The Department of Health and Human Services, Department of Labor, Department of the Treasury, and Office of Personnel Management have released the first set of rules from the No Surprises Act, a new law aimed at preventing...more
SEYFARTH SYNOPSIS: The Ninth Circuit recently dealt another major blow to healthcare providers that attempt to bring suits as assignees of their individual patients, holding that an ERISA plan’s anti-assignment provision bars...more
Seyfarth Synopsis: The Fourth Circuit found that the medical necessity of a given service constitutes a material element of representations regarding submissions for payment, potentially providing payors with another legal...more
11/16/2017
/ Clinical Laboratories ,
Criminal Convictions ,
Drug & Alcohol Abuse ,
Drug Testing ,
Employee Benefits ,
Employee Retirement Income Security Act (ERISA) ,
False Billing ,
Health Clinics ,
Health Insurance ,
Healthcare Fraud ,
Material Misrepresentation ,
Medical Necessity
Seyfarth Synopsis: The Ninth Circuit Court of Appeals recently confirmed that ERISA preempts state insurance law bans on discretionary clauses for self-funded ERISA plans....more
9/11/2017
/ Aetna ,
Denial of Benefits ,
Disability Benefits ,
Discretionary Clauses ,
Employee Benefits ,
Employee Retirement Income Security Act (ERISA) ,
Health Insurance ,
Insurance Industry ,
Popular ,
Preemption ,
Self-Funded Health Plans
A district court in Tennessee recently rejected ERISA claims by healthcare providers against a plan insurer, holding that the providers lacked standing to sue under ERISA as their patients’ assignees. Brown v. Blue Cross...more