AGG Talks: Home Health & Hospice - Reimbursement Audits and Appeals
Podcast: Direct Access Laboratory Testing: Reimbursement & Compliance – Diagnosing Health Care
Podcast: Owner's Outlook: Maximize and Safeguard Reimbursement Through Design - Diagnosing Health Care
HealthLaw HotSpot - A Look at Alternative Reimbursement Models in Value-Based Care
The Important and Thriving Role of Private Medical Practices
Value-Based Care and Its Impact on Providers
The Year Ahead: Litigation Hot Spots at a Glance
Teleworking: Amazing or amazingly complex?
(Video) Reimbursement of College Tuition and Fees After COVID-19
Value-based health care: compliance infrastructure
K&L Gates Triage: 340B Eligibility - Hospital Covered Entities
Value-based health care: fraud & abuse laws
Value-based health care: issues for pharmaceutical companies
Condo Water Invasion: Potential Medical Liability?
On August 2, health care providers scored yet another significant victory when the US Court of Appeals for the Fifth Circuit affirmed the vacatur of various federal regulations regarding the arbitration procedures used to...more
This month’s Friday Five explores recent decisions with issues spanning physician power of attorney to preexisting exclusions and the fiduciary duty of an insurance company....more
In Florida, personal injury protection (PIP) coverage limits reimbursement of medical charges to 80% of “all reasonable expenses.” What is “reasonable” is generally determined by a statutory schedule of maximum charges...more
In Patterson v. United Healthcare Insurance Company, 76 F.4th 487 (6th Cir. 2023), the Sixth Circuit held that the plaintiff insured had stated an equitable claim for disgorgement under ERISA where he sought disgorgement of...more
Fine Art Title Insurance Artwork title insurance reimburses an insured if another owner makes a claim to the title of a piece of artwork that the insured purchased. This is an important coverage, which is often purchased...more
Weighing in on an issue that has divided courts nationwide, the U.S. Court of Appeals for the First Circuit has ruled that an insurer under Massachusetts law has no right to recoup defense costs, or amounts the insurer pays...more
In Part I (”When Can an Insurer Pursue a Malpractice Claim Against Defense Counsel Retained for an Insured”) of our two-part article published by the ABA’s Insurance Coverage Litigation Committee (ICLC), we addressed the...more
1. German Federal Court of Justice rules on reimbursement of disputed workshop invoices by insurance companies - On 16 January 2024, the German Federal Court of Justice (Bundesgerichtshof, “BGH”) decided five cases, all...more
Orange Cty. Sch. Bd., a/k/a Orange Cty. Public Schools, County Court 9th Judicial Circuit Orange County, Civil Division, Case No: 2021-CC-016105-O - State Farm sought reimbursement from the School Board of Orange County for...more
As 2024 rapidly approaches, we look back at some of the key decisions, trends, and developments impacting the U.S. insurance industry in 2023 and look ahead at some trends and cases to watch in 2024. Insurers continue to...more
Our December Insurance Update features a few firsts from state high courts. For the first time: •The Supreme Court of Hawaii addresses reimbursement of defense costs. •The Supreme Court of Illinois addresses coverage for...more
Next Medical Florida, LLC a/a/o Marvin Jackson v. United Services Automobile Assoc., Volusia County Case No: 2022-11377-CODL (71) - This suit involved the legal issue of whether or not the insurer was required to reimburse...more
DEFENSE COST REIMBURSEMENT - Cont’l Cas. Co. v. Winder Labs., LLC, 73 F.4th 934 (11th Cir. 2023) Eleventh Circuit predicts that, under Georgia law, insurers found to have no duty to defend underlying suits could not...more
Eric R. Cruz v. Security National Ins. Co., Circuit Court, 17th Judicial Circuit in and for Broward County, Case No. CACE 20-00612 (07), Feb. 24, 2023 - The trial court granted the defendant’s motion to dismiss the...more
ISO Diagnostic Testing Inc. v. United Automobile Ins. Co., Broward County Case No: COINX-22-024098 - This suit was for allegedly underpaid PIP benefits. ISO Diagnostic Testing billed seven units of CPT code 95851. United Auto...more
Progressive Express Ins. Co. v. SimonMed Imaging a/a/o Hilleri Brown, 6th District, Case No. 6d23-1145. L.T. Case No. 2020-SC-043217-O, (48 Fla. L. Weekly D990a) - This suit involved a dispute regarding application of the...more
Progressive Select Ins. Co. v. In House Diagnostic Services, Inc. a/a/o Darryl Frazier, No. 4D21-2581 - This suit involved the legal issue of whether Progressive Select Insurance Company incorrectly determined the...more
A recent decision by the U.S. Court of Appeals for the Sixth Circuit (Patterson v. United HealthCare Ins. Co., No. 22-3167, 2023 WL 4882436 (6th Cir. Aug. 1, 2023)) illustrates the importance of clearly describing key plan...more
What is subrogation? Why am I being asked to waive it? Should I care? To answer that last question, let’s take a quick run at the first two. What Is Subrogation? “Subrogation” refers to the act of one person or party standing...more
Hosts Lynda A. Bennett and Eric Jesse of Lowenstein’s Insurance Recovery Group continue their discussion about the difference between the duty to defend, the duty to reimburse, and the duty to advance. They run through the...more
In this episode of “Don’t Take No for an Answer,” hosts Lynda A. Bennett and Eric Jesse of Lowenstein’s Insurance Recovery Group discuss the difference between a duty to defend versus a duty to reimburse. They explain why...more
Based on two Commonwealth Court decisions filed on March 17, 2023, medical marijuana is now medical treatment covered by the PA Workers’ Compensation Act (WC Act), and failure to pay is a violation of the Act, with up to 50%...more
The United States Court of Appeals for the Eighth Circuit, applying Iowa law, has held that a professional liability insurer had no duty to defend and indemnify a medical clinic and its director for claims by the clinic...more
On January 10, New York’s Governor, Kathy Hochul, delivered the 2023 “State of the State” address. The address featured a number of health care reform initiatives—a strong indication that New York will prioritize health care...more
On November 28, 2022, the Illinois Supreme Court unanimously reversed the appellate court’s decision that an insurer would have to defend a rental property’s tenants against a third-party negligence claim arising from a fire....more