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Healthcare and Pension Plans

Two specific areas of extensive federal regulatory activity concern healthcare and employee benefits. We have significant experience in litigation arising from the Medicare as Secondary Payer (MSP) statute, the federal law that coordinates the benefits of Medicare and those of private insurance plans, having represented a variety of clients affected by MSP rules. Also see our current cases page for pending MSP litigation.

We also have the capability to handle complicated benefit and fiduciary cases involving healthcare and pension plans under the Employee Retirement Income Security Act (ERISA), including cases challenging the investment of pension plan assets in employer stock. Among our achievements on the ERISA front was a settlement that secured healthcare benefits for over 20,000 non-union retirees of McDonnell Douglas Corporation.

Medicare, Insurance Law, Administrative Law, Employment

Blue Cross & Blue Shield

Mr. Cynkar, while at another firm, was part of a team representing the Blue Cross & Blue Shield Association challenging Medicare regulations promulgated under a federal statute that makes Medicare a payer secondary to private insurers in certain circumstances, and requires reimbursement of Medicare when it has improperly made a primary payment.

Mr. Cynkar successfully argued Health Insurance Association of America v. Shalala in the U.S. Court of Appeals for the DC Circuit that regulations that purported to allow Medicare to secure reimbursement from the third party administrators of insurance plans, and to ignore the claims filing deadlines in insurance contracts, was unlawful.

New York Life Insurance

Mr. Cynkar, while at another firm, was lead counsel representing New York Life in New York Life Insurance Co. v. United States, a case against the federal government to recover medical expenses of New York Life's older agents that should have been paid by Medicare. Under Medicare, employers who provide health insurance to their employees are required to pay for their older employees' medical expenses first, before Medicare.

New York Life had erroneously paid for the medical expenses of its older agents and sought reimbursement from Medicare. The Court of Appeals for the Federal Circuit held that these agents were not "employees" under the Medicare statute, so that New York Life was entitled to reimbursement. The case settled with a significant payment by the federal government to New York Life.

Healthcare and Pension Plans

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