News & Analysis as of

Health Insurance Claim Procedures

WilmerHale

In Narrow Victory for Tribal Nations, US Supreme Court Requires Federal Government to Reimburse Tribal Nations for Healthcare...

WilmerHale on

On June 6, 2024, the US Supreme Court decided Becerra v. San Carlos Apache Tribe and Becerra v. Northern Arapaho Tribe (Nos. 23-250 and 23-253), holding that the Indian Health Service (IHS) must reimburse Native nations,...more

Holland & Knight LLP

Tribes: Act Now to Take Advantage of Supreme Court's Decision on Contract Support Costs

Holland & Knight LLP on

The U.S. Supreme Court ruled on June 6, 2024, that the Indian Health Service (IHS) must pay contract support costs with respect to program income – payments from Medicare, Medicaid and private insurers – received by tribes...more

Robinson+Cole ERISA Claim Defense Blog

Second Circuit Clarifies That Reclassification of Health Status That Limits Scope of Disability Benefits Does Not Constitute...

In Ruderman v. Liberty Mut. Grp., Inc., No. 21-817, 2022 WL 244086 (2d Cir. Jan. 27, 2022), the U.S. Court of Appeals for the Second Circuit ruled that reclassification of a claimant’s disability from one that is...more

Saul Ewing LLP

The Friday Five: Five Current ERISA Litigation Highlights – January 2019

Saul Ewing LLP on

This month's Friday Five covers three cases that address issues that can be critical for LTD insurers litigating matters in federal court, specifically issues related to injunctions, statutes of limitations and ERISA...more

Winstead PC

Another Lesson on Bullet Proofing Your Claims Process

Winstead PC on

On July 12, 2018, a previous alert entitled “Bullet Proofing Your Claims Process” discussed lessons learned from a recent 5th Circuit decision in White v. Life Insurance Company of North America, (5th Cir. June 13, 2018,...more

Ballard Spahr LLP

Health Care Reform in Transition While Congress Deliberates

Ballard Spahr LLP on

Changes are imminent for the Affordable Care Act and a range of other laws and regulations affecting the health care industry. Ballard Spahr attorneys established a Health Care Reform Initiative in 2008 to monitor and analyze...more

Proskauer - Employee Benefits & Executive...

DOL’s New Audit Focus? Health Plan Claims and Appeals and Hard to Value Assets

In recent talks and appearances, representatives of the U.S. Department of Labor have issued a warning about new areas of focus of DOL audits and enforcement actions. While there are a number of different enforcement...more

Carlton Fields

Insurer Sues Department of Insurance Over Multi-Million Dollar Penalty

Carlton Fields on

In suing the California Insurance Commissioner on July 10, 2014, PacifiCare Life Insurance Company sought a writ of mandamus ordering the Commissioner to set aside his Decision and Order imposing a record $173 million penalty...more

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