Author: National Law Forum

A group of in-house attorneys developed the National Law Review on-line edition to create an easy to use resource to capture legal trends and news as they first start to emerge. We were looking for a better way to organize, vet and easily retrieve all the updates that were being sent to us on a daily basis.In the process, we’ve become one of the highest volume business law websites in the U.S. Today, the National Law Review’s seasoned editors screen and classify breaking news and analysis authored by recognized legal professionals and our own journalists. There is no log in to access the database and new articles are added hourly. The National Law Review revolutionized legal publication in 1888 and this cutting-edge tradition continues today.

CMS Releases its CY 2012 OPPS Final Rule

Posted recently in  the National Law Review by Scott J. Thill of von Briesen & Roper, S.C.  regarding  CY 2012 Outpatient Prospective Pzyment System:

 

CMS has released its CY 2012 Outpatient Prospective Payment System (OPPS) Final Rule, effective January 1, 2012.  Notable provisions of the Final Rule include:

  • A market basket update of 1.9%.
  • Adjustment to payment rates for certain cancer hospitals.
  • A process for the APC Panel to evaluate requests for alternative supervision levels for hospital outpatient therapeutic services and issue recommendations to CMS on the same.
  • The addition of three quality measures for hospital outpatient departments to report for purposes of the CY 2014 and CY 2015 payment determinations.  The new measures include: (i) a measure relating to cardiac rehabilitation patient referrals; (ii) a measure relating to the use of a safe surgery checklist; and (iii) a measure relating to hospital outpatient department volume for selected surgical procedures.
  • A reduction in the number of randomly selected hospitals (from 800 to 450) for validating hospital outpatient quality reporting data for the CY 2013 payment determination.
  • Revisions to the hospital value-based purchasing program.
  • A process for physician-owned hospitals to apply for an exception to the federal prohibition on expanding facility capacity in physician-owned hospitals.

Intervening Rights Can Apply to an Original Claim Based on Arguments Made During Reexamination

Recently posted in the National Law Review an article by Cynthia Chen, Ph.D. of McDermott Will & Emery  regarding the U.S. Court of Appeals for the Federal Circuit’s decision to grant injunction and reasonable royalty damages for patent infringement:

 

In reversing and vacating a district court’s decision to grant injunction and reasonable royalty damages for patent infringement, the U.S. Court of Appeals for the Federal Circuit held that intervening rights can apply to an original claim based on arguments made by the patentee during reexamination.   Marine Polymer Technologies, Inc. v. HemCon, Inc., Case No. 10-1548 (Fed. Cir., Sept. 26, 2011) (Dyk, J.) (Lourie, J., dissenting).  Intervening rights typically occur where the scope of coverage of a patent changes during reexamination.

Marine Polymer sued HemCon for infringing its patent claiming a biocompatible polymer.   In the ensuing litigation, the district court construed the term “biocompatible” as meaning polymers “with no detectable biological reactivity as determined by biocompatibility tests.”  Meanwhile, in the parallel reexamination proceeding, the examiner construed the term “biocompatible” as meaning polymers with “little or no detectable reactivity” reasoning that certain dependent claims recited a biocompatibility test score that is greater than zero.  Marine Polymer urged the examiner to adopt the district court’s claim construction and canceled all dependent claims reciting a biocompatibility test score greater than zero.  In view of the cancellation of those dependent claims, the examiner adopted the district court’s claim construction, and the remaining claims were issued.

In this appeal from the district court (where HemCon was subjected to a $29 million dollar damages award against it), HemCon argued that it was entitled to intervening rights because Marine Polymer changed the scope of the claims of the asserted patent during reexamination.  Marine Polymer, contended that intervening rights cannot apply because the actual language of the asserted claims was not amended during reexamination.

The Federal Circuit agreed with HemCon and held that Marine Polymer indeed narrowed the scope of the claims by “argument rather than changing the language of the claims to preserve otherwise invalid claims.”   Noting that intervening rights are available if the original claims have been “substantively changed,” the Court emphasized that “in determining whether substantive changes have been made, we must discern whether the scope of the claims [has changed], not merely whether different words are used.”  In particular, those dependent claims that were canceled during reexamination indicated that “the term ‘biocompatible’ must include slight or mild biological reactivity.”  As such, the district court’s claim construction, which required that the polymer show “no detectable biological reactivity,” imposed a new claim limitation that narrowed the scope of the claims. Therefore, intervening rights did apply in this case, as “argument to PTO on reexamination constituted disavowal of claim scope even though ‘no amendments were made.’”

Judge Lourie dissented and argued that the majority went beyond the statutory rules for intervening rights under 35 U.S.C. §§ 307(b) and 316(b).   Judge Lourie believes that, according to the language of the statute, intervening rights should only apply to “amended or new claims.”

Practice Note:   Post-grant proceedings could be a pitfall for patentees seeking to enforce their patents.  A patentee should consider whether it would be better off filing a continuing application before grant of the original patent to leave a vehicle to present new or amended claims.

© 2011 McDermott Will & Emery

Q&A / Fee Disclosure Requirements Top the List of Issues Facing Retirement Plan Sponsors

 Recently posted in the National Law Review an article by  f Much Shelist Denenberg Ament & Rubenstein P.C.  Much Shelist spoke toNorman D. Schlismann (Senior Managing Director) and David H. Dermenjian (Senior Vice President) in the Retirement Plan Advisory Group about current issues facing 401(k) plan sponsors.

