In this week’s episode, Gary Qualls discusses the recent Louisiana federal district court decision in Crescent City Surgical Centre vs. United Healthcare of Louisiana, in which the court found that an out-of-network...more
In this episode, Gary Qualls discusses a recent development in payer litigation which implicates a number of recurring issues often raised in Employee Retirement Income Security Act (ERISA) cases. Specifically, a federal...more
2/7/2019
/ Administrative Remedies ,
Anti-Assignment Clauses ,
Assignment of Benefits (AOB) ,
Breach of Duty ,
Employee Retirement Income Security Act (ERISA) ,
Fiduciary Duty ,
Health Care Providers ,
Health Insurance ,
Hospitals ,
Motion to Dismiss ,
Patients ,
Payor Contracts ,
Plan Administrators ,
Preemption
In this episode, Gary Qualls discusses a recent development in payer litigation, regarding a provider’s recovery of Medicare Advantage payments pursuant to a Medicare Advantage contract. Specifically, a recent federal case...more
7/26/2018
/ Administrative Appeals ,
Administrative Remedies ,
Breach of Contract ,
Centers for Medicare & Medicaid Services (CMS) ,
Health Care Providers ,
Health Insurance ,
Hospitals ,
Insurer Liability ,
Jurisdiction ,
Medicare ,
Medicare Advantage ,
Medicare Advantage Organizations (MAOs) ,
Patients ,
Payor Contracts ,
Preemption ,
State Law Claims ,
Underpayment