News & Analysis as of

Damages Health Insurance

Haight Brown & Bonesteel LLP

Can a Jury Consider a Plaintiff’s Medicare Coverage in Evaluating Future Medical Damages Claims?

Can a Jury consider a Plaintiff’s medicare coverage in evaluating future medical damages claims? A California Court of Appeals held in the affirmative in David Audish v. David Macias; Case No. D081689....more

Littler

Fourth Circuit Establishes New Standards for Plaintiffs Seeking Unjust Enrichment as an Equitable Remedy under ERISA

Littler on

The United States Court of Appeals recently shed light on when—and under what conditions—a plaintiff may seek a monetary recovery under § 502(a)(3) of the Employee Retirement Income Security Act (ERISA). Section 502(a)(3)...more

Akerman LLP - Health Law Rx

The Trebling Effect of (Some) False Claims Act Trials

There are multiple components to the risk defendants must consider when faced with going to trial for a matter involving the False Claims Act (FCA). Setting aside the incalculable impact that litigation can have on business...more

Haight Brown & Bonesteel LLP

Thought Unpaid Lien Doctors’ Bills Were Admissible at Trial? Not so Fast, Plaintiff Must First Prove the Full Amount of the Bill...

In Qaadir v. Figueroa (“Qaadir”), the Second District Court of Appeal held it is an abuse of discretion for the trial court to admit evidence of the full amount unpaid medical bills without first requiring the plaintiff to...more

Morgan Lewis

High Court Checks Government in Risk Corridors Case

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In Maine Community, the US Supreme Court found on April 27, 2020, that the Risk Corridors program created by Congress was a “money-mandating obligation” requiring the federal government to make payments under Section 1342 of...more

Ballard Spahr LLP

Health Insurance Exchanges: A $12B Judgment

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The U.S. Supreme Court has determined that the federal government must pay over $12 billion to certain health insurers that participated in health insurance exchanges in the first three years that those exchanges were in...more

Akerman LLP - Health Law Rx

SCOTUS Rules Government Must Pay $12 Billion to Unprofitable ACA Insurers

Despite Congress’ efforts to use riders to neutralize a provision of the Affordable Care Act (ACA or Act), the Federal government (Government) owes certain insurers $12 billion....more

Troutman Pepper

Supreme Court Finds Insurers Entitled To Millions In ACA Payments

Troutman Pepper on

On April 27, the U.S. Supreme Court held that the federal government is on the hook for $12 billion it failed to pay insurers under the Affordable Care Act (ACA) risk-mitigation program known as the Risk Corridors Program. ...more

Epstein Becker & Green

Supreme Court: The ACA & Risk Corridor Obligations

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The U.S. Supreme Court decision in Maine Community Health Options v. United States, is a major decision affecting healthcare and resolving a significant Obamacare dispute. The Affordable Care Act famously established online...more

Sheppard Mullin Richter & Hampton LLP

Supreme Court Issues Long Awaited Ruling on Affordable Care Act Risk Corridors Program

The Supreme Court issued a long-awaited ruling on April 27, 2020, directed at a more than $12 billion challenge related to the temporary risk corridors program established by the Affordable Care Act (the “ACA”). Challenges...more

Faegre Drinker Biddle & Reath LLP

Supreme Court Decides Moda Health Plan, Inc. v. United States

On April 27, 2020, the U.S. Supreme Court decided Moda Health Plan, Inc. v. United States, holding that the Affordable Care Act requires the federal government to compensate insurers for significant losses their health plans...more

Seyfarth Shaw LLP

Supreme Court Rules Government Must Pay $12 Billion to Health Insurers Under ACA Risk Corridor Program

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On April 27, 2020, the US Supreme Court ruled by an 8-1 decision that the federal government must pay billions of dollars to health insurers who sold consumer policies on exchanges under the Affordable Care Act’s (“ACA”)...more

Locke Lord LLP

Supreme Court Rules 8-1 That Government Must Pay Health Insurers Under ACA Risk Corridor Program

