News & Analysis as of

Appeals Mental Health Medical Necessity

Ogletree, Deakins, Nash, Smoak & Stewart,...

Ninth Circuit Affirms ERISA Plan Administrator’s Decision, Validates Use of Industry Guidelines and Medical Evidence

On March 5, 2019, Magistrate Judge Joseph C. Spero of the U.S. District Court for the Northern District of California issued his opinion in Wit v. United Behavioral Health, in which he attempted to significantly change how...more

Sheppard Mullin Richter & Hampton LLP

Less is More: Brevity is the Soul of Wit

Last month, a three-judge panel in the Ninth Circuit reversed the Northern District of California’s ruling in Wit v. United Behavioral Health. In Wit, the district court ruled that United Behavioral Health (“UBH”) breached...more

Hinshaw & Culbertson LLP

The LHD/ERISA Advisor - October 2020: Tenth Circuit Finds District Court Applied Wrong Standard of Review in Evaluating Plan...

Hinshaw & Culbertson LLP on

In Lyn M. v. Premera Blue Cross, 2020 U.S. App. LEXIS 23395 (10th Cir. July 24, 2020), the Tenth Circuit held that a district court had applied the wrong standard of review and incorrectly evaluated an ERISA plan...more

K&L Gates LLP

K&L Gates Triage: Michael P. V. BCBS Of Texas

K&L Gates LLP on

In this week’s episode, Gary Qualls discusses a recent case decided in the Western District of Louisiana, which highlights how the application of the arbitrary and capricious standard as applied to payor coverage...more

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