News & Analysis as of

Enforcement Actions Insurance Industry

Cozen O'Connor

FTC Nets $145M to Resolve Deceptive Online Health Insurance Marketing Claims

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The FTC has reached proposed settlements with Assurance IQ, LLC and MediaAlpha, Inc., resolving allegations that the companies misled consumers into buying health insurance plans without the promised coverage and subjected...more

Troutman Amin LLP

WHOA! MASSIVE $140 MILLION JUDGMENT AGAINST ASSURANCE IQ: FTC Slams Assurance IQ for Misleading Health Plan Marketing in Violation...

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The FTC announced today a $100 million judgment against Assurance IQ for alleged deceptive practices targeting consumers seeking health insurance. The FTC initiated the complaint, FTC v. Assurance IQ LLC, U.S. District Court,...more

Foley & Lardner LLP

CMS Finalizes Rule Change Applying Preponderance of the Evidence Standard to Agent, Broker, and Web-Broker Exchange Agreement...

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In its recently issued Final Rule (CMS-9884-F; 90 FR 27074-01; the Final Rule), the Centers for Medicare and Medicaid Services (CMS) finalized revisions to 45 C.F.R. § 155.220(g)(2) to specify a standard of proof for...more

Troutman Amin LLP

GETTING PERSONAL: Insurance Agent Sued Personally In TCPA Class Action Against Senior Life Insurance Company

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Said it before. Will say it again– the rule of personal liability for TCPA violations undertaken for an employer is the most unfair in all of American jurisprudence. Take the case of Matthews v. Senior Life Insurance Co.,...more

Polsinelli

EKRA Gets Teeth: Ninth Circuit Strengthens EKRA Enforcement in Schena Ruling

Polsinelli on

Key Takeaways - First Appellate Interpretation of EKRA: The Ninth Circuit’s decision in United States v. Schena marks the first appellate court interpretation of the Eliminating Kickbacks in Recovery Act (EKRA), affirming...more

Epstein Becker & Green

The Record-Setting First National Health Care Fraud Takedown of the Second Trump Administration: What Stayed the Same and What is...

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On June 30, 2025, the U.S. Department of Justice (“DOJ”), together with the U.S. Department of Health and Human Services Office of Inspector General (“HHS OIG”) and other law enforcement partners, announced the results of the...more

Cozen O'Connor

Nebraska AG Latest to Hit the Brakes on GM Data Practices

Cozen O'Connor on

Nebraska AG Mike Hilgers sued General Motors LLC and its subsidiary OnStar LLC (collectively, “GM”) over allegations that GM misled vehicle purchasers into enrolling in programs that collected and shared their driving data...more

King & Spalding

District Court Orders CVS Caremark to Pay U.S. Government $95 Million

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On June 25, 2025, Chief Judge Mitchell S. Goldberg of the U.S. District Court for the Eastern District of Pennsylvania issued a ruling in the case of U.S. ex rel. Sarah Behnke v. CVS Caremark Corp. et al., ordering CVS...more

Husch Blackwell LLP

MHPAEA July 2025 Update: What Employers and Plans Need to Know about Federal Non-Enforcement

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The Mental Health Parity and Addiction Equity Act of 2008 (MHPAEA) was enacted to ensure that group health plans and health insurance issuers offering mental health and substance use disorder (MH/SUD) benefits do not impose...more

Eversheds Sutherland (US) LLP

New York’s proposed FAIR Business Practices Act – potential implications for business

The Consumer Financial Protection Bureau recently signaled a retreat from its regulatory and enforcement posture by outlining its 2025 supervisory and enforcement priorities and rescinding 67 regulatory guidance documents. In...more

ArentFox Schiff

Federal Courts Divided Over Private Enforcement of ‘No Surprises Act’ Arbitration Awards

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Congress enacted the No Surprises Act (NSA) to protect patients from unexpected medical bills. A central pillar of the NSA is its independent dispute resolution (IDR) process, under which payers and providers can submit...more

Sheppard Mullin Richter & Hampton LLP

Pennsylvania Launches Centralized Consumer Complaint System, Expands State Enforcement Under Dodd-Frank

On May 1, Pennsylvania Governor Josh Shapiro announced a new centralized consumer protection hotline, website, and email address, providing residents with streamlined access to state agencies for reporting scams, financial...more