 

In today’s turbulent economy, 401(k) defined-contribution plans are under the microscope. Plan participants and government agencies are scrutinizing every element of retirement plans, paying special attention to the fiduciary responsibilities of plan sponsors and the fees being paid to their service providers. As a diversified financial services firm, Mesirow Financial provides a broad range of asset management, investment advisory, broker-dealer and consulting services to institutions and private clients worldwide. Much Shelist spoke toNorman D. Schlismann (Senior Managing Director) and David H. Dermenjian (Senior Vice President) in the Retirement Plan Advisory Group about current issues facing 401(k) plan sponsors.

Much Shelist: What have been some of the primary effects of the economic crisis on employer-sponsored retirement plans and 401(k) plans in particular?

David Dermenjian: Perhaps the greatest effect of the global economic situation is that everyone—from individual plan participants to plan sponsors, investment fund managers and regulatory officials—is looking more closely at fund performance, employee education and the administrative and other costs associated with these plans. This is quite understandable; over the past several years, virtually every retirement plan has experienced at least a temporary decline in value.

Individual plan participants, including employees and executives, tend to focus on the range of funds available in their plans, as well as fund performance and minimizing costs. Plan sponsors are typically interested in ensuring that they are fulfilling their fiduciary responsibilities and limiting potential liability. Government regulators want to protect individuals against unnecessary losses by stepping up their use of audits and investigations to uncover and correct potential irregularities in financial reporting, self-dealing or the occasional misuse of employee contributions. Ultimately, all of these steps are being taken in pursuit of the same goal: to help employees make wise decisions regarding their retirement assets and preserve value to the maximum extent possible.

Norm Schlismann: Education is the centerpiece of these efforts. By providing in-person counseling and seminars, online webinars and printed materials that clearly describe the various fund options, rules and fees, employers can help employees make more informed decisions, and plan sponsors can be sure they are meeting their fiduciary obligations.

One example of how education can help is in the area of target-date retirement funds. Typically, these funds are built around an estimated retirement year, say 2030. As the target date approaches and participants near their expected retirement, the fund will shift into a more conservative investment mode, often moving assets from stocks into bonds and money market instruments. What many people don’t realize, however, is that target-date funds may appear to be similar but are actually based on different assumptions. A “to-date” fund assumes that participants will withdraw all of their assets upon retirement, whereas a “through-date” fund assumes that smaller withdrawals will occur over time, perhaps on a monthly basis. Since through-date funds assume that assets will remain in the fund even after retirement, they may take a more risky approach to investment allocations.

MS: Fee disclosures have received significant attention of late. Briefly, what are they?

DD: The concept of fee disclosures has been floating around for a while, but the final rule—described under ERISA Section 408(b)2—will go into full effect April 2012. Under the rule, retirement plan fiduciaries must ensure that “reasonable fees” are being paid to providers for “reasonable services.” Fiduciaries must also obtain information sufficient to enable them to make informed decisions about the costs associated with these providers and must disclose this information to plan participants.

Typical information contained in a disclosure includes benchmarking data (comparing the fees associated with a particular fund or retirement plan to other, similar funds or plans) and fee structures. It’s important to note that higher fees are not necessarily unreasonable. Some providers offer a higher level of service—one-on-one employee counseling, real-time access to complete fund reports, etc.—which can justify the higher costs to participants.

NS: Clarity and transparency are the watchwords of disclosures. For this reason, disclosures should often include information beyond simple fee information. For example, disclosures should also include an assessment of the independence of—and potential conflicts between—service providers, as well as possible conflicts between service providers and fiduciaries. Revenue sharing and finders fees are typical areas of concern.

MS: To that point, what is the difference between a plan fiduciary and a service provider?

NS: Plan fiduciaries are individuals or groups of individuals who use their own judgment in administering and managing the plan or who have the power to actually control the plan’s assets. Service providers, on the other hand, execute the instructions of plan fiduciaries; they may include plan recordkeepers, administrators, custodians, advisors and other financial or investment professionals engaged to operate retirement plans or provide guidance with respect to the plans.

In some cases, a service provider may also act in the role of a fiduciary. For example, a broker-dealer, whose responsibility to the client for suitability and appropriateness of a recommendation ends the moment a sale is made, could be considered a service provider but not a fiduciary. A registered investment advisor, who may be involved in the recommendation of a particular investment option to the plan and who may continue to provide guidance over the life of an investment, is considered both a service provider and a fiduciary.

MS: Where can plan sponsors find the information they need to make proper disclosures?

DD: That’s the $64,000 question! While it is getting easier to obtain this information, plans and their cost structures have grown more complex over the years. Understanding exactly what the data is telling you, vis-à-vis your own plans, can be difficult. This is where the assistance of experienced financial professionals is critical.

In terms of accessing information, the trend today is toward a more open plan architecture, which makes it easier to find the required data. Similarly, a number of third-party providers offer benchmarking data and analytics. Other companies, such as Fi360, offer a more comprehensive range of resources, tools and training to help fiduciaries fulfill their duties.

However, as we’ve already noted, it is often in the best interests of fiduciaries to obtain the services of an experienced investment advisor and fiduciary consultant. In doing so, independence is probably the most important consideration. Consultants should also have proven tools and procedures that enable them to conduct a fiduciary audit (including a detailed analysis) and provide evidentiary documentation in the process.

