News & Analysis as of

Health Insurance Insurance Litigation

Eversheds Sutherland (US) LLP

AI Litigation Insights - Barrows et al. v. Humana, Inc.

Health insurer Humana was sued in a class action challenging the process by which it made claim determinations and alleging that it knowingly used a “highly inaccurate” artificial intelligence model, nH Predict, to improperly...more

Hall Benefits Law

Court Orders Claims Reprocessing After Finding TPA Illegally Excluded Gender-Affirming Care in Violation of ACA Section 1557

Hall Benefits Law on

A federal district court has awarded injunctive relief, including claims processing, after finding that an insurer acting as a third-party administrator (TPA) for a self-insured plan violated Section 1557 of the Affordable...more

DRI

[Event] Boot Camp for New Life, Health, and Disability Lawyers - July 24th - 25th, Chicago, IL

DRI on

The DRI Life, Health, and Disability Committee is once again sponsoring a program aimed at providing a basic understanding of the concepts applicable to life, health, and disability litigation. The program, which receives...more

Manatt, Phelps & Phillips, LLP

[Webinar] Mental Health Parity Update 2024: The Latest Regulatory and Litigation Trends - March 26th, 1:00 pm - 2:00 pm ET

The Mental Health Parity and Addiction Equity Act (MHPAEA) requires health plans and insurers to offer mental health coverage in “parity” with a plan’s medical or surgical coverage. In 2024, as the post-COVID era brings a...more

Carlton Fields

Expect Focus - Volume III, September 2023

Carlton Fields on

Regulators Hit Jackpot: Off-Channel Communications - Several years before announcing the first “off-channel” communications enforcement action, the SEC and FINRA cautioned broker-dealers and investment advisers about...more

Manatt, Phelps & Phillips, LLP

[Webinar] Mental Health Parity Update: Key Takeaways From the Newest Regulatory Guidance and Litigation Trends - September 19th,...

The Mental Health Parity and Addiction Equity Act (MHPAEA) requires health plans to provide mental health benefits, including coverage for substance use disorders (SUDs), that are in “parity” with medical and surgical...more

Jackson Walker

Summary of HB 3359: Changes to Preferred Provider Benefit Plans

Jackson Walker on

HB 3359 amends Chapter 1301 of the Texas Insurance Code. Chapter 1301 sets forth the legal requirements and obligations of a “preferred provider benefit plan”. A “preferred provider benefit plan” is a benefit plan in which an...more

Carlton Fields

7th Cir. Holds Insurance Coverage Applies to Settlement Payments for Alleged Anti-Kickback and False Claims Act Violations

Carlton Fields on

On May 3, 2023, the Seventh Circuit Court of Appeals, in Astellas US Holding Inc. v. Federal Insurance Co., held that a liability insurer was required to contribute its limits toward its insured’s payment to settle potential...more

Manatt, Phelps & Phillips, LLP

[Webinar] No Surprises Act Update: The Latest Litigation, Enforcement and Implementation Challenges - February 16th, 3:00 pm -...

The No Surprises Act (NSA), which went into effect January 1, 2022, was designed to protect patients from surprise medical bills when they are treated in out-of-network emergency departments or by out-of-network providers at...more

Polsinelli

Ninth Circuit Reverses Landmark Wit Case Addressing Behavioral Health Coverage

Polsinelli on

The President and his administration continue to tout their efforts to strengthen coverage for behavioral health care, including significantly increasing behavioral health spending and strengthening parity between physical...more

Verrill

Surprise Medical Bills: Texas District Court Vacates Portion of Independent Dispute Resolution (IDR) Process in Agency Rule

Verrill on

The U.S. District Court for the Eastern District of Texas recently vacated a portion of the Requirements Related to Surprise Billing, Part II, Interim Final Rule (the “Rule”) regarding the independent dispute resolution (IDR)...more

Faegre Drinker Biddle & Reath LLP

Louisiana Secures Temporary Injunction in Connection with the SHIP Rehabilitation Plan

Senior Health Insurance Company of Pennsylvania (“SHIP”) was placed in rehabilitation in Pennsylvania in January 2020. On August 24, 2021, the Commonwealth Court of Pennsylvania approved the Rehabilitation Plan (the “Plan”),...more

Epstein Becker & Green

Another Setback for UnitedHealthcare Insurance Company in Nevada Trial Just Days after $60 Million Punitive Verdict

On January 12, 2022, the closely watched Nevada lawsuit filed by emergency medicine providers against one of the largest health insurance companies in the world—UnitedHealthcare Insurance Company—was again the focus of...more

Wiley Rein LLP

Insured Barred From Settling Without Insurer’s Consent Absent Breach of Duty to Defend But Insurer Must Exercise Good Faith in...

