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Healthcare Insurance Litigation Insurance Claims

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

Pullman & Comley, LLC

Deadline Reminder: BCBS Settlement Claims Due by July 29, 2025

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Health care providers who have treated or provided services, equipment, or supplies to patients insured by Blue Cross Blue Shield (BCBS) between July 24, 2008 and October 4, 2024 may be entitled to compensation under a $2.67...more

Napoli Shkolnik

What the MultiPlan MDL Tells Us About Rebrands During Litigation

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When a company faces mounting public scrutiny, especially in high-stakes litigation, it sometimes does what any crisis playbook might suggest: change the name. It’s not a financial reset. It’s a reputational one, and a...more

Proskauer - Health Care Law Brief

No Surprises Here!  Payers Push Back on IDR Submissions, Opening New Front in NSA Implementation Landscape

On May 27, 2025, Blue Cross Blue Shield Healthcare Plan of Georgia (“BCBSGA”) sued several emergency physician groups and their billing agent, Halo MD, alleging abuse of the No Surprises Act’s (“NSA”) independent dispute...more

Troutman Pepper Locke

Litigation Heats Up Over Air Ambulance Billing Practices Under the No Surprises Act

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There has been a flurry of recent activity in a case originally filed by six air ambulance companies claiming $20 million in unpaid emergency services invoices. ...more

Wiley Rein LLP

For the Record: Cyber Coverage “For” a Security Breach is Ambiguous under New Mexico Law

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The New Mexico Court of Appeals has held that cyber policy language affording coverage “for” a security breach was ambiguous and must be construed broadly to provide coverage for a breach of contract claim “because of,”...more

Tyson & Mendes LLP

Calculating Past Medicals in California

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The Third District Court of Appeal in California recently addressed the standard in proving the reasonableness of charges for past medical services within the context of the Hospital Lien Act’s definition of emergency and...more

Troutman Pepper Locke

Fifth Circuit Clarifies Enforcement of IDR Awards Under the No Surprises Act

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On June 12, the U.S. Court of Appeals for the Fifth Circuit issued a significant opinion in the case involving Guardian Flight, LLC and Med-Trans Corporation, two air ambulance providers, against the defendant insurance...more

Carlton Fields

Tenth Circuit Interprets Excess Policy’s Definition of “Medical Incident” as Applying to the Injuries of One Single Person

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On May 2, 2025, the Tenth Circuit Court of Appeals issued an opinion in AdHealth Limited v. PorterCare Adventist Health Systems affirming the lower court’s summary judgment ruling that a hospital’s excess liability insurance...more

ArentFox Schiff

Anthem Set to Settle Five-Year Long Mental Health Coverage Class Action

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Anthem Inc. has agreed to settle a class action lawsuit brought by participants in employee health plans administered by the insurer....more

Bradley Arant Boult Cummings LLP

Effective Risk Management for Nursing Facilities: Insurance Insights on Retaliation Claims

This is the first in a series of articles addressing critical issues in risk management and insurance for skilled nursing facilities. Owners and operators of skilled nursing facilities know that a claim or lawsuit against...more

Wiley Rein LLP

Pennsylvania Federal Court Holds Notice of Intent to File Third-Party Complaint Constitutes a “Claim”

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The United States District Court for the Eastern District of Pennsylvania, applying Pennsylvania law, has held that a letter notifying the insured of the sender’s intent to file a joinder complaint, i.e., a third-party claim,...more

Searcy Denney Scarola Barnhart & Shipley

The Importance of Seeking Medical Attention After a Tallahassee Car Accident

Car accidents are an unfortunate reality on Tallahassee roads, with collisions occurring daily due to distracted driving, speeding, and other negligent behaviors. Whether an accident seems minor or severe, one of the most...more

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

Kerr Russell

The Difference Between ‘Non-Covered’ vs. ‘Disallowed’ Services

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Question: I have had several colleagues describe their experience with dental plan audits. All of them have had to pay something back. Sometimes they say this is due to a service being deemed a “noncovered service.” Other...more

Faegre Drinker Biddle & Reath LLP

Court Sides with Long-Term Care Insurer Over Claim Denial and Potential Fraud

A judge from the District of Colorado recently issued an opinion that might leave the door open for long-term care insurers to void policies after the contestability period expires if an insured commits fraud. See Meyer v....more

Morrison & Foerster LLP - Left Coast Appeals

This Week At The Ninth: Insurance Coverage for COVID and In-Person Informed Consent for Abortion

This week, the Court considers insurance coverage for business losses sustained as a result of COVID-19 and the constitutionality of Guam’s in-person informed consent requirement for abortion. THE OREGON CLINIC, PC V....more

Carlton Fields

7th Cir. Holds Insurance Coverage Applies to Settlement Payments for Alleged Anti-Kickback and False Claims Act Violations

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On May 3, 2023, the Seventh Circuit Court of Appeals, in Astellas US Holding Inc. v. Federal Insurance Co., held that a liability insurer was required to contribute its limits toward its insured’s payment to settle potential...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

Steptoe & Johnson PLLC

The West Virginia Medical Professional Liability Act Applies Broadly to Services Encompassing Patient Care – Not Just the Care...

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The Supreme Court of Appeals of West Virginia issued a new opinion that finds that litigants cannot characterize claims as “corporate” or “general” negligence in an attempt to circumvent the West Virginia Medical Professional...more

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