Locke Lord LLP on

In a major win for health insurers, the U.S. Supreme Court ruled in an 8-1 decision that the federal government owes roughly $12.3 billion to health insurers who claimed losses under the risk corridor program of the...more

Smart & Biggar

2019 Mid-Year Highlights in Canadian Life Sciences IP

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Below are the major highlights in Canadian life sciences intellectual property and regulatory law that we have reported on in the first half of 2019....more

Akerman LLP - Health Law Rx

Antitrust Exemption Allows Health System to Avoid All Claims for Damages in Antitrust Class Action

Atrium Health (formerly known as Carolinas Healthcare System) scored a big victory in its defense of an antitrust class action on March 4, when the Court ruled that the plaintiffs in Benitez v. The Charlotte-Mecklenburg...more

Smart & Biggar

Rx IP Update - February 2019

Smart & Biggar on

Orders of prohibition relating to polymorphic form patent for PRISTIQ upheld on appeal - As previously reported, the Federal Court, in a pair of decisions, granted orders prohibiting Apotex and Teva from marketing their...more

King & Spalding

Litigation Victory for NorthBay HealthCare Group

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King & Spalding partner Daron Tooch represented NorthBay HealthCare Group, a two-campus hospital in Solano County, California at trial in the Northern District of California against Blue Shield for underpayment of...more

Bass, Berry & Sims PLC

Healthcare Fraud & Abuse Review 2017

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A LOOK BACK... A LOOK AHEAD - While the uncertainty associated with legislative efforts to repeal the Patient Protection and Affordable Care Act (PPACA) dominated most of the headlines for the healthcare industry last year,...more

Bradley Arant Boult Cummings LLP

Tennessee Supreme Court Rejects Efforts to Alter Existing Law on the Collateral Source Rule in Personal Injury Cases

Last month the Tennessee Supreme Court, in Dedmon v. Steelman, affirmed the long-standing collateral source rule in personal injury cases. As long as an injured plaintiff can establish that the medical expenses they incurred...more

Butler Snow LLP

Dedmon Decided: The Destiny of “Reasonable” Medical Expenses In Tennessee Revealed

Butler Snow LLP on

In a stunning reversal of what appeared to be the trend towards discounted medical damages in personal-injury cases, the Tennessee Supreme Court ruled on Friday, November 17, 2017, that the Collateral Source Rule reigns...more

Seyfarth Shaw LLP

A Liar and A Cheat? 3 Ways to Pay...

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Seyfarth Synopsis: Insurer gets to pick its remedy when hospital engages in dishonest billing and illegal kickbacks…to the tune of $41 million. Judge Lynn Hughes of the U.S. District Court for the Southern District of...more

Akerman LLP - Health Law Rx

11th Circuit Awards Humana Double Damages Under Medicare Secondary Payer Act

Humana Medical Plan, Inc. v. Western Heritage Insurance Co., case number 15-11436. Liability insurers beware, as the 11th Circuit held that Medicare Advantage Organizations (MAO) are entitled to the same rights...more

Carlton Fields

Medicare Advantage Organizations May Sue For Double Damages Under MSP Act - Humana Medical Plan, Inc. v. Western Heritage Ins....

Carlton Fields on

On August 8, the Eleventh Circuit Court of Appeals decided an issue of first impression in the circuit under the Medicare Secondary Payer (MSP) Act. In sum, the Eleventh Circuit held that a Medicare Advantage Organization...more

Manatt, Phelps & Phillips, LLP

Health Update - September 2015

Latest Healthcare False Claims Act Roundup and Top 3 Best Practices to Reduce Exposure - As the legal landscape in healthcare becomes increasingly complex, healthcare companies that receive federal program funds face...more

Dickinson Wright

Healthcare Legal News Volume 5 Number 2

Dickinson Wright on

According to a recent study by Accenture, by 2017 approximately 18 percent of the American public will purchase insurance through exchanges versus relying on traditional employer healthcare coverage or foregoing insurance...more

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