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Insurance Health Civil Procedure

Read Insurance Law updates, alerts, news, and legal analysis from leading lawyers and law firms:

Reaping the Jurisdictional Whirlwind

by Reed Smith on

Literally for decades plaintiffs in mass torts have employed the business model of flooding jurisdictions seen as friendly to them with more solicited plaintiffs than any court system can possibly handle. They have employed...more

Dismissal of Medicare Advantage FCA Suit Marks Significant Defeat for Government

by Bass, Berry & Sims PLC on

The U.S. District Court for the Central District of California recently dismissed a complaint-in-intervention filed by the U.S. Department of Justice (DOJ) in U.S. ex rel. Swoben v. Secure Horizons. As previously reported,...more

Mintz Levin Health Care Qui Tam Update - Recently Unsealed Whistleblower Cases: September 2017

by Mintz Levin on

In this month’s issue of our Qui Tam Update, we review an unusual cluster of five cases alleging that common defendants — a health care provider and its subsidiaries — provided medically unnecessary services to hospice,...more

D.C. Circuit Holds Cyber-Theft of Customers’ Medical Identifying Information Created Sufficient Increased Risk of Harm to...

Earlier this month, an appellate panel of the federal DC Circuit unanimously held that individuals affected by a healthcare insurer’s data breach in 2014 could pursue claims against the insurer stemming from the cyberattack....more

Specialty Pharmacy's Antitrust Claim against Humana Fails

by Baker Ober Health Law on

On August 9, District Judge Susan Wigenton (D. NJ) issued a ruling in Prime Aid Pharmacy v. Humana, Civ. No. 16-2104, granting Humana's motion to dismiss the plaintiff's Second Amended Complaint, finding that the plaintiff...more

Aetna and its Vendor Face Class Action Lawsuit over HIV Disclosure

A Pennsylvania man has filed a class action lawsuit against Aetna Inc., accusing it of violating his privacy rights when the insurer mailed him prescription information in an envelope with a large, clear window that disclosed...more

Ripeness: A Question of Subject Matter Jurisdiction - Allied World Surplus Lines Insurance Company v. Blue Cross and Blue Shield...

by Nexsen Pruet, PLLC on

Addressing a contractual requirement to exhaust Alternative Dispute Resolution (ADR) prior to commencing litigation, the United States District Court for the District of South Carolina chose to forge its own path, rejecting...more

The Ninth Circuit Weighs in on ERISA’s Plan Document and Summary Plan Description Requirements: Mull v. Motion Picture Ind. Health...

Mull v. Motion Picture Ind. Health Plan educates employers on the basics of the requirements of the Employee Retirement Income Security Act (ERISA) governing plan documents and summary plan descriptions. The lessons are...more

Recent 11th Circuit Decision Is a Victory for Health Care Providers Challenging Insurer Reimbursement Decisions and a Reminder of...

by K&L Gates LLP on

The existence and scope of assignments of benefits from patients to health care providers continues to be critically important to a provider’s ability to challenge an insurer’s reimbursement decision under the Employee...more

Failure To Hold Back Settlement Funds Subject To A Medical Lien Can Expose An Insurer To Treble Damages

by Ellis & Winters LLP on

A court’s decision to impose liability for committing an unfair or deceptive trade practice in a particular case may have wide-ranging implications—even when the amount in dispute in the matter itself is relatively...more

Torts & Insurance Cases from the 4th Circuit Court of Appeals - May 2017

by Nexsen Pruet, PLLC on

Each month, Nexsen Pruet attorney Marc Manos, a member of the SC Bar Torts and Insurance Practice Section Council, sheds light on a few recent cases from the Fourth Circuit Court of Appeals, focused in the area of Torts &...more

Admissibility of Insurance Coverage: Sauce for the Goose

by Faegre Baker Daniels on

When Kerrie Evans’s child was born with cystic fibrosis, she sued her nurse practitioner and doctor for failure to adequately inform her about prenatal testing for CF, making concerns about cost the centerpiece of her...more

