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
A federal court recently rejected arguments by MultiPlan, Inc. and Cigna Health and Life Insurance Company that they had no obligation to ensure payments at the contractually negotiated, in-network rate to Anatomic and...more
California is leading the way in ensuring that determinations of medically necessary health care services are made by licensed physicians and not artificial intelligence (AI) algorithms....more
1/31/2025
/ Artificial Intelligence ,
California ,
Class Action ,
Compliance ,
Health Care Providers ,
Health Insurance ,
Healthcare ,
Insurance Industry ,
New Legislation ,
Physicians ,
Regulatory Agenda
The US Court of Appeals for the Third Circuit recently confirmed that “anti-assignment” provisions — provisions prohibiting insureds from assigning their rights under a health plan to third parties, including medical...more