News & Analysis as of

Health Insurance Insurance Litigation Employee Retirement Income Security Act (ERISA)

Epiq

When Treatment Costs Exceed Settlements

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Navigating the complex landscape of lien resolutions in mass torts is a challenge for both plaintiffs’ and defense attorneys. One of the biggest hurdles is complying with federal and state regulations to resolve health care...more

Mayer Brown

Hot Topics in US Health & Welfare

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AT A GLANCE - There have been a number of important developments in the United States relating to health and welfare over recent months....more

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

Arnall Golden Gregory LLP

Landmark $9.25M AGG Class Action Settlement Against UnitedHealthcare Receives Preliminary Approval, Class Claim Submission Process...

AGG Healthcare Litigation attorneys Rich Collins and Landen Benson represent two of the three named plaintiffs in an ERISA class action against UnitedHealthcare (“United”), involving the insurer’s denial of access to proton...more

Carlton Fields

Faulty COBRA Notices Can Cost Big Bucks

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When COBRA cases survive motions to dismiss, big dollars are at stake. Marrow v. E.R. Carpenter Co., No. 8:23-cv-02959, is a class action lawsuit filed in the U.S. District Court for the Middle District of Florida on behalf...more

Keating Muething & Klekamp PLL

Benefits Monthly Minute - April 2025

The April Monthly Minute showers readers with some eye-opening case law updates, ranging from a $38.8M jury verdict in a 401(k) fee case, to a pair of cases involving Elevance (f/k/a Anthem) health plan coverage exclusions....more

Maynard Nexsen

JPMorgan Sued Over Management of Prescription Drug Benefits

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On March 13, 2025, several current and former participants in the JPMorgan Chase Health Care and Insurance Program for Active Employees, as well as its component Medical Plan (collectively referred to as the “Plan”) filed a...more

ArentFox Schiff

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

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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

ArentFox Schiff

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

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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

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

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

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

Fennemore

Lessons Learned from ERISA Health Plan Representation and Recommendations for Plan Design and Oversight

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ERISA Health Plan clients are engaged in nearly every industry in the United States. There are nearly 139 million Americans covered by ERISA Health Plans and 2.5 million Health Plans. Yet, operating a health plan has become...more

Carlton Fields

Expect Focus - Volume III, September 2023

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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

Polsinelli

Ninth Circuit Reverses Landmark Wit Case Addressing Behavioral Health Coverage

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The President and his administration continue to tout their efforts to strengthen coverage for behavioral health care, including significantly increasing behavioral health spending and strengthening parity between physical...more

Verrill

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

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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

Sheppard Mullin Richter & Hampton LLP

State, Federal, and Private Enforcement of Mental Health Parity Compliance

Six months ago, we cautioned health plans and plan sponsors that states, the federal government, and private litigants were laser focused on Mental Health Parity and Addiction Equity Act (“MHPAEA”) compliance. The United...more

K&L Gates LLP

Recent District Court Decision Highlights the Importance of Adequate Behavioral Health Claims Processing Guidelines for ERISA...

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On this week’s episode, Carla DewBerry and Sarah Carlins discuss a recent California Federal District Court decision in David Wit v. United Behavioral Health, in which the court found that the defendant insurer violated ERISA...more

Dickinson Wright

Recent Developments in Mental Health Benefit Denials

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The Mental Health Parity and Addiction Equity Act (Parity Act) requires health plans to provide the same coverage for mental health conditions as they provide for physical conditions, and that financial Requirements and...more

Williams Mullen

Plaintiffs’ Misdirected Demand for Documents Fails, and Their Claim for ERISA Civil Penalties Is Dismissed: Boyd v. Sysco...

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A federal court dismissed the plaintiffs’ claim to recover civil penalties for failure to provide plan documents requested by the plaintiffs. Boyd v. Sysco Corporation, No. 4:13-cv-00599 (D. S. C. September 3, 2015), provides...more

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