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Primary Care Providers Win Challenge of CMS Interpretation of Enhanced Payment Law

With the help and support of the Tennessee Medical Association, 21 Tennessee physicians of underserved communities joined together and retained Bass, Berry & Sims to file suit against the Centers for Medicare & Medicaid Services to stop improper collection efforts. Our team, led by David King, was successful in halting efforts to recoup TennCare payments that were used legitimately to expand services in communities that needed them. Read more

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Healthcare Private Equity Compliance Checklist

The complex and ever-changing healthcare regulatory and enforcement environment, including increased focus on the role of private equity firms in their portfolio companies, make compliance a top priority for private equity firms investing in healthcare companies. The best way to limit your exposure as a private equity firm is to avoid a compliance misstep in the first place. Additionally, an effective and robust compliance program for your portfolio healthcare company makes it much more attractive to potential buyers and helps you avoid an unexpected and costly investigation or valuation hit down the road. Download the Healthcare Private Equity Compliance Checklist to assess whether your portfolio company's compliance program is up-to-date.

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Labor Talk Blog: U.S. Supreme Court Rejects Sixth Circuit’s Long-Standing Presumption Treating Healthcare Benefits as Vested for Life

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February 2, 2015

Employers in Michigan, Kentucky, Ohio and Tennessee may now have more freedom to alter, reduce or eliminate healthcare benefits provided to retired union workers. On January 26, 2015, the Supreme Court in M&G Polymers USA, LLC v. Tackett unanimously decided that the Sixth Circuit's long-standing "Yard-Man" presumption violates traditional principles of contract law. 2015 U.S. LEXIS 759 (2015). Under Yard-Man, courts should presume that healthcare benefits provided to union employees are vested for the life of the retired employee unless the collective-bargaining agreement clearly states to the contrary. See United Auto Workers v. Yard-Man, Inc., 716 F.2d 1476 (6th Cir. 1983). As Justice Clarence Thomas noted, however, such a presumption distorts any attempt to ascertain the actual intent of the parties. As a result, it effectively disregards ordinary contract principles and "plac[es] a thumb on the scale in favor of vested retiree benefits in all collective-bargaining agreements." M&G Polymers, 2015 U.S. LEXIS, at *18.

This is a major win for employers. While the Court's holding does not imply a presumption in favor of employers or offer guidance to lower courts when determining whether retirees are entitled to vested lifetime benefits, the decision removes a significant hurdle for employers seeking to reduce financial liabilities to retirees. In addition, the Court specifically identified and rejected a number of arguments that union retirees could make in favor of vested health benefits. For example, the Court rejected the idea that a clause specifically limiting the duration of retiree health benefits is necessary for a court to find that the benefits are not vested. And the Court dismissed the idea that contract language tying retiree health benefits to pension benefits indicates the intent for the benefits to be vested.

For more labor and employment information, visit www.BassBerryLaborTalk.com.


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