There has been a flurry of recent activity in a case originally filed by six air ambulance companies claiming $20 million in unpaid emergency services invoices. ...more
7/10/2025
/ Aetna ,
Airline Deregulation Act ,
Ambulance Providers ,
Aviation Industry ,
Contract Disputes ,
CUTPA ,
Dispute Resolution ,
Health Care Providers ,
Health Insurance ,
Healthcare ,
Insurance Claims ,
Insurance Litigation ,
Medical Expenses ,
No Surprises Act (NSA) ,
Out of Network Provider ,
Surprise Medical Bills ,
Unfair or Deceptive Trade Practices
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
6/27/2025
/ 42 U.S.C. §1983 ,
Appeals ,
Beneficiaries ,
Constitutional Challenges ,
Health Care Providers ,
Health Insurance ,
Healthcare ,
Judicial Authority ,
Medicaid ,
Medina v Planned Parenthood South Atlantic ,
Patient Access ,
Planned Parenthood ,
Reproductive Healthcare Issues ,
SCOTUS ,
State and Local Government ,
Statutory Interpretation
On June 12, the U.S. Court of Appeals for the Fifth Circuit issued a significant opinion in the case involving Guardian Flight, LLC and Med-Trans Corporation, two air ambulance providers, against the defendant insurance...more
6/18/2025
/ Ambulance Providers ,
Appeals ,
Arbitration Awards ,
Dispute Resolution ,
Emergency Response ,
Federal Arbitration Act ,
Health Care Providers ,
Health Insurance ,
Healthcare ,
Insurance Claims ,
Insurance Litigation ,
No Surprises Act (NSA) ,
Post-Judgment Enforcement Actions ,
Private Right of Action ,
Surprise Medical Bills
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
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
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
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
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
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
As discussed here, D.K. et al. v. United Behavioral Health et al. is a case that has been carefully watched in the health benefits space for its impact on what health plan administrators must include in adverse benefit...more
As discussed here, D.K. et al. v. United Behavioral Health et al. is a case that has been carefully watched in the health benefits space for its potential to change what health plan administrators must include in adverse...more
As discussed here, administrators’ health plan benefit denial letters have recently been under scrutiny by the courts. For example, in D.K. et al. v. United Behavioral Health et al., the Tenth Circuit is reviewing a district...more
In recent years, several lawsuits have challenged wilderness therapy program exclusions in health plans. Not only do members typically assert a claim for benefits, alleging a denial of wilderness therapy benefits was improper...more
In October 2022, the Tenth Circuit heard oral argument in D.K. et al. v. United Behavioral Health et al., a case that could significantly impact what health plans must include in any notification to claimants of an adverse...more
On December 9, the American Medical Association (AMA) and the American Hospital Association (AHA) (the Associations) filed a lawsuit in the U.S. District Court for the District of Columbia challenging the proposed regulations...more
On September 30, U.S. Departments of Health and Human Services (HHS), Labor, and Treasury, as well as the Office of Personnel Management, issued another interim final rule — “Requirements Related to Surprise Billing: Part II”...more
The federal government’s push for greater price transparency in health care has been highly controversial among health care stakeholders. In 2020, the American Hospital Association (AHA) unsuccessfully challenged HHS’s “Price...more
On July 1, U.S. Departments of Health and Human Services (HHS), Labor, and Treasury, as well as the Office of Personnel Management, issued an interim final rule implementing the No Surprises Act (Act) and requesting...more
On July 17, 2020, a panel majority of the D.C. Circuit Court of Appeals upheld a rule issued by the Department of Treasury, the Department of Labor, and the Department of Health and Human Services (collectively, the...more
7/28/2020
/ Affordable Care Act ,
Chevron Deference ,
COBRA ,
Department of Health and Human Services (HHS) ,
Department of Labor (DOL) ,
Employer Group Health Plans ,
Essential Health Benefits ,
Health Insurance ,
Health Insurance Portability and Accountability Act (HIPAA) ,
Preexisting Conditions ,
U.S. Treasury