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Mealey's Health Law - Kentucky Appeals Court: Insurer Breached Contract In Terminating Agreement

STANTON, Ky. - In an unpublished opinion, the Kentucky Court of Appeals on Feb. 6 affirmed that a managed care company that had contracted with the Commonwealth of Kentucky breached its contract to provide Medicaid services to state residents by terminating the contract early (Kentucky Spirit Health...

Mealey's Health Law - California Federal Judge: Fraud Claim Continues In Reimbursement Case

LOS ANGELES - A California federal judge on Feb. 9 allowed a fraud claim to continue in a health care reimbursement suit, but dismissed three other claims (Mountain View Surgical Center v. CIGNA Health Corp., No. 13-8083, C.D. Calif.; 2015 U.S. Dist. LEXIS 15320).

Mealey's Health Law - 3rd Circuit: ACA Birth Control Mandate Accommodation Doesn't Burden Religion

PHILADELPHIA - The accommodation through which those who object to the contraceptive mandate of the Patient Protection and Affordable Care Act (ACA) can avoid providing or paying for the insurance coverage does not burden religious practice, a Third Circuit U.S. Court of Appeals panel held Feb. 11 (Geneva...

Mealey's Health Law - Washington Federal Judge: Supplier Not Entitled To Medicare Reimbursement

TACOMA, Wash. - Upon remand by the Ninth Circuit U.S. Court of Appeals, a Washington federal judge on Feb. 13 determined that the supplier of a piece of durable medical equipment used to treat osteoarthritis of the knee was not entitled to the benefits of any of Medicare's "limited liability"...

Mealey's Health Law - 11th Circuit Denies Rehearing In ACA Employer Mandate Implementation Challenge

MIAMI - The 11th Circuit U.S. Court of Appeals on Feb. 13 declined to rehear a Patient Protection and Affordable Care Act (ACA) case, leaving stand a divided panel's conclusion that an orthodontist lacked standing to challenge delayed implementation of the law's employer mandate (Kawa Orthodontics...

Mealey's Health Law - Judge Rejects Man's Challenge To Legitimacy Of Anti-ACA Bill's Fiscal Note

NASHVILLE, Tenn. - A man lacks standing to pursue a suit accusing a government official of fraudulently concocting a fiscal note to torpedo a Tennessee bill blocking implementation of the Patient Protection and Affordable Care Act (ACA), a federal judge held Feb. 18 (Louie E. Johnston Jr. v. Lucien C...

Mealey's Health Law - Federal Judge Declines To Dismiss Antitrust Claims In Surgery Center Dispute

DENVER - A Colorado federal judge on Feb. 20 declined to dismiss antitrust claims in a suit alleging that health insurers conspired with hospitals to drive multiple ambulatory surgical centers out of business (Arapahoe Surgery Center, et al. v. CIGNA Healthcare Inc., et al., No. 13-3422, D. Colo.; 2015...

Mealey's Health Law - High Court Denies Certiorari In Suit Over Involving Antitrust, ERISA Claims

WASHINGTON, D.C. - The U.S. Supreme Court on Feb. 23 declined to grant certiorari, which left standing an agreement reached in In re Managed Care Litigation that bars several physicians and physician groups from bringing claims against WellPoint Inc. in In re WellPoint, Inc. Out-of-Network "UCR"...

Mealey's Health Law - High Court Denies Certiorari In Medicare Reimbursement Dispute

WASHINGTON, D.C. - The U.S. Supreme Court on Feb. 23 denied certiorari, leaving stand a Third Circuit U.S. Court of Appeals decision holding that the Medicare as a Secondary Payer Act (MSP Act) authorizes the government to seek reimbursement from a settlement a plaintiff receives from a tortfeasor because...

Mealey's Health Law - Divided Illinois Appeals Court Reverses Class Action Status In Subrogation Suit

CHICAGO - A divided Illinois appeals court on Feb. 27 reversed and vacated the judgment of a trial court granting the plaintiff's motion for summary judgment and class certification in a health care subrogation dispute, saying the plaintiff had no right to rely on the common fund doctrine to support...

Mealey's Health Law - House Republicans Tell Judge Standing Exists In ACA Funding Challenge

WASHINGTON, D.C. - The House of Representatives' role as controller of the purse strings gives it sufficient injury to challenge the administration's alleged misallocation of public funds related to the Patient Protection and Affordable Care Act (ACA), Republicans told a federal judge in the...

Mealey's Health Law - Colorado Federal Judge Declines To Dismiss Health Care Breach Of Contract Suit

DENVER - A federal judge in Colorado on Feb. 25 declined to dismiss a suit in which the plaintiff accused his health insurance company of breach of contract for allegedly wrongfully informing him that the effective date of his coverage was later than it really was, causing the plaintiff to receive treatment...

