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Healthcare › Appeals › Employee Retirement Income Security Act (ERISA)

McDermott Will & Schulte

PBMs Score a Win in Federal Court Against State Regulation

McDermott Will & Schulte on

A recent federal court decision has the potential to tip the balance in an ongoing series of skirmishes over state regulation of pharmacy benefit managers (PBMs). In McKee Foods Corp. v. BFP Inc. d/b/a/ Thrifty Med Plus...more

ArentFox Schiff

Cross-Plan Offsetting: Recent Eighth Circuit Opinion Affirms Dismissal of Cross-Plan Offsetting Case Concluding Plaintiffs Did Not...

ArentFox Schiff on

In a recent opinion, Smith et al. v. UnitedHealth Group Inc. et al., the US Court of Appeals for the Eighth Circuit affirmed the dismissal of an Employee Retirement Income Security Act (ERISA) class action suit brought by...more

BakerHostetler

Second Circuit Finds Member Associations Have Standing to Bring Claims on Behalf of Members

BakerHostetler on

Last month the Second Circuit Court of Appeals reversed the U.S. District Court’s decision to deny the New York State Psychiatric Association (NYSPA) standing in its claim against UnitedHealth Group and related entities...more

Baker Donelson

Court of Appeals to Plan Administrators: Inform Claimants of Time Limits on Front End of Discussions

Baker Donelson on

Recently, in Mirza v. Insurance Administrator of Am., Inc., __ F.3d__ (3d. Cir. 2015), the United States Court of Appeals for the Third Circuit was asked to determine whether plan administrators are required to include a...more

Littler

Ninth Circuit Rules Assignee Health Care Providers May Sue Health Plans Under ERISA for Payment of Benefits

Littler on

In an opinion with mixed implications for both insurers and health care providers, the U.S. Court of Appeals for the Ninth Circuit recently ruled that when plan beneficiaries assign their claims for payment of benefits to...more

Laner Muchin, Ltd.

Self-Insured Health Plans May Be Required To Allow Health Care Providers Access To Their Claims And Appeals Process

Laner Muchin, Ltd. on

In a precedent-setting case, a district court in the Northern District of Illinois recently ruled that in-network chiropractors were considered “beneficiaries” under the Employee Retirement Income Security Act of 1974 (ERISA)...more

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