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Unjust Enrichment Out of Network Provider

ArentFox Schiff

Navigating Out-of-Network Claims: Key Takeaways for Providers From Surgery Center Case in New York Federal Court

ArentFox Schiff on

The US District Court for the Eastern District of New York in Manalapan Surgery Ctr., et al. v. 1199 SEIU National Benefit Fund, No. 23-CV-03525 (EDNY March 12, 2025), recently granted a motion to dismiss a complaint filed by...more

Hinshaw & Culbertson LLP

The LHD/ERISA Advisor – June 2021: Second Circuit Issues Statute of Limitations Ruling Favorable to Healthcare Plan Administrators

Federal law does not supply a statute of limitations for a claim seeking equitable relief under ERISA, 29 U.S.C. 1132(a)(3), and therefore federal courts borrow the limitations period of the state-law cause of action to which...more

Hinshaw & Culbertson LLP

The LHD/ERISA Advisor - October 2020: Third Circuit Rules State Law Reimbursement Claims Brought by Out-of-Network Medical...

In Plastic Surgery Center, P.A. v. Aetna Life Ins. Co., 2020 U.S. App. LEXIS 22274 (July 17, 2020), the Third Circuit held that an out-of-network medical provider's state law claims against an insurer were not precluded by...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

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