News & Analysis as of

Health Insurance Breach of Contract Employee Retirement Income Security Act (ERISA)

Holland & Knight LLP

Sixth Circuit Reverses Dismissal of ERISA Healthcare Fee Suit Against Third-Party Administrator

Holland & Knight LLP on

There has been a recent rise in Employee Retirement Income Security Act of 1974 (ERISA) litigation against third-party administrators (TPAs) and other service providers challenging their management of self-funded health...more

ArentFox Schiff

Navigating Out-of-Network Claims: Key Takeaways for Providers From Surgery Center Case in New York Federal Court

ArentFox Schiff on

The US District Court for the Eastern District of New York in Manalapan Surgery Ctr., et al. v. 1199 SEIU National Benefit Fund, No. 23-CV-03525 (EDNY March 12, 2025), recently granted a motion to dismiss a complaint filed by...more

Keating Muething & Klekamp PLL

Benefits Monthly Minute - March 2025

The March Monthly Minute brings you three recent case updates addressing 401(k) forfeiture utilization, TPA responsibility for recovering self-insured plan’s fraudulently paid claims, and continued PBM litigation in the wake...more

ArentFox Schiff

Federal Court Holds That Pathology Group States Viable Claims Against Multiplan and Cigna for Failing to Ensure In-Network Payment

ArentFox Schiff on

A federal court recently rejected arguments by MultiPlan, Inc. and Cigna Health and Life Insurance Company that they had no obligation to ensure payments at the contractually negotiated, in-network rate to Anatomic and...more

Robinson+Cole ERISA Claim Defense Blog

Ninth and Second Circuit Courts of Appeals Rule that Preauthorization Process Does Not Impose Independent Contractual Liability on...

Within days of one another, the U.S. Court of Appeals for the Ninth and Second Circuits ruled—on issues of first impression for both—that ERISA expressly preempts state law breach of contract and promissory estoppel claims...more

Carlton Fields

Expect Focus - Volume III, September 2023

Carlton Fields on

Regulators Hit Jackpot: Off-Channel Communications - Several years before announcing the first “off-channel” communications enforcement action, the SEC and FINRA cautioned broker-dealers and investment advisers about...more

Epstein Becker & Green

Third Circuit: Provider’s Out-of-Network Claims not Pre-empted by ERISA

Epstein Becker & Green on

In an important win for healthcare providers, on July 17, 2020, the Third Circuit determined in a published opinion that an out-of-network provider’s direct claims against in insurer for breach of contract and promissory...more

Rivkin Radler LLP

Employee Benefit Plan Review – From the Courts

Rivkin Radler LLP on

Second Circuit Affirms Decision Rejecting ERISA Claims for Retiree Health Benefits The U.S. Court of Appeals for the Second Circuit has affirmed a district court’s decision dismissing claims under the Employee Retirement...more

Holland & Knight LLP

Religious Institutions Update: August 2016

Holland & Knight LLP on

When was the last time your organization reviewed your insurance policies? Not all policies are equal. Many religious organizations are underinsured. Most should have general liability, property, professional liability,...more

Proskauer Rose LLP

The ERISA Litigation Newsletter - October 2015

Proskauer Rose LLP on

Editor's Overview - This month, we review the Second Circuit's ruling in New York State Psychiatric Ass'n, Inc. v. UnitedHealth Grp. wherein the Second Circuit ruled that: (i) a provider association has associational...more

Franczek P.C.

Employee Benefits Alert - August 2015

Franczek P.C. on

Retirement Plans - IRS Issues Guidance on Benefit Suspension Voting under MPRA - As we have written in prior alerts, the Multiemployer Pension Reform Act of 2014 (MPRA) permits trustees of financially troubled...more

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