Exploring Procedural Justice | Judge Steve Leben | Texas Appellate Law Podcast
Handling Post-Conviction Death Penalty Cases Pro Bono | McKenzie Edwards | Texas Appellate Law Podcast
Inside the Fourth Court of Appeals’ Clerk’s Office | Michael Cruz | Texas Appellate Law Podcast
Supersedeas and Other Recent Rule Changes | Texas Appellate Law Podcast
Supreme Court Miniseries: Tribal Rights in the 21st Century
SDNY Chooses “Time Approach” to Calculating Lease Termination Damages Collectible Against a Bankrupt Estate
AGG Talks: Home Health & Hospice - Reimbursement Audits and Appeals
After ALJ: Options and Opportunities in the Face of an Unfavorable ALJ Decision
Understanding the SCOTUS Shadow Docket | Steve Vladeck | Texas Appellate Law Podcast
Podcast: The Legal Battle Over Mifepristone - Diagnosing Health Care
Checking in On the 88th Texas Legislature | Jerry Bullard | Texas Appellate Law Podcast
Law Brief®: Rich Schoenstein and New York State Senator Luis Sepúlveda Discuss The Chief Judge Controversy
Appellate Justice for Domestic Violence Survivors
Jury Charges and Oral Argument | David Keltner | Texas Appellate Law Podcast
The Evolution of Texas Appellate Practice| David Keltner | Texas Appellate Law Podcast
Podcast: California Employment News - Time to Do Away With Rounding Policies
Two Federal Courts Deal Blow to Biden Administration’s Federal Student Loan Forgiveness Program: A Close Look at the Decisions
This Am Law 50 senior counsel cements his authority through two appellate analytics blogs - Legally Contented Podcast
An Inside Look as a Juror - FCRA Focus Podcast
Reflections on 100 Episodes | Texas Appellate Law Podcast
Last week, a federal judge in North Carolina declined to preliminarily enjoin Novant Health, Inc.’s (“Novant”) acquisition of two hospitals from Community Health Systems, Inc. (“CHS”). The FTC filed suit in federal court and...more
A federal appeals court recently held that an employer’s health insurance plan wrongly excluded coverage for gender-affirming care in violation of federal civil rights law – offering a warning to employers across the country...more
Illumina Agrees to Unwind Acquisition of Grail Following Fifth Circuit Decision. On December 15, 2023, the Fifth Circuit vacated the FTC’s order that Illumina unwind its acquisition of Grail—a developer of a multi-cancer...more
Last week, the US Court of Appeals for the Ninth Circuit, in its third opinion in the case, reversed a lower court’s decision allowing patients challenging United Behavioral Health’s (UBH) internal mental health coverage...more
On May 15, 2023, the Fifth Circuit temporarily stayed a district-court ruling that struck down a key part of the Affordable Care Act (ACA). As a result of the stay, the ACA’s health insurance coverage requirements for...more
On Monday, the U.S. Court of Appeals for the Fifth Circuit issued an administrative stay of enforcement of the district court decision in Braidwood Management Inc. v. Becerra. Readers of our earlier blog (found here) will...more
On March 30, Judge Reed O’Connor of the U.S. District Court for the Northern District of Texas issued a decision in Braidwood Management Inc. v. Becerra (“Braidwood”), invalidating the Affordable Care Act’s (“ACA’s”) mandate...more
In response to Braidwood Mgmt. Inc. v. Becerra, a recent case striking down part of the Affordable Care Act (ACA) preventive services mandate, the US Departments of Labor, Health and Human Services, and the Treasury...more
The Florida Supreme Court heard arguments Wednesday, March 8, 2023, in the case of Allstate Insurance Co. et al. v. Revival Chiropractic LLC, case number SC22-735, regarding payment of medical expenses that could affect...more
As originally enacted, the Affordable Care Act (“ACA”) required most people to maintain health insurance. Those who did not maintain the required insurance were obligated to pay a “shared responsibility payment” (“SRP”),...more
Welcome to the fourth edition of The Employment Edit – a summary of the most important recent cases and news affecting employers in the UK. We hope you find this newsletter helpful and informative. In this edition we look at:...more
On August 17, 2022, the U.S. Court of Appeals for the Fifth Circuit held that a Department of Labor (“DOL”) advisory opinion, which found that an insurance plan was not governed by ERISA, was unenforceable under the...more
On June 15, 2022, the U.S. Supreme Court unanimously ruled in favor of “340B” hospitals in a notable statutory interpretation case concerning how the federal Medicare program reimburses hospitals for prescription drugs. The...more
Health plans routinely assert that contracted providers must appeal underpayments or claim denials according to the health plans’ internal dispute process. The payer/provider agreement itself, or provider manuals that health...more
A recent decision by the U.S. Court of Appeals for the Ninth Circuit (Wit et al. v. United Behavioral Health and Alexander et al. v. United Behavioral Health) exemplifies the challenge in balancing a desire to cover evolving...more
Various smaller health insurance issuers have challenged the risk-adjustment program under the Patient Protection and Affordable Care Act (ACA), alleging, among other things, that its underlying methodology favors larger...more
The U.S. District Court for the Eastern District of Texas recently vacated a portion of the Requirements Related to Surprise Billing, Part II, Interim Final Rule (the “Rule”) regarding the independent dispute resolution (IDR)...more
Senior Health Insurance Company of Pennsylvania (“SHIP”) was placed in rehabilitation in Pennsylvania in January 2020. On August 24, 2021, the Commonwealth Court of Pennsylvania approved the Rehabilitation Plan (the “Plan”),...more
On August 11, 2021, the California Court of Appeals for the Second District extended the Pebley v. Santa Clara Organics (“Pebley”) Court’s analysis as applied to the admissibility of unpaid medical liens. Based on the Court’s...more
Building on our recent overview presentation “Six Lessons Patients and Providers Need to Know," we invite you to join us as we examine a single medical provider/patient encounter, in order to identify the concrete steps a...more
While too many of us get overdosed with clownish depictions - from doctors, hospitals, insurers, and corporations, especially Big Pharma firms - of how the civil justice system operates, it’s always worth a reminder of the...more
On December 23, 2020, the U.S. Senate unanimously passed the Competitive Health Insurance Reform Act of 2020, which includes a provision that would repeal the limited federal antitrust immunity currently granted to certain...more
Under the "genuine dispute" doctrine, an insurer is not liable for bad faith if its denial of a claim was reasonable. In Ghazarian v. Magellan Health, Inc., 53 Cal. App. 5th 171 (2020), a California appellate court reversed a...more
In this week’s episode, Gary Qualls discusses a recent case decided in the Western District of Louisiana, which highlights how the application of the arbitrary and capricious standard as applied to payor coverage...more
After the U.S. Court of Appeals for the Fifth Circuit, in a 2-1 decision last December, declared the Affordable Care Act’s (ACA’s) individual health insurance mandate unconstitutional as a result of Congress’ elimination of...more