MS: How do I know if I need this type of fiduciary audit?

NS: The easy answer is that all plan sponsors need information, and they need to fully understand how that information applies to their unique combination of employer-sponsored retirement plans and services. That said, a number of companies—especially small and mid-sized businesses—have let their plans go “dormant” over the years, acting as if nothing has changed. If you can’t clearly articulate your fiduciary process, then you probably don’t have one! And, you are probably at greater risk of failing a Department of Labor audit of your plan.

Plan sponsors may also be concerned about the cost of a consultant. However, the money spent on the services of an experienced consultant is often considerably less than the savings recouped once the plan sponsor has actionable information. The likelihood increases over time that your retirement plan is spending too much on administrative and management fees. We advise plan sponsors to benchmark their plans against comparable averages annually and benchmark against other providers in the market every few years.

The bottom line? Plan sponsors are in a better position to fulfill their fiduciary responsibilities, and lower costs mean that more money is preserved in participants’ accounts—which can result in improved returns over time.

For more information on this topic, contact Norm Schlismann (nds@mesirowfinancial.com) or Dave Dermenjian (dhd@mesirowfinancial.com).

This article contains material of general interest and should not be construed as legal advice or a legal opinion on any specific facts or circumstances. Under professional rules, this content may be regarded as attorney advertising.

© 2011 Much Shelist Denenberg Ament & Rubenstein, P.C.

ABA Conference: Criminal Tax Fraud and Tax Controversy

The National Law Review wanted to bring your attention to the upcoming 28th Annual National Institute on Criminal Tax Fraude and the Fisrt National Institute on Tax Controversy on December 1-2, 2011 in Las Vegas:

  • Program Description

The  National Institute on Criminal Tax Fraud is the annual gathering of the criminal tax defense bar.  This year, it will be combined with the National Institute on Tax Controversy, bringing together high-level Government representatives, judges, corporate counsel, and private practitioners engaged in all aspects of tax controversy, tax litigation, and criminal tax defense.

The two Institutes will meet each morning of the conference in joint plenary sessions, addressing issues concerning international tax enforcement and ethics.  Participants will then chose break- out sessions that will focus on current civil tax controversy or criminal tax defense topics.

As in past years, these Institutes will offer the most knowledgeable panelists from the government, the judiciary, and the private bar.  Attendees will include attorneys and accountants just beginning to practice in tax controversy and tax fraud defense, as well as highly experienced practitioners.  The break-out sessions will encourage an open discussion of hot topics.  The program will provides valuable updates on new developments and strategies, along with the opportunity to meet colleagues, renew acquaintances and exchange ideas.

The IRS has focused on international enforcement, from its reorganization of its Large Business and International Division to its focus on global high wealth taxpayers and offshore activities, and both Institutes will focus on these issues, in a combined plenary session and in break-out sessions.  The break-out sessions will also include roundtable discussions with senior representatives from the IRS, and the Treasury and Justice Departments, and panels will focus on topics ranging from the nuts-and-bolts of representing clients in examination, at Appeals, at trial and in criminal investigations, to the hottest areas of civil and criminal enforcement.  It promises to be a program that no tax litigator should miss.

  • CLE Information

ABA programs ordinarily receive Continuing Legal Education (CLE) credit in AK, AL, AR, AZ, CA, CO, DE, FL, GA, GU, HI, IA, ID, IL, IN, KS, KY, LA, ME, MN, MS, MO, MT, NH, NM, NV, NY, NC, ND, OH, OK, OR, PA, RI, SC, TN, TX, UT, VT, VA, VI, WA, WI, WV, and WY. These states sometimes do not approve a program for credit before the program occurs. This course is expected to qualify for TBD CLE credit hours (including TBD ethics hours) in 60-minute-hour states, and TBD credit hours (including TBD ethics hours) in 50-minute-hour states. This transitional program is approved for both newly admitted and experienced attorneys in NY. Click here for more details on CLE credit for this program.

How Lessors and Lenders Can Audit the Eurocontrol Accounts of Lessees

Recently posted in the National Law Review an article by attorney John I. Karesh of Vedder Price P.C. regarding  lessors will no longer receive an aircraft operator’s statement of account from Eurocontrol via e-mail.

Eurocontrol has implemented a change to the way lessors, lenders and security trustees can audit the Eurocontrol accounts of lessees. Effective September 1, 2011, lessors will no longer receive an aircraft operator’s statement of account from Eurocontrol via e-mail. In an attempt to provide better security, Eurocontrol will now provide such statements only upon the lessor’s request via a secured extranet system called CEFA (Central Route Charges Office Extranet for Airspace Users). We have been advised by Eurocontrol that lenders and security trustees also will be granted access to CEFA under the same protocol. In order to gain access, the requesting party needs to complete an Agreement (available on Eurocontrol’s website). Once the Agreement is completed and received by Eurocontrol, the requesting party can view an operator’s statement of account online 24/7. Access is free. However, requesting parties must obtain approval from each operator whose statement of account they wish to view by having the operator sign an Authorization Letter in the prescribed form.

