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
3/31/2025
/ Ambulatory Surgery Centers ,
Breach of Contract ,
Employee Retirement Income Security Act (ERISA) ,
Health Care Providers ,
Health Insurance ,
Hospitals ,
Insurance Claims ,
Insurance Litigation ,
New York ,
Out of Network Provider ,
Promissory Estoppel ,
SEIU ,
Unjust Enrichment
On April 23, the US Department of Labor (DOL) released a final rule significantly expanding the definition of who qualifies as a fiduciary under the Employee Retirement Income Security Act (ERISA) (the Retirement Security...more
5/15/2024
/ Biden Administration ,
Department of Labor (DOL) ,
Employee Retirement Income Security Act (ERISA) ,
Exemptions ,
Fiduciary ,
Final Rules ,
Internal Revenue Code (IRC) ,
Investment ,
Pensions ,
Prohibited Transactions ,
Retirement Plan ,
Securities and Exchange Commission (SEC)
Last week, the US Court of Appeals for the Ninth Circuit, in its third opinion in the case, reversed a lower court’s decision allowing patients challenging United Behavioral Health’s (UBH) internal mental health coverage...more
On December 5, 2022, the US District Court for the Middle District of North Carolina held that the North Carolina State Health Plan (NCSHP) constitutes a “Health Program or Activity” under the Affordable Care Act (ACA). In so...more
12/14/2022
/ Affordable Care Act ,
Bostock v Clayton County Georgia ,
Civil Rights Act ,
Employee Retirement Income Security Act (ERISA) ,
Gender Discrimination ,
Health Insurance ,
North Carolina ,
Rulemaking Process ,
SCOTUS ,
Summary Judgment ,
Transgender
The Ninth Circuit Court of Appeals recently reversed the Northern District of California’s landmark decision against UnitedHealth Group Inc.’s behavioral health unit, United Behavioral Health (“UBH”), under which UBH had been...more
In December, the Supreme Court requested that U.S. Solicitor General Elizabeth Prelogar file a brief in John Doe 1 v. Express Scripts Inc., weighing in on whether the Court should hear a case about prescription drug costs. If...more
2/8/2022
/ Amicus Briefs ,
Drug Pricing ,
Employee Benefits ,
Employee Retirement Income Security Act (ERISA) ,
Fiduciary Duty ,
Health Insurance ,
Healthcare ,
Petition for Writ of Certiorari ,
Pharmacy Benefit Manager (PBM) ,
Prescription Drugs ,
SCOTUS
States seeking to regulate pharmacy benefit managers (PBMs) and prescription drug pricing received a win from the Supreme Court, which reversed an Eighth Circuit decision that had invalidated an Arkansas law governing...more