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

Ropes & Gray LLP

Hospital and Health Systems Reimbursement Check July 2025

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In the early days of the second Trump Administration, several federal funding agencies announced caps to indirect cost (“IDC”) rates for federally funded research awards. In many cases, these caps would substantially reduce...more

Zuckerman Spaeder LLP

A Pivotal Moment in the Fight for Behavioral Health Equity: New Parity Regulations and More

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The NAADAC 2024 Conference & Hill Day is an annual conference that brings together thousands of addiction counselors, educators, and other addiction-focused health care professionals from across the country. The conference...more

Arnall Golden Gregory LLP

California Federal District Court Rules That AGG Clients’ Case Against Cigna for Institutional Practice of Under-Reimbursing...

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U.S. District Court Judge David O. Carter ruled in favor of AGG’s clients on March 18, 2024, in a case involving “matters of widescale public concern” and a strong “public interest in access” to some of Cigna’s most coveted...more

Hendershot Cowart P.C.

Texas ER Physicians Sue Insurer for Underpayment – Thousands of Claims at Stake

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An appeal brought before the Texas Supreme Court could unleash a wave of legal action by out-of-network ER physicians pursuing insurers for underpayment of claims. Unlike in-network providers who negotiate reimbursement...more

Arnall Golden Gregory LLP

Ninth Circuit Sides With Plaintiff, Reviving $8.6M Reimbursement Suit

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AGG Healthcare attorneys Matthew M. Lavin and Aaron R. Modiano recently secured a revival of an $8.6 million reimbursement suit against Cigna Health and Life Insurance. In Bristol SL Holding, Inc. v. Cigna Health and Life...more

King & Spalding

Don’t Be Surprised – The No Surprises Act Takes Effect January 1, 2022

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The No Surprises Act (the Act), enacted December 27, 2021, will take effect on January 1, 2022. The No Surprises Act puts into place important patient protections from surprise medical bills, while imposing significant...more

K&L Gates LLP

Recent 11th Circuit Decision Is a Victory for Health Care Providers Challenging Insurer Reimbursement Decisions and a Reminder of...

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The existence and scope of assignments of benefits from patients to health care providers continues to be critically important to a provider’s ability to challenge an insurer’s reimbursement decision under the Employee...more

Kilpatrick

Ninth Circuit Issues Shocking Opinion Concerning Health Care Provider ERISA Claims

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The Ninth Circuit Court of Appeals is not known for being employer-friendly. So, when the Ninth Circuit issued its latest opinion on health care provider ERISA claims, most thought it would be against employer-sponsored...more

Troutman Pepper Locke

Health Care Providers Should Review Assignment of Benefit Forms After 9th Cir. Decision

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A federal appeals court recently brushed aside the claims of several health care providers, in large part because of the language in the assignment forms signed by their patients. The opinion from the U.S. Court of Appeals...more

K&L Gates LLP

Health Care Institutions

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Originally published in Haig, Business and Commercial Litigation in Federal Courts, Fourth Edition §§ 87:1 et seq. © 2016 American Bar Association. This chapter discusses federal court litigation relating to health care...more

K&L Gates LLP

Sixth Circuit Holds That Michigan Health Insurance Claims Assessment Act Falls Outside of ERISA’s Preemptive Reach

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Whether state common law claims are preempted by the Employee Retirement Income Security Act of 1974 (ERISA) is a common issue in reimbursement disputes involving health care providers and insurance companies. In cases when...more

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