Because lenders and lessors must execute the Agreement, they should take note that the Agreement contains various noteworthy provisions including the following: Article 4 provides that to the extent permitted by national law, in the event of a dispute, Eurocontrol’s data, including metadata, shall be admissible in court and shall constitute evidence of the facts contained therein unless contrary evidence is adduced. Section 9.2 provides that once a statement of account becomes available on CEFA, it shall be deemed received by the “Leasing Company,” which agrees to proactively and regularly check the CEFA site. Article 13 contains various provisions concerning confidentiality and protection of data. Section 14.2 requires the Leasing Company to indemnify Eurocontrol against any claims for damages made by third parties where the claims or damages are due to a fault of the Leasing Company. Article 15 provides that without prejudice to any mandatory national law, the transmission of electronic data under the Agreement shall be governed by Belgian law. Article 16 provides that any dispute arising out of or in connection with the Agreement shall be referred to the Brussels Court of First Instance (Belgium), which shall have sole jurisdiction.

Also, Section 17.3 provides that the Agreement is for an indefinite period, but either party may terminate it on not less than three months’ written notice, and that Eurocontrol is entitled to terminate or suspend the Agreement in a case foreseen under the confidentiality and protection of data provisions (Section 13.1) or if all authorizations to release Statements of Account to the lessor have been withdrawn. Section 17.4 provides that access to the Statements of Account of an Aircraft Operator will be terminated without notice in case of the withdrawal of the authorization to release such Statements of Account. However, the prescribed form of Authorization Letter provides that it may only be revoked or amended by written instructions from the operator and lessor.

The foregoing is merely a summary of a few of the provisions of the Agreement. All provisions should carefully be reviewed before signing. However, it appears the only way lessors, lenders and security trustees can obtain the statement of an operator’s account is by means of the Authorization Letter and signed Agreement.

© 2011 Vedder Price P.C.

Under The Radar–The Supreme Court, Commercial Speech and the First Amendment

Recently posted in the National Law Review an article by attorney  Charles M. English of Ober | Kaler regarding U.S. Supreme Court’s  view of the First Amendment as applied especially to political speech:

Ober

Over the past several years, a great deal has been written about the .  In both the 2010 and 2011 terms the Court in dramatic and well-publicized cases struck down federal (Citizens United) and state (Arizona Free Enterprise Club’s Freedom PAC) campaign finance restrictions as applied to corporate political donations and laws supporting public financing of candidates who forgo private donations.  These are of course significant, far-reaching decisions with major impacts on political discourse in the United States.  But even more may be going on in First Amendment jurisprudence when one looks beyond the headline-grabbing cases to less well publicized commercial speech cases.

More often than not the Court moves not dramatically, but in incremental steps as both the law and the Justices evolve and the Court personnel change.   Such an incremental step appears to have been taken by the Court this year with respect to commercial speech regulation – speech intended not for political discourse, but by commercial entities seeking to buy, sell, advertise, market or provide information to each other and consumers.

On June 23, 2011, the Court, in a 6-3 majority, issued Sorrell v. IMS Health, Inc.,No. 10-779, striking down on First Amendment grounds Vermont’s law that prohibited the sale and use of physician prescription data for commercial purposes especially by pharmaceutical companies wishing to use that data to advertise and otherwise reach out to physicians in order to market their drugs.  Having monitored the case closely and attended the Court’s oral argument, I don’t think that the result itself was much of a surprise.  The Court concluded that the regulated activity interfered with the exchange of ideas and was thus speech and then concluded that the protected speech could not be regulated by Vermont in the fashion proposed.

What to many observers was less predictable was the breadth of the decision and the language employed in the majority opinion written by Justice Anthony Kennedy and joined both by the four justices normally considered “conservative”, but also joined by Justice Sonia Sotomayor.  The majority appears to have applied a stricter standard to the “content and speaker-based” commercial speech restrictions than it has applied in the past.  So the question arises: Is the Court moving, however incrementally, towards a change in how it treats commercial speech under the First Amendment – one that would increase the level of scrutiny applied to restraints on such speech?

While Sorrell received far less coverage than many of other cases decided by the Court in the 2011 Term, commercial speech proponents have been quick to embrace the decision and to assert broader commercial speech rights.  After the Food and Drug Administration adopted new cigarette warning label requirements in the summer of 2011, R.J. Reynolds, together with other tobacco companies and supported by national advertising organizations, were quick to seek court intervention against the new warning label requirements. They relied in no small part on the expansive language found in Sorrell.  That suit, filed in mid-August, is set for a decision on motions for a preliminary injunction and summary judgment after a hearing before Judge Richard Leon in the U.S. District Court for the District of Columbia on September 21, 2011.

To understand where the Court may be heading, it is important first to know where we have been.  While the First Amendment, which is also applicable to the States, might appear to the casual reader to be absolute  – “Congress shall make no law . . . abridging the freedom of speech. . .”, it in fact has not been so regarded historically by the Court.  In 1942, the Court declared that commercial speech was not protected by the First Amendment at all.  The Court reversed course in 1976, declaring that some form of intermediate protection did exist for commercial speech, and established in 1980 a multi-part test (Central Hudson) for evaluating the constitutionality of commercial speech restrictions:  In order to regulated non-misleading commercial speech regarding otherwise legal activity, the government must establish that there is a substantial state interest, that the regulation directly advances that state interest, and that the regulation is narrowly tailored to advance that substantial interest.

