News & Analysis as of

Insurance Health Civil Procedure

Read Insurance Law updates, alerts, news, and legal analysis from leading lawyers and law firms:
Nexsen Pruet, PLLC

Ripeness: A Question of Subject Matter Jurisdiction - Allied World Surplus Lines Insurance Company v. Blue Cross and Blue Shield...

by Nexsen Pruet, PLLC on

Addressing a contractual requirement to exhaust Alternative Dispute Resolution (ADR) prior to commencing litigation, the United States District Court for the District of South Carolina chose to forge its own path, rejecting...more

Mintz - Employment, Labor & Benefits...

The Ninth Circuit Weighs in on ERISA’s Plan Document and Summary Plan Description Requirements: Mull v. Motion Picture Ind. Health...

Mull v. Motion Picture Ind. Health Plan educates employers on the basics of the requirements of the Employee Retirement Income Security Act (ERISA) governing plan documents and summary plan descriptions. The lessons are...more

K&L Gates LLP

Recent 11th Circuit Decision Is a Victory for Health Care Providers Challenging Insurer Reimbursement Decisions and a Reminder of...

by K&L Gates LLP on

The existence and scope of assignments of benefits from patients to health care providers continues to be critically important to a provider’s ability to challenge an insurer’s reimbursement decision under the Employee...more

Nexsen Pruet, PLLC

Torts & Insurance Cases from the 4th Circuit Court of Appeals - May 2017

by Nexsen Pruet, PLLC on

Each month, Nexsen Pruet attorney Marc Manos, a member of the SC Bar Torts and Insurance Practice Section Council, sheds light on a few recent cases from the Fourth Circuit Court of Appeals, focused in the area of Torts &...more

Faegre Baker Daniels

Admissibility of Insurance Coverage: Sauce for the Goose

by Faegre Baker Daniels on

When Kerrie Evans’s child was born with cystic fibrosis, she sued her nurse practitioner and doctor for failure to adequately inform her about prenatal testing for CF, making concerns about cost the centerpiece of her...more

Baker Ober Health Law

10th Circuit Affirms Dismissal of Antitrust Case Against Health Insurer

by Baker Ober Health Law on

On May 31, the Tenth Circuit Court of Appeals affirmed the dismissal of plaintiff's claims in Bristow Endeavor Healthcare v. Blue Cross Blue Shield Association et al., handing Blue Cross Blue Shield of Oklahoma, and its...more

Proskauer - Employee Benefits & Executive...

Out-of-Network Physician’s Claim Against Insurer Not Preempted by ERISA

The Second Circuit concluded that a promissory estoppel claim by an out-of-network provider against an insurer was not completely preempted by ERISA and thus remanded the claim to state court for further proceedings. The...more

Faegre Baker Daniels

$4 Million Liability for Bad Legal Advice to a Chiropractor

by Faegre Baker Daniels on

Allstate Insurance has won a judgment of nearly $4 million against a NY lawyer and Calif. consultant who guided a NJ chiropractor in structuring a medical practice designed to appear to meet the requirements of the state...more

Chambliss, Bahner & Stophel, P.C.

Dispute Between Brothers Demonstrates Need to Plan for Long-Term Care

A recent New Jersey appeals court case demonstrates how important it is for families to come up with a long-term care plan before an emergency strikes. The case involves two brothers who got into a fight over whether to place...more

Proskauer - Employee Benefits & Executive...

New Class Action Lawsuits Asserting Violations of the MHPAEA

Banner Health and the Kaiser Foundation were recently hit with separate class action lawsuits challenging their denials of certain mental health care coverage...more

Baker Ober Health Law

Anthem Loses Merger Appeal in a 2-1 Decision by the D.C. Circuit

by Baker Ober Health Law on

On March 24, the D.C. Circuit held oral argument on Anthem's appeal in United States v. Anthem, in which Anthem sought to have the appellate court overturn District Court Judge Amy Berman Jackson's ruling that barred the...more

Fisher Phillips

HR 1313 and the Future of Employee Wellness Programs

by Fisher Phillips on

On March 8, the House’s Education and Workforce Committee passed a bill, HR 1313 – Preserving Employee Wellness Programs Act. The bill, which was introduced by U.S. Rep. Virginia Foxx in order to “reaffirm existing law to...more

Baker Ober Health Law

Blues Defeat Antitrust Claim by Heart Monitoring Device Maker

by Baker Ober Health Law on

On April 3, Judge Eduardo Robreno, District Judge for the Eastern District of Pennsylvania, granted judgment to a collection of insurer defendants in an antitrust conspiracy case brought against them by heart monitoring...more

