Son Says She Was a Victim of Nursing Home Dumping," by Jessica Ravitz, the case story about Gloria Single. Read

Case Issue: Can a nursing facility refuse to readmit a resident who has exercised her administrative due process rights and won the right to readmission?


Case Name:  Smith v. Board of Directors of Triad Manufacturing (Employee Benefits)

Court: U.S. Ct. App. 7th Cir. Docket: 20-2708

Decided: 9/10/2021

Read AARP Amicus Brief (PDF) and Decision (PDF)

Case Result: The Seventh Circuit affirmed the district court’s denial of the Defendants’ motion to compel arbitration or, in the alternative, to dismiss.


Case Name: Talevski v. Health and Hosp. Corp.

Court: U.S. Ct. App. 7th Cir. Docket: 20-1664

Read AARP Brief (PDF) and Decision (PDF)

Decided: 7/27/2021

Case Result: The Seventh Circuit ruled that the federal Nursing Home Reform Act creates a private right of action under Section 1983 of the Civil Rights Act to enforce a violation of resident’s right to be free of chemical restraints and illegal discharges.


Case Name: Teets v. Great-West

Court: U.S. Ct. App. 10th Cir. Docket: 18-1019

Read AARP's Amicus Brief (PDF) and Decision

Case Result: Appellate court upheld the district court's dismissal of plaintiff's ERISA claims on the basis that Great West was not acting as a fiduciary.


Case Name: Thole v. U.S. Bank

Court: U.S. Supreme Court Docket: 17-1712

Read AARP's Amicus Brief (PDF)

Case Result: The Court held that when fiduciary misconduct is not likely to affect a defined benefit plan participant’s actual receipt of benefits, the participant has no standing under ERISA, even though the statute creates a right of action for such a lawsuit.


Case Name: U.S. ex rel Ruckh v. CMC II, LLC

Court: U.S. Ct. App. 11th Cir.  Docket: 18-10500D

Decided: 6/25/2020

Read AARP's Amicus Brief (PDF) and Opinion (PDF)

Case Result: The Eleventh Circuit reversed the district court’s decision in part and remanded the case to reinstate the jury’s $85 million verdict. It found that billing discrepancies and upcoding were material to the government’s decision to pay Medicare claims and sufficient to prove Medicare fraud. The Court also affirmed the part of the district court’s decision that denied the Medicaid claims.


Case Name: Whitman Walker Clinic v. U.S. Dep't of Health and Human Services

Court: U.S. Dist Ct. D.C. Docket: 20-1630

Decided: 9/2/2020

Read AARP's Amicus Brief (PDF), Press ReleaseOpinion (PDF), Article

Case Result: The district court for the District of Columbia enjoined HHS from implementing the provisions of the rule that would have eliminated discrimination based on sex stereotypes from the definition of discrimination on the basis of sex, and incorporated Title IX’s exemption of certain religious organizations from Section 1557. 


Case Name: United States v. Vaello-Madero (Public Benefits)

Court: U.S. Supreme Court Docket: 20-303

Read AARP Amicus Brief (PDF)

Filed: 9/3/2021

Case Issue: Did Congress violate the equal-protection rights of  Puerto Rico's residents by categorically excluding them from the Supplemental Security Income Program?


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