It doesn’t take a lawyer to conclude that this test is confusing, and not surprisingly, most observers from a wide array of the political spectrum have concluded that the results of the cases decided under Central Hudson are unpredictable and that the test is simply unworkable.  Importantly, Justice Clarence Thomas has repeatedly criticized the Court’s commercial speech jurisprudence directly, with some indirect support from others from the Court’s so-called conservative wing.

The majority in Sorrell certainly did not overrule (at least not expressly or entirely)Central Hudson.  However, the majority opinion , however subtly, appears to provide a measurable shift in the First Amendment analysis by the Court by carving out in commercial speech cases types of restrictions to which the majority appears to provide some form of scrutiny greater than the protections found in theCentral Hudson test.   Indeed and perhaps most tellingly the minority opinion written by Justice Stephen Breyer accuses the majority of having created a new test, stricter than Central Hudson, for content-based or speaker-based speech that undermines the differentiation of commercial speech from what is often called core First Amendment speech.  If so, the court may have indirectly moved towards Justice Thomas’ assertion that commercial speech should not be treated differently from core speech.

In the short run, we should expect the decision in Sorrell to actually add to the confusion that surrounds Central Hudson.  Will lower courts such as the one now presented with the cigarette warning dispute conclude that there is a new, higher standard?  If so, in which cases will this new standard apply, and how will those cases be decided?  This is not an academic or legalistic point.  Both business and government thrive on certainty in results, and legal uncertainty is simply very expensive for everyone:  When states lose these First Amendment cases, they normally must pay the attorneys’ fees to the prevailing party; meanwhile, businesses subject to regulation of uncertain legality incur costs in complying and challenging such regulation.  Nobody benefits from this kind of uncertainty – well, except for the lawyers of course.

Of course, we may not have long to wait after all.  The case of the FDA regulation of cigarette packaging,  or possible other cases involving other governmental regulation of health-care claims or of health insurance, or new food safety regulation – any one of these could give rise to litigation that provides new guidance, clarity or even another incremental step.  However, when one goes back to the text of the First Amendment and its absolute prohibition on abridging the freedom of speech, examines the Court’s recent dramatic political speech cases in the past two terms, considers the muscular conservative majority, and carefully reads between the lines of Sorrell (decided with six votes in the majority), one must conclude that we are in for interesting times, and that advocates of commercial speech restrictions, including anti-smoking advocates, may now face a greater uphill battle in defending and maintaining what have come to be accepted restrictions in marketing and advertising in the United States.

© 2011 Ober | Kaler

 

 

Second Circuit's Citigroup Decision Endorses Presumption of Prudence, Upholds Dismissal of Disclosure Claims

Posted this week at the National Law Review by Morgan, Lewis & Bockius LLP regarding the decision that employer stock in a 401(k) plan is subject to a “presumption of prudence” that a plaintiff alleging fiduciary breach:

 

 

 

In a much-anticipated decision, the U.S. Court of Appeals for the Second Circuit joined five other circuits in ruling that employer stock in a 401(k) plan is subject to a “presumption of prudence” that a plaintiff alleging fiduciary breach can overcome only upon a showing that the employer was facing a “dire situation” that was objectively unforeseeable by the plan sponsor. In re Citigroup ERISA Litigation, No. 09-3804, 2011 WL 4950368 (2d Cir. Oct. 19, 2011). The appellate court found the plaintiffs had not rebutted the presumption of prudence and so upheld the dismissal of their “stock drop” claims.

BACKGROUND

The Citigroup plaintiffs were participants in two 401(k) plans that specifically required the offering of Citigroup stock as an investment option. The plaintiffs alleged that Citigroup’s large subprime mortgage exposure caused the share price of Citigroup stock to decline sharply between January 2007 and January 2008, and that plan fiduciaries breached their duties of prudence and loyalty by not divesting the plans of the stock in the face of the declines. The plaintiffs further alleged that the defendants breached their duty of disclosure by not providing complete and accurate information to plan participants regarding the risks associated with investing in Citigroup stock in light of the company’s exposure to the subprime market. On a motion to dismiss, the district court found no fiduciary breach because the defendants had “no discretion whatsoever” to eliminate Citigroup stock as an investment option (sometimes referred to as “hardwiring”). Alternatively, the lower court ruled that Citigroup stock was a presumptively prudent investment and the plaintiffs had not alleged sufficient facts to overcome the presumption.

SECOND CIRCUIT DECISION

Oral argument in the Citigroup case occurred nearly a year ago, and legal observers have been anxiously awaiting the court’s ruling. In a 2-1 decision, with Judge Chester J. Straub issuing a lengthy dissent, the Second Circuit rejected the “hardwiring” rationale but confirmed the application of the presumption of prudence, which was first articulated by the Third Circuit in Moench v. Robertson, 62 F.3d 553 (3d Cir. 1995). The court also rejected claims that the defendants violated ERISA’s disclosure obligations by failing to provide plan participants with information about the expected future performance of Citigroup stock.

Prudence

Joining the Third, Fifth, Sixth, Seventh, and Ninth Circuits,[1] the court adopted the presumption of prudence as the “best accommodation between the competing ERISA values of protecting retirement assets and encouraging investment in employer stock.” Under the presumption of prudence, a fiduciary’s decision to continue to offer participants the opportunity to invest in employer stock is reviewed under an abuse of discretion standard of review, which provides that a fiduciary’s conduct will not be second-guessed so long as it is reasonable. The court also ruled that the presumption of prudence applies at the earliest stages of the litigation and is relevant to all defined contribution plans that offer employer stock (not just ESOPs, which are designed to invest primarily in employer securities).

