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Healthcare Providers Keep Singing the Blues About Unfair Reimbursement Rates But Blue Cross Blue Shield Won’t Change Its Tune

After more than a decade of litigation and more than $5 billion in settlements, the Blue Cross Blue Shield Association (“BCBSA”) and its affiliate insurance companies (the “BCBS Entities”) appear to be up to their old tricks....more

Federal Court Certifies Class Action Against Blue Cross Blue Shield of Montana for Improperly Denying Large Dollar Claims

The Chief Judge of the U.S. District Court for the District of Montana recently certified a class action against Blue Cross Blue Shield of Montana for its standard operating procedure of reviewing and denying claims in...more

Health Insurers Under Fire: New Administration Cracks Down on Evasive Pricing Practices

Health insurance regulations are rapidly shifting with unprecedented intensity. Amid growing public outrage over evasive and abusive pricing practices by insurers and years of federal underenforcement, the new administration...more

UnitedHealthcare Must Face State Law Claims in Class Action Suit for AI Driven Coverage Denials of Medicare Advantage Claims

Daytime television inundates American seniors with advertisements for UnitedHealthcare’s (“UHC”) Medicare Advantage Plans. On its website, UHC claims its Medicare Advantage Plans “stand out from the rest,” providing...more

New Federal Parity Rules: A Step Forward for Equitable Mental Health and Substance Use Disorder Coverage

In September 2024, the U.S. Departments of Labor, Health and Human Services, and the Treasury (collectively, “the Departments”) released final rules to strengthen the enforcement of the Paul Wellstone and Pete Domenici Mental...more

California Invasion of Privacy Act Lawsuits: An Update

Over the past year, lawsuits under the California Invasion of Privacy Act (“CIPA”) have gained significant momentum, and there’s no sign of them slowing down. Both state and federal courts in California are seeing a rise in...more

The Caris MPI Decision: A Potential Turning Point in Out-of-Network Litigation Against Medicare Advantage Organizations

Nonparticipating providers have often struggled to recover fair reimbursement from vertically integrated, well-resourced Medicare Advantage Organizations (“MAOs”) through out-of-network litigation. The pattern is...more

AGG Talks: Healthcare Insights Podcast - Episode 4: What to Do When Insurance Companies Deny Behavioral Health Claims [Audio]

In this episode, AGG Healthcare Litigation co-chair Jason Bring is joined by AGG Healthcare Litigation partners Rich Collins and Damon Eisenbrey to discuss what you can do when insurance companies deny behavioral health...more

AGG Talks: Healthcare Insights Podcast - Episode 2: Substance Use Disorder Litigation [Audio]

In this episode AGG Healthcare Litigation co-chair Jason Bring is joined by AGG Healthcare Litigation partners Rich Collins and Damon Eisenbrey to discuss substance use disorder (“SUD”) litigation. The attorneys dive into...more

AGG Talks: Healthcare Insights - Episode 1: A Primer for Providers When Insurance Companies Refuse to Pay [Audio]

In this episode AGG Healthcare Litigation co-chair Jason Bring is joined by AGG Healthcare Litigation partners Rich Collins and Damon Eisenbrey to discuss commercial payor litigation. Jason, Rich, and Damon offer a primer for...more

Navigating California’s Surge in CIPA Cases: How to Safeguard Websites Using Third-Party Tech

California continues to grapple with a significant surge in lawsuits and arbitration demands aimed at businesses operating websites employing technology to monitor online activities. These cases hinge on the California...more

Appeals Court Revives AGG Class Action Against UnitedHealth Group for Federal Mental Health Parity Law Violations

The United States Court of Appeals for the Ninth Circuit ruled on April 11, 2024, that AGG’s class action lawsuit against UnitedHealth Group and its subsidiaries for the wrongful and systematic denial of mental health and...more

California Federal District Court Rules That AGG Clients’ Case Against Cigna for Institutional Practice of Under-Reimbursing...

U.S. District Court Judge David O. Carter ruled in favor of AGG’s clients on March 18, 2024, in a case involving “matters of widescale public concern” and a strong “public interest in access” to some of Cigna’s most coveted...more

Preemption and Exhaustion Requirements Thwart Medicare Advantage Plan Members’ Ability to Hold Health Insurers Accountable

Most states have statutes or common law that allow an insurance policyholder to bring a civil action and seek more than just compensatory damages (e.g., punitive damages) when her insurance company denies coverage in bad...more

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