Administrative Appeals Appeals

News & Analysis as of

New York’s Highest Court: No “Stretch” in Yogi’s Independent Contractor Classification

Seyfarth Synopsis: The New York Court of Appeals recently rejected the narrow view of the Unemployment Insurance Appeal Board and found that substantial evidence did not support a finding that certain yoga instructors were...more

Five Key Takeaways From the D.C. Circuit’s PHH Decision

The legal challenge by PHH Corp. (PHH) to a June 4, 2015, decision by the director of the Consumer Financial Protection Bureau (Bureau) in connection with the Bureau’s enforcement proceeding against PHH has captivated the...more

District Court Denies Stay in Litigation Over Medicare Appeals Backlog

On September 19, 2016, the U.S. District Court for the District of Columbia rejected a request by HHS to stay proceedings in litigation brought by the American Hospital Association and several providers seeking to compel the...more

D.C. District Ct Applies Prohibition on Administrative and Judicial Review to IRF PPS Rates

On July 25, 2016, Judge John D. Bates of the United States District Court for the District of Columbia issued a memorandum opinion broadly construing 42 U.S.C. § 1395ww(j) to prohibit administrative or judicial review of a...more

Tenth Circuit Orders Truck Driver Who Abandoned Trailer on Interstate Highway to be Reinstated with Backpay

Seyfarth Synopsis: The Tenth Circuit held that a trucking company unlawfully retaliated against a truck driver after he abandoned a trailer on a public highway, finding that his actions constituted a protected refusal to...more

A Favorable, New Climate for Challenging Medicare Appeals

Over the past decade, health care providers seeking to challenge Medicare claim denials have faced increasing delays in reaching what many consider the most important step in the Medicare appeals process - a hearing before an...more

HHS Proposes Significant Changes to ALJ Hearing Procedures

HHS announced a Proposed Rule on July 5, 2016 aimed at reducing the backlog of appeals at the Office of Medicare Hearings and Appeals (OMHA) and Departmental Appeals Board (DAB) for Medicare payment and coverage...more

Cutting Through the Constitutionality Haze in the Battle Between PHH Corporation and the Consumer Financial Protection Bureau

So much has been written in recent weeks about the battle between PHH Corporation and the Consumer Financial Protection Bureau in the U.S. Court of Appeals for the D.C. Circuit. The panel heard oral argument on April 12,...more

Is the CFPB Constitutional?

Is the Consumer Financial Protection Bureau (CFPB) constitutional? A panel of the D.C. Circuit Court of Appeals is currently considering the issue after hearing oral argument in PHH Corporation v. CFPB....more

CFPB Suffers First Official CID Challenge

On April 21, 2016, Judge Richard J. Leon of the United States District Court for the District of Columbia ruled on the first judicial challenge to the Consumer Financial Protection Bureau’s (“CFPB,” or “Bureau”) authority to...more

D.C. Circuit Appears Poised to Overturn First CFPB Enforcement Action to Reach the Court: Five Key Takeaways From Yesterday’s Oral...

Major financial firms almost never litigate with their regulators. As a result, regulators often take aggressive enforcement positions with little fear of judicial scrutiny. That’s been especially true for the Consumer...more

D.C. Circuit Judge Expresses Concern That CFPB Concentrates “Huge Power” in Single Director

Yesterday’s oral argument in the CFPB v. PHH Corporation appeal included sharp questioning about the constitutionality of the Consumer Financial Protection Bureau’s (CFPB) single-director structure, which the parties agreed...more

Appeals Procedures for Tax Court Cases

The Internal Revenue Service (Service) on March 23, 2016, issued Revenue Procedure 2016-22 which clarifies and describes the practices for the administrative appeals process in cases docketed in the United States Tax Court...more

ERISA — 10th Circuit: What Happens When a “Procedural Irregularity” Occurs in an Appeal Denial?

You know that procedural irregularities in an appeal denial of a claim for ERISA-governed benefits can change the standard of review from arbitrary and capricious to de novo review. But not all the time. The claimant should...more

Cuozzo Speed Technologies, LLC v. Lee

The Supreme Court on Friday granted certiorari to review the Federal Circuit's decision that the U.S. Patent and Trademark's Patent Trial and Appeal Board was entitled to perform claim construction in inter partes review...more

Court Rules that Medicare and Medicaid Payments to Nursing Home Must Continue Pending Jurisdictional Dispute

On October 27, 2015, United States District Judge James S. Moody, Jr. extended a stay of proceedings thereby permitting Bayou Shores SNF, LLC (“Bayou Shores”) to remain viable and continue receiving Medicare and Medicaid...more

Despite 1st Administrative Appeal, CFPB Seeks Out Courts

On June 4, 2015, Consumer Financial Protection Bureau Director Richard Cordray issued a decision in the first appeal of a CFPB administrative proceeding. The appeal to Director Cordray followed the CFPB's first administrative...more

Ninth Circuit Extends ERISA Deadline, Revives Untimely Appeal

Last week, the Ninth Circuit Court of Appeals issued its opinion in LeGras v. AETNA Life Insurance Company, No. 12-56541 (May 28, 2015), holding that the 180-day period to appeal a denial of a long-term disability claim was...more

Don’t Sit on Your Hands: Intervene at OHA If the NAICS Code Matters to You

A recent decision from the Federal Circuit clarified whether the Court of Federal Claims (“COFC”) has jurisdiction to review the selection of North American Industry Classification System (“NAICS”) codes and reminded small...more

Illinois Supreme Court Holds Treasurer Needs Appeal Bond Too

Earlier this month, a unanimous Illinois Supreme Court held in Illinois State Treasurer v. Illinois Workers’ Compensation Commission that the State Treasurer, when appealing a workers’ compensation award in a case where he...more

Virginia Supreme Court Opinions Affecting Local Government Law – February 26, 2015

This term resulted in two cases which, in our opinion, affect Virginia local government law.  One, decided by order, deals with the effect of a failure to name a necessary party (a governing body) in appealing a BZA decision....more

Illinois Supreme Court Agrees to Decide Breadth of Misconduct Exception for Unemployment Benefits

In the closing days of its January term, the Illinois Supreme Court agreed to hear a case from Division 5 of the First District, Petrovic v. The Department of Employment Security. Petrovic presents an interesting issue on the...more

The NC Property Tax Appeal Process: Great Fun Every Eight Years! (Insert Sarcasm)…

As sure as the FIFA World Cup and the Summer and Winter Olympics will occur every four years, every county in North Carolina has its own tradition that will occur every eight years What is that tradition you may ask? Property...more

Illinois Supreme Court Reinstates Attorney General's Appeal from Illinois Commerce Commission Order

On Thursday morning, the Illinois Supreme Court resolved a confused issue in utilities law, holding unanimously in The People of the State of Illinois ex rel. Madigan v. Illinois Commerce Commission that the 35-day period...more

Self-Insured Health Plans May Be Required To Allow Health Care Providers Access To Their Claims And Appeals Process

In a precedent-setting case, a district court in the Northern District of Illinois recently ruled that in-network chiropractors were considered “beneficiaries” under the Employee Retirement Income Security Act of 1974 (ERISA)...more

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