Having announced the relevant legal standard, the court of appeals dispatched the plaintiffs’ prudence claim in relatively short order. The plaintiffs alleged that Citigroup made ill-advised investments in the subprime market and hid the extent of its exposure from plan participants and the public; consequently, Citigroup’s stock price was artificially inflated. These facts alone, the court held, were not enough to plead a breach of fiduciary duty: “[T]hat Citigroup made a bad business decision is insufficient to show that the company was in a ‘dire situation,’ much less that the Investment Committee or the Administrative Committee knew or should have known that the situation was dire.” Nor could the plaintiffs carry their burden by alleging in conclusory fashion that individual fiduciaries “knew or should have known” about Citigroup’s subprime exposure but failed to act. Relying on the Supreme Court’s decision in Bell Atlantic Corp. v. Twombly, 550 U.S. 544 (2007), the court of appeals held these bald assertions were insufficient at the pleadings stage to suggest knowledge of imprudence or to support the inference that the fiduciaries could have foreseen Citigroup’s subprime losses.

Disclosure

The court’s treatment of the disclosure claims was equally instructive. Plaintiffs’ allegations rested on two theories of liability under ERISA: (1) failing to provide complete and accurate information to participants (the “nondisclosure” theory), and (2) conveying materially inaccurate information about Citigroup stock to participants (the “misrepresentation” theory).

As to the nondisclosure theory, the court found that Citigroup adequately disclosed in plan documents made available to participants the risks of investing in Citigroup stock, including the undiversified nature of the investment, its volatility, and the importance of diversification. The court also emphasized that ERISA does not impose an obligation on employers to disclose nonpublic information to participants regarding a specific plan investment option.

Turning to the misrepresentation theory, the court found plaintiffs’ allegations that the fiduciaries “knew or should have known” about Citigroup’s subprime losses, or that they failed to investigate the prudence of the stock, were too threadbare to support a claim for relief. Though plaintiffs claimed that false statements in SEC filings were incorporated by reference into summary plan descriptions (SPDs), the court found no basis to infer that the individual defendants knew the statements were false. It also concluded there were no facts which, if proved, would show (without the benefit of hindsight) that an investigation of Citigroup’s financial condition would have revealed the stock was no longer a prudent investment.

IMPLICATIONS

Coming from the influential Second Circuit, the Citigroup decision represents something of a tipping point in stock-drop jurisprudence, especially with respect to the dozens of companies (including many financial services companies) that have been sued in stock-drop cases based on events surrounding the 2007-08 global financial crisis. The Second Circuit opinion gives the presumption of prudence critical mass among appellate courts and signals a potential shift in how stock-drop claims will be evaluated, including at the motion to dismiss stage.[2]

Under the Citigroup analysis, fiduciaries should not override the plan terms regarding employer stock unless maintaining the stock investment would frustrate the purpose of the plan, such as when the company is facing imminent collapse or some other “dire situation” that threatens its viability. Like other circuits that have adopted the prudence presumption, the Citigroup court emphasized the long-term nature of retirement investing and the need to refrain from acting in response to “mere stock fluctuations, even those that trend downhill significantly.” It also sided with other courts in holding that the presumption of prudence should be applied at the motion to dismiss stage (i.e., not allowing plaintiffs to gather evidence through discovery to show the imprudence of the stock). Taken together, these rulings may make it harder for plaintiffs to survive a motion to dismiss, especially where their allegations of imprudence are based on relatively short-lived declines in stock price.

Some had predicted the Second Circuit would endorse the “hardwiring” argument and allow employers to remove fiduciary discretion by designating stock as a mandatory investment in the plan document. The Citigroup court was unwilling to go that far, but it did adopt a “sliding scale” under which judicial scrutiny will increase with the degree of discretion a plan gives its fiduciaries to offer company stock as an investment. This is similar to the approach taken by the Ninth Circuit inQuan and consistent with the heightened deference that courts generally give to fiduciaries when employer stock is hardwired into the plan. Thus, through careful plan drafting, employers should be able to secure the desired standard of review. Language in the plan document and trust agreement (as well as other documents) confirming that employer stock is a required investment option should result in the most deferential standard and provide fiduciaries the greatest protection.

Also noteworthy was the court’s treatment of the disclosure claims. Many stock-drop complaints piggyback on allegations of securities fraud, creating an inevitable tension between disclosure obligations under the federal securities laws and disclosure obligations under ERISA. The Second Circuit did not resolve this tension, but it construed ERISA fiduciary disclosure requirements narrowly and rejected the notion that fiduciaries have a general duty to tell participants about adverse corporate developments. The court made this ruling in the context of SPD disclosures under the 401(k) plan that identified specific risks of investing in Citigroup stock. Plan sponsors should review their SPDs and other participant communications to make sure company stock descriptions are sufficiently explicit about issues such as the volatility of a single-stock investment and the importance of diversification. These disclosures may go beyond what is already required under Department of Labor regulations.