Rivkin Radler LLP

FBI Warns Consumers of Discount Medical Scams

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On April 30, the Federal Bureau of Investigation (FBI) released a Public Service Announcement warning consumers about fraudulent discount medical scams. These scams typically involve deceptive offers for health insurance...more

Littler

The Parity Paradox: MHPAEA Compliance for Employers and Insurers During the 2024 Enforcement Pause

Littler on

The U.S. Departments of Labor, Health and Human Services, and Treasury have announced that they will pause enforcement of the 2024 Mental Health Parity and Addiction Equity Act (MHPAEA) Final Rule (the “2024 Final Rule”) for...more

Arnall Golden Gregory LLP

Health Insurers Under Fire: New Administration Cracks Down on Evasive Pricing Practices

Health insurance regulations are rapidly shifting with unprecedented intensity. Amid growing public outrage over evasive and abusive pricing practices by insurers and years of federal underenforcement, the new administration...more

Cozen O'Connor

Justice Department Continues Pattern of False Claims Act Suits Due to Alleged Kickbacks

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On May 1, the federal government brought a False Claims Act (“FCA”) suit against three health insurers, as well as three insurance brokers. The Justice Department’s suit alleges that the insurers paid millions of dollars in...more

Rivkin Radler LLP

FCA Case Against Insurers Alleges Kickbacks and Discriminatory Practices

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On May 1, a whistleblower filed a complaint under the federal False Claims Act (FCA) against Aetna, Elevance Health (formerly Anthem) and Humana alleging that the insurers paid hundreds of millions of dollars in illegal...more

Ballard Spahr LLP

Citing CFPB cutbacks, Pennsylvania Governor is beefing up consumer protection efforts

Ballard Spahr LLP on

Citing cutbacks at the federal level, Pennsylvania Governor Josh Shapiro has launched a new centralized consumer protection hotline, website and email address to make it easier for state residents to report allegations of...more

Zelle  LLP

Itemized Appraisal Ordered Over Delay and Coverage Dispute Objections: A Shift in the Appraisal Enforcement Paradigm?

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In a recent decision, Gray v. Philadelphia Contributionship, 748 F. Supp. 3d 367 (D. Md. 2024), U.S. District Judge James K. Bredar granted a policyholders’ motion to compel appraisal and stayed litigation in a diversity...more

Ropes & Gray LLP

Medicare Advantage Fraud and Abuse: A Bipartisan Enforcement Priority

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Early signs from the initial months of the Trump administration indicate that fraud and abuse enforcement related to the Medicare Advantage program (“MA”) remains a bipartisan focus, as evidenced by the recent statements from...more

Sheppard Mullin Richter & Hampton LLP

Auto Insurer Settles With New York AG Over Insurance Application Platform Security Issues

The New York Attorney General recently entered into an assurance of discontinuance with Root Insurance Company following a 2021 data incident. According to the AG, the threat actors obtained people’s drivers’ license numbers...more

Cozen O'Connor

NY Settles With Insurer on Data Breach Rooted in Security Deficiencies

Cozen O'Connor on

New York AG Letitia James settled with Root Insurance Company to resolve allegations that the company’s data security deficiencies led to a 2021 data breach involving 72,000 people, in violation of state consumer protection...more

IMS Legal Strategies

Giving Anger a Voice: Approaching Anti-Corporate Frustration Through Trial Strategy

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The assassination of UnitedHealthcare CEO Brian Thompson ignited a complex array of public reactions. Amid the standard shock and sympathy, many less orthodox responses emerged: expressions of dark humor, bitter comparisons...more

K&L Gates LLP

Australia: Compensation Scheme of Last Resort (CSLR)

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Underfunded From Inception - The operator of CSLR has released the latest actuarial report commissioned on the scheme and the initial estimates of projected levies for 2025 / 26 (3rd levy period), triggering widespread...more

Mayer Brown

Brasília em Pauta – Edição Nº 188

Mayer Brown on

PAUTAS: STF – CONTROLE CONCENTRADO E REPERCUSSÃO GERAL | STJ – REPETITIVOS | TCU – PLENÁRIO | CÂMARA DOS DEPUTADOS | SENADO FEDERAL - Prezados e prezadas, O - “Brasília em Pauta” é um boletim semanal preparado pela...more

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