News & Analysis as of

Out of Network Provider Aetna

Troutman Pepper Locke

Litigation Heats Up Over Air Ambulance Billing Practices Under the No Surprises Act

Troutman Pepper Locke on

There has been a flurry of recent activity in a case originally filed by six air ambulance companies claiming $20 million in unpaid emergency services invoices. ...more

Latham & Watkins LLP

California Supreme Court Rules on Unfair Competition Law

Latham & Watkins LLP on

The decision provides organizational plaintiffs, including nonprofits and trade associations, with a basis to establish standing to bring UCL claims. In July 2023 the California Supreme Court expanded the ability of...more

ArentFox Schiff

ERISA Does Not Bar Medical Providers from Enforcing Health Plans’ Payment Promises Under State Law

ArentFox Schiff on

Medical providers treating patients covered by ERISA-governed health plans on an out-of-network basis can assert state-law claims to hold plans to their payment promises without running afoul of ERISA’s preemption provision...more

Epstein Becker & Green

Third Circuit: Provider’s Out-of-Network Claims not Pre-empted by ERISA

Epstein Becker & Green on

In an important win for healthcare providers, on July 17, 2020, the Third Circuit determined in a published opinion that an out-of-network provider’s direct claims against in insurer for breach of contract and promissory...more

Mintz - Health Care Viewpoints

Lessons Learned from FCA Settlement Involving Waiver of Medicare Coinsurance Amounts

The waiver of copayments, coinsurance, and deductibles owed by patients treated by out-of-network laboratories and other providers is a hot topic in the health care industry. Despite the near absence of clear legal...more

BakerHostetler

Insurer Actions Cut the Heart Out of Out-of-Network Providers

BakerHostetler on

Aetna Life Insurance Company recently won a $37 million verdict against a group of Northern California surgical centers, Bay Area Surgical Management, LLC and its affiliates (collectively, Bay Area), for an alleged...more

Buchalter

Aetna vs. BASM: Pigs Get Fat and Hogs Get Slaughtered

Buchalter on

On April 13, 2016, a jury in Santa Clara, California awarded Aetna, Inc. $37.4 million from Bay Area Surgical Management, LLC (“BASM”), six of its affiliated surgery centers and its three principals. Aetna had accused the...more

BakerHostetler

Texas Hospital Strikes Back at Aetna

BakerHostetler on

On February 23, 2015, Aetna filed suit in Texas federal court against Robert A. Behar, M.D. and North Cypress Medical Center (North Cypress), alleging that Dr. Behar, the CEO of North Cypress, offered impermissible ownership...more

BakerHostetler

Aetna Out of Patience With Hospital’s Alleged Out-of-Network Billing Scheme

BakerHostetler on

Aetna Life Insurance Company (Aetna) is going on the offensive against a Northwest Houston hospital with an out-of-network strategy. On February 23, 2015, Aetna filed suit in Texas federal court against Robert A. Behar, M.D....more

9 Results
 / 
View per page
Page: of 1

"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