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Appeals Court Revives Company’s Suit against Blue Cross for Breach of ERISA Fiduciary Duty

On May 21, 2025, the Sixth Circuit revived a company’s lawsuit against Blue Cross Blue Shield of Michigan (BCBSM) for breaching its fiduciary duties under ERISA as a third-party administrator (TPA). The plaintiff company,...more

Second Circuit Holds No FCA Violation Where Defendant Relied on Favorable OIG Advisory Opinions

On April 14, 2025, the Second Circuit issued a summary order holding that the relator failed to plead scienter, a necessary element under the Anti-Kickback Statute (AKS) and the False Claims Act (FCA), where the defendant...more

Federal Court Vacates Air Ambulance Portion of No Surprises Act Dispute Resolution

On July 26, 2022, LifeNet was granted summary judgment in its challenge to portions of the second set of implementing regulations for the Independent Dispute Resolution (IDR) process for air ambulance providers under the No...more

Federal Court Vacates Portion of No Surprises Act Dispute Resolution Rule

On February 23, 2022, the Texas Medical Association was granted summary judgment in its challenge to portions of the second set of implementing regulations that implement the No Surprises Act’s Independent Dispute Resolution...more

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