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Health Insurance UnitedHealth

Arnall Golden Gregory LLP

UnitedHealthcare Must Face State Law Claims in Class Action Suit for AI Driven Coverage Denials of Medicare Advantage Claims

Daytime television inundates American seniors with advertisements for UnitedHealthcare’s (“UHC”) Medicare Advantage Plans. On its website, UHC claims its Medicare Advantage Plans “stand out from the rest,” providing...more

Holland & Knight LLP

Change Healthcare Cybersecurity Incident: Financial Impact and Resulting Litigation

Holland & Knight LLP on

On Feb. 21, 2024, the ransomware hacker group ALPHV, otherwise known as "BlackCat," disabled Change Healthcare's nationwide healthcare billing and information systems and demanded a ransom to unlock them....more

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

The Ninth Circuit Speaks Out on Mental Health Parity

On April 11, 2024, the U.S. Court of Appeals for the Ninth Circuit, in Ryan S. v. UnitedHealth Group, Inc., set a very broad pleading standard to allege a violation of the Paul Wellstone and Pete Domenici Mental Health Parity...more

Williams Mullen

Change Can Be Hard: Will the DOJ Antitrust Division’s Loss of Its UnitedHealth/Change Merger Challenge Cause It To Reassess Its...

Williams Mullen on

​​​​​​​Earlier this year, Assistant Attorney General Jonathan Kanter, who leads the Department of Justice’s (DOJ) Antitrust Division, announced that the Antitrust Division would eschew settlements in merger challenges in...more

Cozen O'Connor

UnitedHealth Settles Allegations It Wrongfully Reduced Or Denied Mental Health And Substance Abuse Coverage

Cozen O'Connor on

New York AG Letitia James and the S. Department of Labor (“DoL”) reached a settlement with health insurer UnitedHealth Group Inc. and related entities (collectively “UHG”) to resolve allegations that it wrongfully reduced or...more

King & Spalding

Recent Health Plan Practices That Are Resulting in Underpayments to Providers

King & Spalding on

Health Plans’ Use of Policies and Guidelines to Reduce Coverage and Reimbursement - A technique we have seen payers use more commonly in recent months than in the past is to unilaterally implement policies or “clinical...more

Troutman Pepper Locke

Federal Court Strikes DOJ's Risk Adjustment False Claims Act Case - For Now

Troutman Pepper Locke on

On October 5, a federal district court in California dealt a significant setback to the government’s efforts to extend False Claims Act (FCA) liability to Medicare risk adjustment submissions....more

Sheppard Mullin Richter & Hampton LLP

Alert: In a Surprise Decision Issued on October 5, 2017, Honorable John Walter, United States District Judge, Dismissed a Medicare...

On October 5, 2017, the Honorable Judge John Walter of the United States District Court, Central District of California, granted the Defendants’ Motion to Dismiss the Medicare Advantage (“MA”) Federal False Claims Act (“FCA”)...more

Sheppard Mullin Richter & Hampton LLP

Medicare Advantage Plans Under Fire: The Department of Justice Files Complaints-in-Intervention

As reported in earlier blogs, the federal Department of Justice (DOJ) has been actively looking into potential abuses by Medicare Advantage (MA) Organizations as to allegedly improper risk adjustment claims submissions and...more

Foley & Lardner LLP

Second Circuit Reinstates Mental Health Parity Case Against UnitedHealth

Foley & Lardner LLP on

In late August the U.S. Court of Appeals for the Second Circuit reinstated a lawsuit by a physician association against a third-party plan administrator. The case against UnitedHealth Group and related entities (United) had...more

Carlton Fields

Insurer Sues Department of Insurance Over Multi-Million Dollar Penalty

Carlton Fields on

In suing the California Insurance Commissioner on July 10, 2014, PacifiCare Life Insurance Company sought a writ of mandamus ordering the Commissioner to set aside his Decision and Order imposing a record $173 million penalty...more

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