News & Analysis as of

United Healthcare Insurance Co.

Double Whammy for United Healthcare: Two False Claims Act Cases in Two Weeks

by Michael Volkov on

The False Claims Act is the government’s weapon of choice in fighting healthcare fraud. In the beginning of the Obama Administration, Congress amended the False Claims Act and enacted a wish list from DOJ prosecutors. ...more

Justice Department Joins Whistleblower Suit Accusing UnitedHealth Group of Overcharging Medicare by “Hundreds of Millions”

The U.S. Department of Justice (DOJ) has joined a whistleblower lawsuit, United States of America ex rel Benjamin Poehling v. Unitedhealth Group Inc., No. 16-08697 (Cent. Dist. Cal. Sep. 17, 2010), ECF No. 79, against...more

“Onionhead” is a Religion Under Title VII: Court Finds in Favor of Employees in Reverse Religious Bias Case

A federal district court recently ruled that an employer-initiated program known as Onionhead was a religion for the purposes of Title VII of the Civil Rights Act of 1964. In Equal Employment Opportunity Commission v. United...more

California Court Finds That Discretionary Clauses in Health Insurance Policies Are Enforceable

In 2011, the California legislature passed Insurance Code Section 10110.6 which bans the use of discretionary clauses in any policy, contract, certificate, or agreement offered, issued, delivered, or renewed, whether or not...more

IREG Update - Insurers and big data

by Dentons on

Insurers and big data - Insurance companies are increasingly using “big data” to optimize all aspects of their businesses—from claims processing and marketing to underwriting and pricing. Recognizing this trend among...more

Physician Plaintiff Bound by Arbitration Clause in Nonparty’s Contract

by Faegre Baker Daniels on

Today’s riddle: A physician sues defendants for defamation. The defendants move to compel the arbitration clause of a contract the physician used to have with a nonparty. The defendants win the argument. What’s the...more

The Reformed Health Care Industry: Creative Structures and Alliances Can Yield Great Benefits, but Also Great Risks

Since the Affordable Care Act (the “ACA”) was enacted in 2010, the health care industry has been on the edge of its proverbial seat waiting to see which care delivery models are best suited to sustain all the changes: to...more

Judge Issues Preliminary Injunction Barring UnitedHealthcare from Terminating Certain Physicians From Medicare Advantage Plans

by King & Spalding on

The United States District Court for the District of Connecticut recently granted Fairfield County Medical Association’s and Hartford County Medical Association’s (collectively, the “Associations”) motion for a preliminary...more

Chiropractors Lack Standing Under ERISA to Assert Claims For Benefits

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...more

Eastern District Concludes That ERISA Preempts Negligent Misrepresentation Claim

Korman v. Consolidated Edison Co., No. 12-CV-1561 (JFB-ARL) (E.D.N.Y. Jan 16, 2013): The plaintiff brought the Employee Retirement Income Security Act (ERISA) and common law claims against his benefits provider,...more

SCOTUS Declines Review in Case Allowing Health Care Provider to Pursue State Law Misrepresentation Claims Against ERISA Health...

by Hinshaw & Culbertson LLP on

The United States Supreme Court recently denied certiorari in a Fifth Circuit case, United Healthcare Insurance Co. v. Access Mediquip LLC, that allowed a health care provider to pursue state law misrepresentation claims...more

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