On February 1, the Centers for Medicare & Medicaid Services (CMS) published a final rule strengthening their authority to recover alleged overpayments made to Medicare Advantage plans. The rule formalizes the Medicare Advantage Risk Adjustment Data Validation (RADV), which CMS uses to risk-adjust payments made by CMS to a Medicare Advantage Organization (MAO). While legal
As previously reported here, the Federal Communications Commission (FCC) issued a proposed rule specifying that to be exempt from the Telephone Consumer Protection Act’s (TCPA) consent requirements callers would be limited to three prerecorded non-commercial, non-telemarketing, or non-profit calls per 30 days, or three calls per week (one per day) for healthcare-related calls, and
As previously reported here, the Federal Communications Commission (FCC) issued a proposed rule in December 2020 that would place new call-frequency limitations and opt-out requirements on certain prerecorded non-telemarketing calls to residential numbers that can be called without prior consent under the Telephone Consumer Protection Act (TCPA). The TCPA has long allowed unlimited prerecorded
In October 2022, the Tenth Circuit heard oral argument in D.K. et al. v. United Behavioral Health et al., a case that could significantly impact what health plans must include in any notification to claimants of an adverse benefit determination, i.e. benefit denial letters.
Under ERISA’s claims procedure regulations, there is an express list
On January 9, the district court for the Eastern District of New York dismissed a pro se plaintiff’s TCPA lawsuit for failure to properly allege that the defendants used an automatic telephone dialing system (ATDS) when placing calls to the plaintiff.
In Kannon v. Warranty Protection Services, the plaintiff alleged that the auto warranty
Allowable statutory damages under the Telephone Consumer Protection Act (TCPA) have a floor of $500 and, generally speaking, determining total damages is a simple math calculation. In the class action scenario, however, this damages number can become very significant very quickly. But a recent decision by the Ninth Circuit suggests that, in some circumstances, an
On January 3, DentalPlans.com (DentalPlans) filed a petition with the Federal Communications Commission (FCC) seeking a declaratory ruling that: (1) renewal notifications do not constitute telemarketing or advertising under the Telephone Consumer Protection Act (TCPA), and (2) the language in its online enrollment forms and used by its customer service representatives during telephone conversations with
The Federal Communications Commission (FCC) announced Tuesday that it has opened a new portal which private companies can use to report suspected robocalls and illegal call spoofing of their numbers. The portal, titled the Private Entity Robocall and Spoofing Portal, is designed to provide companies with a tool to combat spam callers using a legitimate
Do the text messages that Facebook sends to your phone with birthday reminders violate the Telephone Consumer Protection Act (TCPA)? According to the Ninth Circuit in a recent decision, the answer is no because users provided their phone numbers to Facebook and, in order to qualify as an automatic telephone dialing system (ATDS) under
On November 16, the Ninth Circuit issued a decision affirming the dismissal of a lawsuit on the grounds that to qualify as an automatic telephone dialing system (ATDS) under the Telephone Consumer Protection Act (TCPA) the telephone system must randomly or sequentially generate telephone numbers, not just any numbers.
In Borden v. eFinancial, LLC,