Wiley Rein LLP on

The United States District Court for the District of South Dakota, applying South Dakota law, has held that an insured healthcare system was barred from settling without its healthcare liability insurer’s consent where the...more

Sheppard Mullin Richter & Hampton LLP

State, Federal, and Private Enforcement of Mental Health Parity Compliance

Six months ago, we cautioned health plans and plan sponsors that states, the federal government, and private litigants were laser focused on Mental Health Parity and Addiction Equity Act (“MHPAEA”) compliance. The United...more

Pullman & Comley - Connecticut Health Law

Notable 2020 Connecticut Decisions Affecting Health Care

Plaintiff Cannot Cure Defective Malpractice Opinion Letter with an Affidavit Connecticut law requires that a plaintiff in a medical malpractice action demonstrate the existence of his or her good faith by obtaining a written...more

K&L Gates LLP

Recent District Court Decision Highlights the Importance of Adequate Behavioral Health Claims Processing Guidelines for ERISA...

K&L Gates LLP on

On this week’s episode, Carla DewBerry and Sarah Carlins discuss a recent California Federal District Court decision in David Wit v. United Behavioral Health, in which the court found that the defendant insurer violated ERISA...more

Haight Brown & Bonesteel LLP

Unreasonableness of Insurer’s “Medical Necessity” Criteria and Inconsistent Expert Testimony Mandate Reversal of Genuine Dispute...

In Ghazarian v. Magellan Health (No. G057113, filed 8/7/20), a California appeals court reversed summary judgment that had been granted for a health plan insurer in a bad faith and unfair business practices lawsuit on the...more

Carlton Fields

Seventh Circuit Rejects Third-Party Administrator’s Attempt to Avoid Multimillion-Dollar Arbitration Award

Carlton Fields on

Standard Security Life Insurance Company of New York and Madison National Life Insurance Co. entered into an administrative services agreement with FCE Benefit Administrators Inc. under which FCE administered insurance...more

K&L Gates LLP

K&L Gates Triage: Michael P. V. BCBS Of Texas

K&L Gates LLP on

In this week’s episode, Gary Qualls discusses a recent case decided in the Western District of Louisiana, which highlights how the application of the arbitrary and capricious standard as applied to payor coverage...more

American Conference Institute (ACI)

[Webinar] Navigating New Risks and Litigation Challenges Facing Payors in the COVID-19 Context and Beyond - May 13th, 12:00 pm -...

What will the post-pandemic world look like? What risks and challenges will it raise and how to navigate the new litigation landscape? These are the most relevant questions amid the pandemic. To respond to them and provide...more

Morrison & Foerster LLP

Coronavirus (COVID-19): Know Your Insurance Coverage

Coronavirus–related litigation has already begun, and private and public investigations and litigation exploring the financial harm suffered by myriad companies and investors across many industries are likely to multiply...more

Carlton Fields

Court Compels Arbitration of Balance Billing Dispute Under a California Health Plan, Severs Certain Unconscionable Provisions, and...

Carlton Fields on

A patient sued her health plan and the plan’s debt collector under various California and federal laws in connection with alleged attempts by the plan to unlawfully collect the balances of the plaintiff’s medical statements...more

Carlton Fields

Court of Federal Claims Finds HHS Offset Invalid Under Colorado’s Insurance Liquidating Priority Scheme

Carlton Fields on

The U.S. Department of Health and Human Services’ Centers for Medicare and Medicaid Services (HHS) operates the reinsurance and risk-adjustments program for Colorado, including the application of the “netting rule” — a method...more

Carlton Fields

“Partial Final” Does Not Mean Final

Carlton Fields on

Don’t try to confirm an arbitration award when there is still arbitration work to be done. Relying on Seventh Circuit precedent, the Northern District of Illinois concluded that it lacked subject-matter jurisdiction to...more

38 Results
 / 
View per page
Page: of 2

"My best business intelligence, in one easy email…"

Your first step to building a free, personalized, morning email brief covering pertinent authors and topics on JD Supra:
*By using the service, you signify your acceptance of JD Supra's Privacy Policy.
- hide
- hide