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Employee Retirement Income Security Act (ERISA) › Appeals › Health Care Providers

King & Spalding

Fifth Circuit Finds No Private Right of Action for Providers to Enforce Surprise Billing Awards

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On Thursday, June 12, 2025, a panel of the United States Court of Appeals for the Fifth Circuit issued two rulings construing parts of the No Surprises Act (NSA) to limit judicial review of arbitration awards issued under the...more

Verrill

Surprise Medical Bills: Texas District Court Vacates Portion of Independent Dispute Resolution (IDR) Process in Agency Rule

Verrill on

The U.S. District Court for the Eastern District of Texas recently vacated a portion of the Requirements Related to Surprise Billing, Part II, Interim Final Rule (the “Rule”) regarding the independent dispute resolution (IDR)...more

Zuckerman Spaeder LLP

[Webinar] A Step-by-Step Strategy for Maximizing Insurance Coverage Under ERISA - July 22nd, 2:00 pm - 3:00 pm ET

Zuckerman Spaeder LLP on

Building on our recent overview presentation “Six Lessons Patients and Providers Need to Know," we invite you to join us as we examine a single medical provider/patient encounter, in order to identify the concrete steps a...more

Seyfarth Shaw LLP

ERISA Preemption — The Courts of Appeal Continue to Rule As They Await Further Supreme Court Attempts To Define, Once and for All,...

Seyfarth Shaw LLP on

Synopsis: Two Courts of Appeal reach opposite results on ERISA preemption, thus continuing the judicial quest for a definitive meaning of ERISA preemption. Stay tuned for more such decisions, and yet more Supreme Court...more

Robinson+Cole ERISA Claim Defense Blog

Ninth Circuit Rejects Arguments Challenging the Enforceability of an ERISA Plan Anti-Assignment Provision

Robinson+Cole ERISA Claim Defense Blog on

In Eden Surgical Ctr. v. Cognizant Tech. Sols. Corp., No. 16-56422, 2018 U.S. App. LEXIS 10597 (9th Cir., Apr. 26, 2018), the U.S. Court of Appeals for the Ninth Circuit upheld the District Court’s Order dismissing the...more

Verrill

Near Unity Among the Circuits: Anti-Assignment Provisions are Enforceable

Verrill on

U.S. Courts of Appeals in all but four Circuits have now held that anti-assignment provisions in health insurance plans governed by ERISA are enforceable. In American Orthopaedic & Sports Medicine v. Independence Blue Cross...more

Seyfarth Shaw LLP

Game Over? Ninth Circuit Doubles Down on Its Commitment To Enforcing Anti-Assignment Provisions In ERISA Plans To Bar Suits By...

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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

Proskauer - Employee Benefits & Executive...

Ninth Circuit: Medical Providers Lack ERISA Standing

Proskauer - Employee Benefits & Executive... on

The Ninth Circuit affirmed two district court decisions that concluded medical providers were not “beneficiaries” under Section 502(a) of ERISA and therefore lacked standing to bring an ERISA claim...more

Faegre Drinker Biddle & Reath LLP

U.S. Third Circuit Allows Providers to Sue Health Insurers Directly

Faegre Drinker Biddle & Reath LLP on

For many years, the United States Court of Appeals for the Third Circuit was out of step with its sister Courts of Appeal when it came to the issue of suing health insurance companies for failing to cover the medical expenses...more

Littler

Ninth Circuit Rules Assignee Health Care Providers May Sue Health Plans Under ERISA for Payment of Benefits

Littler on

In an opinion with mixed implications for both insurers and health care providers, the U.S. Court of Appeals for the Ninth Circuit recently ruled that when plan beneficiaries assign their claims for payment of benefits to...more

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