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U.S. Supreme Court Holds Medicaid’s Any-Qualified-Provider Provision Does Not Confer Enforceable Rights

The U.S. Supreme Court, in a 6-3 decision, ruled that the Medicaid Act’s any-qualified-provider provision does not confer individual rights enforceable under 42 U.S.C. §1983. This decision reverses the Fourth Circuit’s...more

California Governor Signs Legislation Impacting Health Care Claim Reimbursement and DMHC Requests for Records

On September 27, California Governor Gavin Newsom signed into law two bills that will impact health care service plans and insurers in the state....more

9th Circ. Clarifies ERISA Preemption for Healthcare Industry

On May 31, the U.S. Court of Appeals for the Ninth Circuit published an opinion in Bristol SL Holdings Inc. v. Cigna Health and Life Insurance Co., which has significant implications for the healthcare industry. Originally...more

White House Finalizes New Mental Health Parity Rule

The White House has finalized the new Mental Health Parity rule, which focuses on increasing access to mental health/substance use disorder treatment through nonquantitative treatment limitations (NQTL) data and reporting,...more

Fifth Circuit Affirms Vacatur of Insurer-Friendly "No Surprises Act" Regulations

In a win for health care providers, on August 2, the Fifth Circuit Court of Appeals affirmed a Texas federal judge’s grant of summary judgment in favor of the Texas Medical Association and LifeNet, an air ambulance company,...more

Ninth Circuit Court of Appeals Restricts Out-of-Network Providers’ Ability to Avoid ERISA Preemption of State Law Claims

On May 31, the Ninth Circuit Court of Appeals published an opinion in Bristol SL Holdings, Inc. v. Cigna Health and Life Insurance Company, which has significant implications for the healthcare industry, most notably by...more

California Court of Appeal Affirms Grant of Summary Judgment Against Health Care Provider in Win for Managed Care Payors and...

The California Court of Appeal, in a major win for managed care payors and claims administrators, affirmed a lower court decision granting summary judgment in favor of United Healthcare (United), finding that United did not...more

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