Mealey's Health Law - Top Court Hears Arguments Over ACA Federal Exchange Subsidy Availability

WASHINGTON, D.C. - Both sides faced critical questioning from Justice Anthony Kennedy during oral arguments March 4 in the case challenging the availability of subsidies in the Patient Protection and Affordable Care Act (ACA) federal exchange (David King, et al. v. Sylvia Mathew Burwell, et al., No....

Mealey's Health Law - Top Court Cites Hobby Lobby In Vacating, Remanding ACA Accommodation Ruling

WASHINGTON, D.C. - The U.S. Supreme Court on March 9 vacated a Seventh Circuit U.S. Court of Appeals opinion that denied the University of Notre Dame an injunction in its challenge to the Patient Protection and Affordable Care Act (ACA) accommodation process and remanded the case for consideration in...

Mealey's Health Law - Committee's Vote Leaves ACA Medicaid Expansion On Life Support In Montana

HELENA, Mont. - Expansion of Medicaid under the Patient Protection and Affordable Care Act (ACA) appears dead in Montana after a 59-41 vote by a Montana House committee on March 10.

Mealey's Health Law - HHS Says 11.7 Million Found Insurance Through ACA Exchanges

WASHINGTON, D.C. - Nearly 11.7 million consumers found insurance through Patient Protection and Affordable Care Act (ACA) marketplaces for 2015, the U.S. Department of Health and Human Services said March 10.

Mealey's Health Law - Judge Won't Consider Catholic Benefits Group's Class Motion Before Appeals

OKLAHOMA CITY - Judicial economy is not served by considering a class certification motion in a Patient Protection and Affordable Care Act (ACA) challenge while appeals are pending, a federal judge held March 13 (The Catholic Benefits Association LCA; The Catholic Insurance Co. v. Sylvia M. Burwell,...

Mealey's Health Law - Judge Stays Challenge To ACA Mandate Accommodation For 11th Circuit Ruling

TAMPA, Fla. - A federal judge on March 18 granted the government's motion to stay a challenge to the Patient Protection and Affordable Care Act (ACA) contraceptive mandate accommodation until the 11th Circuit U.S. Court of Appeals weighs in on a closely related case (Christian and Missionary Alliance...

Mealey's Health Law - ACA Creates Singular Standard For Discrimination Cases, Federal Judge Says

MINNEAPOLIS - A transgendered individual may proceed with a Patient Protection and Affordable Care Act (ACA) Section 1557 discrimination case because the law creates a singular standard regardless of protected class status, a federal judge in Minnesota held March 16 (Jakob Tiarnan Rumble v. Fairview...

Mealey's Health Law - Government Asks Judge To Dismiss Indian Tribe's ACA Employer Mandate Challenge

CHEYENNE, Wyo. - An Indian tribe waived its objections to the Patient Protection and Affordable Care Act (ACA)'s large employer mandate by not raising them during the rulemaking process, and its action runs afoul of the Anti-Injunction Act's (AIA) bar on tax challenges taxes, the government told...

Mealey's Health Law - Government Tells Appeals Court Man Lacks Injury From ACA, Means Of Redress

WASHINGTON, D.C. - An elected official cannot demonstrate injury from the Patient Protection and Affordable Care Act (ACA)'s transitional policy allowing states to decide whether to impose minimum insurance requirements, and his establishment clause claims would not remedy any alleged injury, the...

Mealey's Health Law - Supreme Court Rejects ACA Privacy Violations Challenge

WASHINGTON, D.C. - The Supreme Court on March 30 declined a challenge to the Patient Protection and Affordable Care Act (ACA) alleging that the individual mandate impermissibly required disclosure of confidential personal information (Nick Coons, et al. v. Jacob L. Lew, et al., No. 14-525, U.S. Sup....

Mealey's Health Law - Government: Representatives In ACA Funding Challenge Lack Standing

WASHINGTON, D.C. - A federal judge should ignore "alarmist" rhetoric and instead find that House of Representatives members lack standing to challenge how the government spends Patient Protection and Affordable Care Act (ACA) funds, the government argues in a March 31 brief (United States House...

Mealey's Health Law - Missouri Law Regulating ACA Advisers Preempted, 8th Circuit Affirms

JEFFERSON CITY, Mo. - A judge properly enjoined portions of a Missouri law governing the conduct of advisers employed to help people navigate the Patient Protection and Affordable Care Act (ACA) exchange, an Eighth Circuit U.S. Court of Appeals panel held April 10 in partially affirming (St. Louis Effort...

Mealey's Health Law - Montana House Passes ACA Medicaid Expansion Legislation

HELENA, Mont. - Montana Legislature on April 9 appeared to ready to enact legislation expanding Medicaid under the Patient Protection and Affordable Care Act (ACA) after a newly introduced bill survived four failed motions for a second reading and two motions to re-refer the legislation to the House...