News & Analysis as of

Hospitals Insurance Litigation

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

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

Arnall Golden Gregory LLP

Healthcare Providers Keep Singing the Blues About Unfair Reimbursement Rates But Blue Cross Blue Shield Won’t Change Its Tune

After more than a decade of litigation and more than $5 billion in settlements, the Blue Cross Blue Shield Association (“BCBSA”) and its affiliate insurance companies (the “BCBS Entities”) appear to be up to their old tricks....more

Davis Wright Tremaine LLP

Two California Appellate Decisions Highlight Liability Risks Arising From Hospital "Conditions of Admission" Forms and Billing...

In the ever-evolving world of healthcare billing, two recent reported California appellate court decisions, Naranjo v. Doctors Medical Center of Modesto and Dameron Hospital Association v. Progressive Casualty Insurance...more

Arnall Golden Gregory LLP

Federal Court Permits MultiPlan Antitrust MDL to Proceed: Court Upholds Federal and State Antitrust and Consumer Protection...

On June 3, 2025, Judge Matthew F. Kennelly of the U.S. District Court for the Northern District of Illinois issued a sweeping ruling in In re MultiPlan Health Insurance Provider Litigation, largely denying motions to dismiss...more

A&O Shearman

Northern District Of Illinois Denies Motion To Dismiss Antitrust Claims In Healthcare Providers’ Price Fixing Lawsuit

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On June 3, 2025, Judge Matthew F. Kennelly denied motions to dismiss federal and state antitrust claims brought by healthcare providers (“plaintiffs”) against MultiPlan (a healthcare payment management service) and...more

Goodwin

Health Headlines: May 2025

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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

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

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

Butler Weihmuller Katz Craig LLP

Sexual Assault Is Not A Professional Service

Not many cases in Florida analyze Professional Services Exclusions in general liability policies.  However, on September 16, 2022, the Eleventh Circuit Court of Appeals released an order providing some clarification about the...more

Steptoe & Johnson PLLC

Fourth Circuit Sets Forth the Requirements for the ‘Loss of Chance’ Provision of West Virginia’s Medical Professional Liability...

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The United States Court of Appeals for the Fourth Circuit recently interpreted the “loss of chance” provision of West Virginia’s Medical Professional Liability Act (the MPLA). In Graham v. Dhar, the Court ruled that a...more

American Conference Institute (ACI)

[Webinar] Navigating New Risks and Litigation Challenges Facing Payors in the COVID-19 Context and Beyond - May 13th, 12:00 pm -...

What will the post-pandemic world look like? What risks and challenges will it raise and how to navigate the new litigation landscape? These are the most relevant questions amid the pandemic. To respond to them and provide...more

BakerHostetler

Darwinian Insurance

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This case demonstrates the need for providers to know and follow the notification provisions set forth in their insurance policies in order to avoid an inadvertent loss of coverage. Once again, the terms of a hospital’s...more

Poyner Spruill LLP

Fourth Circuit Holds Staffing Agency Nurse to be Hospital Employee for Purposes of Liability Insurance

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Is a nurse employed by a staffing agency and temporarily assigned to work at a hospital considered an “employee” of the hospital and therefore entitled to coverage under the hospital’s liability insurance policy?...more

Faegre Drinker Biddle & Reath LLP

Third Cir. Holds Hospitals May Sue Health Insurers Directly

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

BakerHostetler

Aetna Out of Patience With Hospital’s Alleged Out-of-Network Billing Scheme

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Aetna Life Insurance Company (Aetna) is going on the offensive against a Northwest Houston hospital with an out-of-network strategy. On February 23, 2015, Aetna filed suit in Texas federal court against Robert A. Behar, M.D....more

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