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Health Insurance Administrative Appeals

K&L Gates LLP

K&L Gates Triage: Recent Developments in Provider v. Payer Litigation -- Medicare Advantage Disputes

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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

King & Spalding

Court Rules Hospitals Must Exhaust HHS Administrative Appeals Process for Medicare Advantage Out-of-Network Payment Dispute

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According to a Georgia federal district court ruling issued on February 11, 2016, a group of hospitals must exhaust their out-of-network Medicare Advantage (MA) payment dispute through the Department of Health and Human...more

Proskauer Rose LLP

The ERISA Litigation Newsletter - September 2015

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Editor's Overview - It has been a little more than one year since the U.S. Supreme Court altered the legal landscape for litigating ERISA breach of fiduciary duty claims relating to the investment in employer stock...more

Williams Mullen

Plaintiffs’ Misdirected Demand for Documents Fails, and Their Claim for ERISA Civil Penalties Is Dismissed: Boyd v. Sysco...

Williams Mullen on

A federal court dismissed the plaintiffs’ claim to recover civil penalties for failure to provide plan documents requested by the plaintiffs. Boyd v. Sysco Corporation, No. 4:13-cv-00599 (D. S. C. September 3, 2015), provides...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

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