Daytime television inundates American seniors with advertisements for UnitedHealthcare’s (“UHC”) Medicare Advantage Plans. On its website, UHC claims its Medicare Advantage Plans “stand out from the rest,” providing...more
3/6/2025
/ Algorithms ,
Artificial Intelligence ,
Class Action ,
Data Privacy ,
Denial of Insurance Coverage ,
Health Insurance ,
Healthcare ,
Insurance Claims ,
Insurance Industry ,
Insurance Litigation ,
Medicare ,
Medicare Advantage ,
Unfair Competition ,
UnitedHealth
In September 2024, the U.S. Departments of Labor, Health and Human Services, and the Treasury (collectively, “the Departments”) released final rules to strengthen the enforcement of the Paul Wellstone and Pete Domenici Mental...more
Nonparticipating providers have often struggled to recover fair reimbursement from vertically integrated, well-resourced Medicare Advantage Organizations (“MAOs”) through out-of-network litigation. The pattern is...more
In this episode, AGG Healthcare Litigation co-chair Jason Bring is joined by AGG Healthcare Litigation partners Rich Collins and Damon Eisenbrey to discuss what you can do when insurance companies deny behavioral health...more
In this episode AGG Healthcare Litigation co-chair Jason Bring is joined by AGG Healthcare Litigation partners Rich Collins and Damon Eisenbrey to discuss substance use disorder (“SUD”) litigation. The attorneys dive into...more
In this episode AGG Healthcare Litigation co-chair Jason Bring is joined by AGG Healthcare Litigation partners Rich Collins and Damon Eisenbrey to discuss commercial payor litigation. Jason, Rich, and Damon offer a primer for...more
The United States Court of Appeals for the Ninth Circuit ruled on April 11, 2024, that AGG’s class action lawsuit against UnitedHealth Group and its subsidiaries for the wrongful and systematic denial of mental health and...more
U.S. District Court Judge David O. Carter ruled in favor of AGG’s clients on March 18, 2024, in a case involving “matters of widescale public concern” and a strong “public interest in access” to some of Cigna’s most coveted...more
Most states have statutes or common law that allow an insurance policyholder to bring a civil action and seek more than just compensatory damages (e.g., punitive damages) when her insurance company denies coverage in bad...more
Background - Revisiting the topic from an article published earlier this year, another plaintiff has successfully challenged a commercial insurer’s internal Proton Beam Radiation Treatment (“PBT”) policy. PBT is a proven...more
Under the Employee Retirement Income Security Act of 1974 (“ERISA”), a health benefit plan participant who believes her insurer wrongfully denied coverage for services or benefits may bring a Section 502(a)(1)(B) claim to...more
In 2018, an Oklahoma jury awarded $25.5 million to the family of a cancer patient denied coverage for proton radiation therapy by Aetna. The case involved the denial of coverage for Orrana Cunningham, who had stage 4...more