10th Circuit Affirms Dismissal of Antitrust Case Against Health Insurer

by Baker Ober Health Law on

On May 31, the Tenth Circuit Court of Appeals affirmed the dismissal of plaintiff's claims in Bristow Endeavor Healthcare v. Blue Cross Blue Shield Association et al., handing Blue Cross Blue Shield of Oklahoma, and its...more

Out-of-Network Physician’s Claim Against Insurer Not Preempted by ERISA

The Second Circuit concluded that a promissory estoppel claim by an out-of-network provider against an insurer was not completely preempted by ERISA and thus remanded the claim to state court for further proceedings. The...more

Fifth Circuit’s Pierre Deference In ERISA Cases Trumps Texas’s Anti-Discretionary Language Statute

by DeWitt Law, LLC on

In Ariana M. v. Humana Health Plan of Texas, Inc., No. 16-20174, 2017 U.S. App. LEXIS 7072(5th Cir. Apr. 21, 2017), which involved a claim for benefits under an ERISA-governed health policy, the Fifth Circuit held that...more

$4 Million Liability for Bad Legal Advice to a Chiropractor

by Faegre Baker Daniels on

Allstate Insurance has won a judgment of nearly $4 million against a NY lawyer and Calif. consultant who guided a NJ chiropractor in structuring a medical practice designed to appear to meet the requirements of the state...more

The North Carolina Business Court Hands Down An Important Healthcare Antitrust Decision, Part 2

by Ellis & Winters LLP on

In a recent blog post, we discussed a new antitrust decision from the North Carolina Business Court that involves healthcare providers and health insurers. In that post, we examined the significance of that opinion to...more

Dispute Between Brothers Demonstrates Need to Plan for Long-Term Care

A recent New Jersey appeals court case demonstrates how important it is for families to come up with a long-term care plan before an emergency strikes. The case involves two brothers who got into a fight over whether to place...more

New Class Action Lawsuits Asserting Violations of the MHPAEA

Banner Health and the Kaiser Foundation were recently hit with separate class action lawsuits challenging their denials of certain mental health care coverage...more

Anthem Loses Merger Appeal in a 2-1 Decision by the D.C. Circuit

by Baker Ober Health Law on

On March 24, the D.C. Circuit held oral argument on Anthem's appeal in United States v. Anthem, in which Anthem sought to have the appellate court overturn District Court Judge Amy Berman Jackson's ruling that barred the...more

HR 1313 and the Future of Employee Wellness Programs

by Fisher Phillips on

On March 8, the House’s Education and Workforce Committee passed a bill, HR 1313 – Preserving Employee Wellness Programs Act. The bill, which was introduced by U.S. Rep. Virginia Foxx in order to “reaffirm existing law to...more

Blues Defeat Antitrust Claim by Heart Monitoring Device Maker

by Baker Ober Health Law on

On April 3, Judge Eduardo Robreno, District Judge for the Eastern District of Pennsylvania, granted judgment to a collection of insurer defendants in an antitrust conspiracy case brought against them by heart monitoring...more

Darwinian Insurance

by BakerHostetler on

This case demonstrates the need for providers to know and follow the notification provisions set forth in their insurance policies in order to avoid an inadvertent loss of coverage. Once again, the terms of a hospital’s...more

Recovery of Medical Bills: Once Is Enough

by Faegre Baker Daniels on

Strange as it sounds, Missouri state law allowed federal workers to recover medical bills twice: once under their federal health insurance plan and again from the person (or person’s insurer) responsible for their injuries. ...more

Supreme Court says lawyer's referral of client to a doctor for treatment is attorney-client privileged communication, and out of...

The Florida Supreme Court declared that the attorney-client privilege shielded a motor vehicle accident plaintiff from being required to disclose that her attorney had referred her to a doctor for treatment. In Worley v....more

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