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Healthcare › Insurance Litigation › Insurance Industry

Proskauer - Health Care Law Brief

No Surprises Here! Fifth Circuit Holds NSA Provides No Private Right of Action to Enforce IDR Awards, Deepening Judicial Divide...

Proskauer - Health Care Law Brief on

In a recently issued opinion, the Fifth Circuit has added yet another chapter to the growing debate over whether providers may seek judicial enforcement of Independent Dispute Resolution (“IDR”) awards issued under the No...more

Goodwin

Health Headlines: May 2025

Goodwin on

On May 14, 2025, Pennsylvania State Sen. Tim Kearney and State Rep. Lisa Borowski introduced legislation addressing private equity and corporate interests in healthcare. Pennsylvania Gov. Josh Shapiro is touting the companion...more

Bradley Arant Boult Cummings LLP

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

Bradley Arant Boult Cummings LLP on

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

Arnall Golden Gregory LLP

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

Arnall Golden Gregory LLP on

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

Kerr Russell on

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

Faegre Drinker Biddle & Reath LLP on

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

Steptoe & Johnson PLLC

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

Steptoe & Johnson PLLC on

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

Zuckerman Spaeder LLP

In Nevada, Jury Finds against United Healthcare’s Efforts To Underpay for Emergency Medical Services and Generate Profits for...

Zuckerman Spaeder LLP on

On November 29, 2021, a jury in Nevada found United Healthcare liable for underpaying TeamHealth, a nationwide provider of emergency medical services, by millions of dollars. The case, Fremont Emergency Services vs....more

Wiley Rein LLP

Written Consent Must be in Writing: Insured Breaches Consent Requirement and Loses Coverage

Wiley Rein LLP on

Applying Georgia law, a federal district court has held that an insured’s failure to seek consent to incur defense costs pursuant to a consent provision relieved the insurer from any obligation to provide coverage for those...more

Nossaman LLP

Is There Coverage for The Pill Mill Lawsuits?

Nossaman LLP on

In an effort to deal with the terrible epidemic of drug abuse and the human and economic costs of this dilemma, the state of West Virginia has brought lawsuits in several jurisdictions against pharmaceutical companies and...more

Faegre Drinker Biddle & Reath LLP

Third Cir. Holds Hospitals May Sue Health Insurers Directly

Faegre Drinker Biddle & Reath LLP on

Before September 11 the Third Circuit Court of Appeals had been out of step with its sister federal circuits when it came to the right of hospitals, physicians and other health providers to sue health insurers that failed to...more

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