News & Analysis as of

Medicare Insurance Litigation

Rivkin Radler LLP

FCA Case Against Insurers Alleges Kickbacks and Discriminatory Practices

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On May 1, a whistleblower filed a complaint under the federal False Claims Act (FCA) against Aetna, Elevance Health (formerly Anthem) and Humana alleging that the insurers paid hundreds of millions of dollars in illegal...more

Fennemore

Nursing Impact Litigation – A Tale of Two Matters

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This article highlights legal disputes central to APRNs’ ability to practice independently, the use of professional titles, insurance discrimination, and broader healthcare competition dynamics. Around the country, Advanced...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

Snell & Wilmer

Redefining the Rules: How Audish v. Macias Reshaped Future Medical Expense Claims in California Personal Injury Cases

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In Audish v. Macias (2024) 102 Cal.App.5th 740, the California Court of Appeal decided a key issue concerning the admissibility of a plaintiff’s future Medicare eligibility in calculating damages for future medical expense...more

DLA Piper

Lawsuit Over AI Usage by Medicare Advantage Plans Allowed to Proceed

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The US District Court for the District of Minnesota has ruled that plaintiffs may proceed in a putative class action lawsuit brought against a Medicare Advantage organization (MAO) to challenge its alleged use of an...more

JUSTICENTER

Basic Personal Injury Settlement Breakdown: How Much Goes in My Pocket?

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Getting a personal injury settlement can feel like a huge relief after an accident. But many people wonder, “How much of this settlement will I actually get?” Understanding how settlements are broken down can help you know...more

Carlton Fields

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

Carlton Fields on

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

Rivkin Radler LLP

Insurance Update - May 2023

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Additional insured disputes can sometimes get complicated. How much coverage the additional insured gets is often a hotly contested issue, especially when the named insured has coverage above the minimum limits it promised...more

Rumberger | Kirk

The Multiple Issues Surrounding Medicare and Past Damages

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What amount of past medical expenses can a plaintiff present to the jury when he or she is a Medicare recipient? The short answer: only the amount of past medical expenses the plaintiff is obligated to pay, not the gross...more

McDermott Will & Emery

This Week in 340B: February 2023 #2

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This weekly series provides brief summaries to help you stay in the know on how 340B cases are developing across the country. Each week we comb through the dockets on more than 40 340B cases to provide you with a quick...more

Butler Weihmuller Katz Craig LLP

Dial v. Calusa Palms Master Association, Inc. - Florida Supreme Court Confirms Only Amounts Actually Paid By Medicare Are...

On April 28, 2022, the Florida Supreme Court issued its decision in Dial v. Calusa Palms Master Association, Inc., which addressed the question: DOES THE HOLDING IN JOERG V. STATE FARM MUTUAL AUTOMOBILE INSURANCE CO., 176...more

Bradley Arant Boult Cummings LLP

$25.5 Million Oklahoma Verdict: Jackpot Justice or Case Study on Bad Faith Litigation?

We all know how prevalent bad faith claims are. It seems like almost every case involving disputed policy benefits includes one. Many have no merit and should be disposed of on summary judgment. The rest, however, arguably...more

Carlton Fields

Recent Ninth Circuit Rulings Uphold Plaintiffs’ Efforts to Predicate Claims on Alleged Insurance Code Violations — Likely More to...

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Recent rulings suggest insurers face increased risk of suits predicating breach of contract and state unfair trade practices claims on alleged violation of state insurance laws, notwithstanding the lack of an express private...more

Butler Weihmuller Katz Craig LLP

Florida's SIU Tool Belt Is a Bit Lighter Today

Florida has been plagued with insurance fraud for decades.  All insurance coverages are susceptible to fraud, but scams are especially prevalent in the context of automobile accidents.  Staged crashes, patient brokering,...more

Searcy Denney Scarola Barnhart & Shipley

Florida DCAs Weigh in on Allstate Case; PIP Litigation Now Headed to Supreme Court

The Florida Supreme Court soon will hear arguments in the case of Florida Wellness & Rehabilitation vs. Allstate Fire & Casualty Insurance Co., which pits medical providers against the automobile insurer on the issue of fees...more

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