Promissory Estoppel, Out of Network Provider, Health Insurance

Navigating Out-of-Network Claims: Key Takeaways for Providers From Surgery Center Case in New York Federal Court

ArentFox Schiff on 3/31/2025

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

Ninth and Second Circuit Courts of Appeals Rule that Preauthorization Process Does Not Impose Independent Contractual Liability on...

Robinson+Cole ERISA Claim Defense Blog on 6/21/2024

Within days of one another, the U.S. Court of Appeals for the Ninth and Second Circuits ruled—on issues of first impression for both—that ERISA expressly preempts state law breach of contract and promissory estoppel claims...more

California Court of Appeal Affirms Grant of Summary Judgment Against Health Care Provider in Win for Managed Care Payors and...

Troutman Pepper Locke on 8/7/2023

The California Court of Appeal, in a major win for managed care payors and claims administrators, affirmed a lower court decision granting summary judgment in favor of United Healthcare (United), finding that United did not...more

Third Circuit: Provider’s Out-of-Network Claims not Pre-empted by ERISA

Epstein Becker & Green on 7/27/2020

In an important win for healthcare providers, on July 17, 2020, the Third Circuit determined in a published opinion that an out-of-network provider’s direct claims against in insurer for breach of contract and promissory...more

Out-of-Network Physician’s Claim Against Insurer Not Preempted by ERISA

Proskauer - Employee Benefits & Executive... on 6/9/2017

The Second Circuit concluded that a promissory estoppel claim by an out-of-network provider against an insurer was not completely preempted by ERISA and thus remanded the claim to state court for further proceedings. The...more

Promissory Estoppel › Out of Network Provider › Health Insurance

Navigating Out-of-Network Claims: Key Takeaways for Providers From Surgery Center Case in New York Federal Court

Ninth and Second Circuit Courts of Appeals Rule that Preauthorization Process Does Not Impose Independent Contractual Liability on...

California Court of Appeal Affirms Grant of Summary Judgment Against Health Care Provider in Win for Managed Care Payors and...

Third Circuit: Provider’s Out-of-Network Claims not Pre-empted by ERISA

Out-of-Network Physician’s Claim Against Insurer Not Preempted by ERISA

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