Expert Analysis

• Health Plan Sponsors Must Inspect 3rd-Party Admin Payments

  

  A newly filed class action against Cigna spotlights issues surrounding how self-funded group health plan fiduciaries pay their third-party administrators, and the outcome could shape what plan sponsors are expected to know about such compensation structures, say attorneys at Thompson Hine.

• Justices' Intel Ruling Could Aid 401(k) Alternative Asset Push

  

  Following the U.S. Supreme Court's recent oral arguments in Anderson v. Intel, a decision favoring Intel over a prudence claim against fiduciaries based on underperformance by comparing two funds that aren't meaningfully similar would undercut the most common litigation theory against including alternative investments in 401(k) plans, say attorneys at Simpson Thacher.

• Series

  Open-Water Swimming Makes Me A Better Lawyer

  

  Swimming long distances in open waters is not necessarily an escape from my intellectual property practice, but a complementary discipline that similarly rewards sustained attention, intellectual curiosity, resilience and the ability to pursue a distant objective without losing command of the immediate task, says Christina MacDougall at Morgan Lewis.

• Opinion

  The Invisible AI Danger That May Undermine Legal Profession

  

  A public database tracking cases involving hallucinations generated by artificial intelligence recently surpassed 2,200 entries, but the bigger risk underlying attorneys’ use of such tools is that they will slowly surrender their judgment to AI and lose analytical skills, says Massachusetts District Court Associate Justice Brian Palmucci.

• What Axing ERISA Exhaustion Rule Means For Plan Sponsors

  

  The Eleventh Circuit’s recent reversal of a 40-year precedent requiring plaintiffs to exhaust administrative remedies before filing statutory Employee Retirement Income Security Act claims eliminates a common threshold defense in fiduciary breach suits, making it important for plan sponsors to reassess their internal review and litigation strategies, say attorneys at Nelson Mullins.

• DOL Association Health Plan Rule Could Cut Employer Costs

  

  The U.S. Department of Labor's proposed rule would redefine who may act as an employer for purposes of sponsoring a group health plan under the Employee Retirement Income Security Act, potentially extending cost relief to many more businesses, says W. James Hamilton at Bose McKinney.

• Defending Hospital Antisteering Clauses From DOJ Scrutiny

  

  The Trump administration has recently made clear that pursuing antitrust challenges to antisteering provisions in hospital-insurer contracts is a priority — but a review of similar cases against hospital systems and important precedent from the U.S. Supreme Court illuminates some potential defenses in such cases, says Derek Moore at Rule Garza.

• How AI Could Help Judges Spot Their Own Biases

  

  In close cases where there’s room for discretion, artificial intelligence could challenge judges’ implicit biases by running counterfactual tests at scale — but any judicial use of such tools would need guardrails, say Arnold Peter at Peter Law and Nancy Rapoport at University of Nevada.

• 3 Strategies To Reduce AI Sycophancy In Legal Work

  

  The tendency of generative artificial intelligence models to tell users what they want to hear can reinforce attorneys’ confirmation bias when testing the strength of arguments, and it can’t simply be prompted away — but a few practices can help mitigate it, says Michael Ott at Ice Miller.

• 2nd Circ. EFAA Ruling Shifts Employer Litigation Strategy

  

  In Diaz-Roa v. Hermes Law, the Second Circuit recently held that, under the Ending Forced Arbitration of Sexual Assault and Sexual Harassment Act, employers can't carve out nonharassment claims and send them to arbitration, which has implications for discovery, litigation costs and resolution strategy in EFAA-covered disputes, say attorneys at Krevolin Horst.

• Series

  Being In The Peace Corps Made Me A Better Lawyer

  

  When I served in the Peace Corps, the people of the West African village where I was stationed helped me acclimate to my new surroundings and enabled me to develop problem-solving, teamwork and empathy skills that have bolstered my legal practice far beyond the ability to offer technical advice, says Brian Bewley at McGuireWoods.

• A Nuanced Reading Of DOL's Mental Health Parity Guidance

  

  Though a recent U.S. Department of Labor bulletin may suggest that agency enforcement pressure on group health plans with respect to mental health parity is easing, the takeaways are more complex, and plan sponsors should not relax compliance efforts, say attorneys at Proskauer.

• What CMS Audit Rule Means For Medicare Advantage Plans

  

  Despite ongoing legal challenges, the Centers for Medicare & Medicaid Services is moving forward with implementation of its risk adjustment data validation audits, raising statistical concerns around overpayments indicated by variance in unbalanced samples, say Stephen Fink, Brad Rice and Igor Karagodsky at Analysis Group.

• What Lawyers Should Know Before Accepting Crypto Payment

  

  As clients increasingly request to pay legal fees, retainers and escrow funds using cryptocurrency, lawyers should consider how only a handful of state bar authorities have addressed the issue with varying ethics opinions, as well as the related questions that no authority has yet answered, says attorney Felix Shipkevich.

• Health Plan Takeaways After 2nd Circ. No Surprises Act Ruling

  

  While the Second Circuit's recent ruling in East Coast Advanced Plastic Surgery v. Cigna gives health plans breathing room in finding that healthcare providers cannot enforce out-of-network billing dispute resolution awards in court, sponsors should not assume that declining to pay awards will go unaddressed by regulators, say attorneys at Thompson Hine.