BakerHostetler

Darwinian Insurance

by BakerHostetler on

This case demonstrates the need for providers to know and follow the notification provisions set forth in their insurance policies in order to avoid an inadvertent loss of coverage. Once again, the terms of a hospital’s...more

Faegre Baker Daniels

Recovery of Medical Bills: Once Is Enough

by Faegre Baker Daniels on

Strange as it sounds, Missouri state law allowed federal workers to recover medical bills twice: once under their federal health insurance plan and again from the person (or person’s insurer) responsible for their injuries. ...more

Butler Weihmuller Katz Craig LLP

Supreme Court says lawyer's referral of client to a doctor for treatment is attorney-client privileged communication, and out of...

The Florida Supreme Court declared that the attorney-client privilege shielded a motor vehicle accident plaintiff from being required to disclose that her attorney had referred her to a doctor for treatment. In Worley v....more

Jones Day

Second Circuit Affirms Dismissal of FCA Cases

by Jones Day on

The Second Circuit affirmed the dismissal of two False Claims Act ("FCA") cases brought by private relators against insurance and other companies based on the alleged failure to reimburse the Centers for Medicare & Medicaid...more

Lane Powell PC

ERISA: Winning Tactic on Summary Judgment to Prove Claimant Received the Policy: Get Key Evidence into the Administrative Record

by Lane Powell PC on

You know that to apply an exclusion in a policy, the claims administrator must show that the claimant received the policy. But what happens when the claimant submits a declaration disputing your proof that she received...more

Cozen O'Connor

Washington Supreme Court Expands Physicians’ Duty to Third Parties

by Cozen O'Connor on

Most states have laws either requiring or permitting mental health professionals to disclose information about patients who may become violent. These voluntary or mandatory reporting laws require a balancing of the...more

Dorsey & Whitney LLP

Insurers’ Suit Against Government for Affordable Care Act Payments May Proceed; If Successful, Insurers Entitled to Billions from...

by Dorsey & Whitney LLP on

In a closely watched case, the Court of Federal Claims last week refused to dismiss a health insurer’s putative class action against the Federal government for payments authorized under the Affordable Care Act. The Court’s...more

King & Spalding

CMS Issues Alert Updating and Clarifying Mandatory Reporting Thresholds for Certain Liability Insurance Settlements, Judgments,...

by King & Spalding on

On December 12, 2016, CMS issued a Technical Alert that announced a change in reporting requirements for several different types of settlements with total payment obligation to claimant (TPOC) dates on or after January 1,...more

Reminger Co., LPA

Indiana Supreme Court Extends the Stanley Doctrine to State-Sponsored Medical Reimbursements

by Reminger Co., LPA on

On October 21, 2016, the Indiana Supreme Court weighed-in on a closely watched case that drew much attention from the defense and plaintiff’s bar alike. Approximately one (1) year ago, I reported that the Indiana Court of...more

Snell & Wilmer

Dealing with Long-Winded Out-of-Network Provider Nuisance Letters

by Snell & Wilmer on

Over the past couple years, more and more of my clients with self-funded plans have received letters from out-of-network providers appealing denied claims. The letters are usually 20 to 30 pages long, not very specific, and...more

Mintz

Big Summary Judgment Win for Hospital Defending $300M Exclusive Dealing Antitrust Suit

by Mintz on

After fending off a motion for judgment on the pleadings in March 2015, a small hospital in Peoria, Illinois lost on summary judgment in its $300 million antitrust suit alleging illegal exclusive dealing and attempted...more

BakerHostetler

Sixth Circuit Vacates Class Settlement, Finding that Sealed Documents Prevented Objectors from Assessing Settlement’s Fairness

by BakerHostetler on

This summer, the Sixth Circuit rejected class action litigants’ filing of the bulk of their class settlement documents under seal. Shane Grp., Inc. v. Blue Cross Blue Shield of Mich., 825 F.3d 299 (6th Cir. 2016). The Sixth...more

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Information for EU and Swiss Residents

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Privacy Officer
JD Supra, LLC
10 Liberty Ship Way, Suite 300
Sausalito, California 94965

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Privacy Officer
JD Supra, LLC
10 Liberty Ship Way, Suite 300
Sausalito, California 94965

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Updates to This Policy

We may update this cookie policy and our Privacy Policy from time-to-time, particularly as technology changes. You can always check this page for the latest version. We may also notify you of changes to our privacy policy by email.

Contacting JD Supra

If you have any questions about how we use cookies and other tracking technologies, please contact us at: privacy@jdsupra.com.

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