Chiropractors Lack Standing Under ERISA to Assert Claims For Benefits

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A federal district court in New Jersey recently dismissed claims asserted by a putative class of chiropractors seeking to enjoin the procedure used by UnitedHealth to determine the necessity of certain treatments administered by in-network physicians, finding that they lacked standing to assert their claims. Premier Health Ctr., P.C. v. UnitedHealth Grp., No. 2:11-cv-00425-ES-CLW (D.N.J. August 1, 2013). The plaintiffs claimed that they had an assignment of the right to reimbursement for services and that this qualified them as a “participant or beneficiary” under ERISA. The court determined that the plaintiffs had no standing to enjoin UnitedHealth’s procedure because they were no longer in-network providers and thus would not be impacted by the procedure in the future. (The plaintiffs’ claims arising from assignments made while the plaintiffs were in-network were subject to arbitration and not part of the lawsuit.) The court also rejected a second proposed class to challenge UnitedHealth’s overpayment recoupment procedures. The court found the named plaintiffs lacked typicality under Rule 23(a) since none of the named plaintiffs had made voluntary repayments, which constituted a significant component of the challenged policy.

Topics:  Chiropractors, Class Action, ERISA, Healthcare, Insurers, Reimbursements, Standing, United Healthcare Insurance Co.

Published In: Civil Procedure Updates, Constitutional Law Updates, Health Updates, Insurance Updates

DISCLAIMER: Because of the generality of this update, the information provided herein may not be applicable in all situations and should not be acted upon without specific legal advice based on particular situations.

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