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Health Insurance › Denial of Insurance Coverage › Appeals

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

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

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

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

Fisher Phillips

Appeals Court Hands Victory to Transgender Employee Seeking Health Benefits: Key Takeaways and 3 Steps Employers Can Take Now

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A federal appeals court recently held that an employer’s health insurance plan wrongly excluded coverage for gender-affirming care in violation of federal civil rights law – offering a warning to employers across the country...more

ArentFox Schiff

Ninth Circuit Reissues Opinion for the Second Time in Suit Challenging United Behavioral Health’s Mental Health Coverage...

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Last week, the US Court of Appeals for the Ninth Circuit, in its third opinion in the case, reversed a lower court’s decision allowing patients challenging United Behavioral Health’s (UBH) internal mental health coverage...more

Proskauer - Employee Benefits & Executive...

Ninth Circuit Defers to Plan Design and Administrative Discretion on Bounds of Mental Health Coverage

Proskauer - Employee Benefits & Executive... on

A recent decision by the U.S. Court of Appeals for the Ninth Circuit (Wit et al. v. United Behavioral Health and Alexander et al. v. United Behavioral Health) exemplifies the challenge in balancing a desire to cover evolving...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

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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

K&L Gates LLP

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

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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

Payne & Fears

Technicalities Don't Defeat Provider Claims for Emergency Services

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Last week, the Court of Appeal gave a victory to non-contracted providers of emergency medical services. In San Jose Neurospine v. Aetna Health of California, the court rejected Aetna's position that because the provider "did...more

King & Spalding

Federal Appeals Court Strikes Down Arkansas Medicaid Work Requirements

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On February 14, 2020, the United States Court of Appeals for the District of Columbia Circuit issued its decision in Gresham et al. v. Azar et al., Case No. 19-5094, a case challenging HHS’s Medicaid waiver that allowed...more

Sheppard Mullin Richter & Hampton LLP

Arkansas and Kentucky Halt Medicaid Work Requirements

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On April 10, 2019, the Department of Justice filed notices appealing two District Court rulings that struck down Medicaid work requirements in both Kentucky and Arkansas to the U.S. Court of Appeals for the District of...more

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