[1]. See Howell v. Motorola, Inc., 633 F.3d 552, 568 (7th Cir.), cert.denied, ­­­2011 WL 4530151 (2011); Quan v. Computer Sciences Corp., 623 F.3d 870, 881 (9th Cir. 2010); Kirschbaum v. Reliant Energy, Inc., 526 F.3d 243, 254 (5th Cir. 2008); Kuper v. Iovenko, 66 F.3d 1447, 1459-60 (6th Cir. 1995).

[2]. That said, plan sponsors and fiduciaries should continue to monitor future developments in Citigroup in light of Judge Straub’s dissenting opinion and the likelihood of a petition for rehearing (or rehearing en banc), which the Citigroup plaintiffs have indicated they intend to seek. In his dissent, Judge Straub rejected the Moench presumption in favor of plenary review of fiduciary decisions regarding employer stock. He also disagreed with the majority’s interpretation of ERISA disclosure duties.

Copyright © 2011 by Morgan, Lewis & Bockius LLP. All Rights Reserved.

Health Care Information Privacy and Security Forum

The National Law Review is pleased to inform you of American Conference Institute’s Health Care Information Privacy and Security Forum Conference on Monday, December 05 to Tuesday, December 06, 2011 at the Union League, Philadelphia, PA.

ACI

Our Nation is poised to harness the power of information technology to improve health care. Transforming our health care system into a 21st century model is a bold agenda… [I]t is more important than ever to ensure consumer trust in theprivacy and security of their health information and in the industry’s use of new technology.

Statement on Privacy and Security, Building Trust in
Health Information Exchange, July 8, 2010.
We Have Entered the Era of Health Information Technology and Face New and Daunting Challenges in Keeping Health Information Private and Secure. Assess Your Current HIPAA Compliance Program to Ensure Best HIT Practices as You Prepare for New Privacy and Security Responsibilities in the Age of HITECH.

Privacy and security of health care information are critical concerns for HIPAA covered entities and an ever expanding circle of business associates.  Knowing the basics of the HIPAA are no longer enough in the age of HITECH when mandates giving rise to the predominance of EHRs and HIEs are taking center stage in the privacy and security challenges with which privacy, information, and security officers, and their counsel must contend every day.  The modes and modalities for storing health care information are becoming more and more complex in the age of HIT — as are the safeguards for keeping this information from unauthorized disclosure.

Now is Not the Time for Regulatory Paralysis, but for Action.

Industry stakeholders are analyzing their obligations under the draft accounting and disclosure rule and awaiting the release of the final HIPAA privacy rule. However, they know that they cannot remain paralyzed with anticipation, but must act upon the information they have and that which they are already obligated to do. Now is the time to ensure that all systems are in compliance with existing law and regulation and flexible enough for reconciliation with new requirements.

Attend ACI’s Health Care Privacy and Security Forum and Get the Critical Information that You Need to Meet Your HIPAA
and HITECH Privacy and Security Challenges Head-On. 

ACI’s Health Care Privacy and Security Forum has been designed to help you navigate the legal and business complexities associated with HIPAA, HITECH (as well as state privacy and security laws and regulations) and the ever evolving legal and regulatory privacy and security landscape. Our faculty of privacy and security experts will walk you through legal and business challenges associated with the anticipated regulations; HIT infrastructure and EHRs; HIEs; business associates; breach; encryption; and enforcement.

Benefit from Special Training and Strategy Sessions that Will Address the Essentials of HIPAA and HITECH and Critical Privacy and Security Compliance Audit Competencies.

To enhance and complete your conference experience, we are pleased to offer the following training and strategy sessions:

•    HIPAA and HITECH Boot Camp: Intensive Training in Privacy and Security Essentials for Health Care Professionals which will provide you with the legal and regulatory backdrop for the more in-depth HIPAA and HITECH controversies discussed in the main conference. This is the perfect course for attendees who are new to health care privacy and security matters or for more experienced professionals who are in need of a refresher; and

•    The Working Group on Auditing, Updating and Perfecting Your Existing HIPAA / HITECH Privacy and Security Compliance Program which will help you implement best practices to ensure that your current health care privacy and security program is in-check with current law and regulations and prepare you for HITECH-mandated HHS compliance audits applicable to both HIPAA covered-entities and business associates.

As an added bonus, your conference registration includes
your choice of one of these sessions.

Reserve Your Place Now at this Critical HIPAA and HITECH Event.
Clearly, this is the health care privacy and security conference that every legal or business advisor to a HIPAA covered entity or business associate cannot afford to miss. Register now by calling 1-888-224-2480, faxing your registration form to 1-877-927-1563 or logging on to www.AmericanConference.com/HIPAA-HITECH.

Medicare Part B premiums for 2012 lower than projected

Recently posted in the National Law Review an article by U.S. Department of Human & Health Services regarding Medicare Part B premiums:

Health & Human Services

Affordable Care Act helps keep Medicare affordable 

The U.S. Department of Health and Human Services (HHS) announced that Medicare Part B premiums in 2012 will be lower than previously projected and the Part B deductible will decrease by $22. While the Medicare Trustees predicted monthly premiums would be $106.60, premiums will instead be $99.90. Earlier this year, HHS announced that average Medicare Advantage premiums would decrease by four percent and premiums paid for Medicare’s prescription drug plans would remain virtually unchanged.

Thanks to the Affordable Care Act, people with Medicare also receive free preventive services and a 50 percent discount on covered prescription drugs when they enter the prescription drug “donut hole.”  This year, 1.8 million people with Medicare have received cheaper prescription drugs, while nearly 20.5 million Medicare beneficiaries have received a free Annual Wellness Visit or other free preventive services like cancer screenings.

“The Affordable Care Act is helping to keep Medicare strong and affordable,” said HHS Secretary Kathleen Sebelius. “People with Medicare are seeing higher quality benefits, better health care choices, and lower costs. Health reform is also strengthening the Medicare Hospital Insurance Trust Fund and cracking down on Medicare fraud.”

Medicare Part B covers physicians’ services, outpatient hospital services, certain home health services, durable medical equipment, and other items. In 2012, the “standard” Medicare Part B premium will be $99.90. This is a $15.50 decrease over the standard 2011 premium of $115.40 paid by new enrollees and higher income Medicare beneficiaries and by Medicaid on behalf of low-income enrollees.

The majority of people with Medicare have paid $96.40 per month for Part B since 2008, due to a law that freezes Part B premiums in years where beneficiaries do not receive cost-of-living (COLA) increases in their Social Security checks. In 2012, these people with Medicare will pay the standard Part B premium of $99.90, amounting to a monthly change of $3.50 for most people with Medicare. This increase will be offset for almost all seniors and people with disabilities by the additional income they will receive thanks to the Social Security cost-of-living adjustment (COLA). For example, the average COLA for retired workers will be about $43 a month, which is substantially greater than the $3.50 premium increase for affected beneficiaries. Additionally, the Medicare Part B deductible will be $140, a decrease of $22 from 2011.

“Thanks in part to the Affordable Care Act, people with Medicare are going to have more money in their pockets next year,” said Centers for Medicare & Medicaid Services (CMS) Administrator Donald Berwick, M.D. “With new tools provided by the Affordable Care Act, we are improving how we pay providers, helping patients get the care they need, and spending our health care dollars more wisely.”

Today, CMS also announced modest increases in Medicare Part A monthly premiums as well as the deductible under Part A. Monthly premiums for Medicare Part A, which pays for inpatient hospitals, skilled nursing facilities, and some home health care, are paid by just the 1 percent of beneficiaries who do not otherwise qualify for Medicare. Medicare Part A monthly premiums will be $451 for 2012, an increase of $1 from 2011. The Part A deductible paid by beneficiaries when admitted as a hospital inpatient will be $1,156 in 2012, an increase of $24 from this year’s $1,132 deductible. These changes are well below increases in previous years and general inflation.

For more information on how seniors are getting more value out of Medicare, please visit:http://www.healthcare.gov/news/factsheets/2011/10/medicare10272011a.html

For more information about the Medicare premiums and deductibles for 2012, please visit:https://www.cms.gov/apps/media/fact_sheets.asp

© Copyright 2011 U.S. Department of Human & Health Services

Protecting Your Brand in the New .XXX Top-Level Domain

Recently posted in the National Law Review an article written by atttorneys  Lee J. Eulgen, Antony J. McShane and Katherine Dennis Nye of Neal, Gerber & Eisenberg LLP regarding  ICANN’s established procedures for the use of .XXX as a new top-level domain :

 

The Internet Corporation for Assigned Names and Numbers (ICANN) recently established procedures for the use of .XXX as a new top-level domain (TLD) like .COM, .NET, and .ORG. However, unlike those other TLDs, .XXX has been designed to clearly signal adult content on the Internet. Given the connection between .XXX and adult content, many brand owners outside the adult industry have reasonable concerns about protecting their name and brand from use with the .XXX TLD.

In part to allay some of these fears, the company behind .XXX, ICM Registry, has created a sunrise period, which has just opened, to help protect brand owners from the use of their trademarks with the .XXX TLD. Between Sept. 7 and Oct. 28, 2011, trademark owners that are not in the adult industry can “reserve” their trademark for a one-time fee of approximately $250. For example, if the fictional ABC Company owns a U.S. federal trademark registration covering the mark ABC, it could reserve www.abc.xxx so that no one else can register or use that domain name for at least the next 10 years.

One important exception to the reservation process is that if two trademark owners both own the same mark, the one that wants to actually register and use the .XXX domain will prevail over the one that simply wants to reserve the same domain. For example, assume the fictional Acme Adult Magazine and Acme Family Restaurant both own U.S. federal trademark registrations for the mark ACME. If the restaurant applies to reserve www.acme.xxx and the magazine applies to register the same domain, ICM Registry will permit the magazine to register and use the domain, and the restaurant will lose its reservation fee.

Failure to reserve important trademarks during this sunrise period could have serious consequences. Most fundamentally, failure to reserve .XXX domain names corresponding to your trademarks could of course lead to undesirable usage of your marks in connection with domain names corresponding to adult web sites. Although brand owners may be able to recover .XXX domain names from others who register and use those domains in bad faith – just as brand owners can in domain name disputes over .COM or .ORG domains – the damage to a brand may be greater from misuse of a trademark in connection with the .XXX TLD by an adult content site than from misuse with another TLD. Furthermore, regardless of what TLD is at issue, the process of forcibly obtaining a domain name through legal means can be expensive. Thus, trademark owners should consider carefully whether reserving their marks during the .XXX sunrise period makes sense for their brands. 

© 2011 Neal, Gerber & Eisenberg LLP.