Mealeys

Recent Posts

Mealey's ACA - Magistrate Judge Recommends Remanding Insurance Billing Spat
Posted on 13 Feb 2020 by Mealeys

FORT LAUDERDALE, Fla. - An orthopedic specialist challenges only the rate of compensation and seeks payment under Florida law, putting it outside the reach of the Employee Retirement Income Security Act, a federal magistrate judge said Feb. 10 in recommending... Read More

Mealey's ACA - Parity Act, ERISA Claims Proceed In Mental Health Coverage Case, Judge Says
Posted on 13 Feb 2020 by Mealeys

SALT LAKE CITY - Father-daughter plaintiffs adequately allege that their health insurer applies different standards to mental health and substance abuse claims than they would medical and surgical claims when making coverage decisions, a federal judge... Read More

Mealey's ACA - Categorical Exclusions Keep Parity Act Claims Alive, Federal Judge Says
Posted on 13 Feb 2020 by Mealeys

SALT LAKE CITY - An action alleging that a health insurer categorically denies coverage for wilderness and substance abuse programs may go forward after a federal judge in Utah on Feb. 7 declined to dismiss the claims (Johnathan Z., et al. v. Oxford Health... Read More

Mealey's ACA - Magistrate Judge Dismisses Hospital's Underpayment Case Against Insurer
Posted on 11 Feb 2020 by Mealeys

MIAMI - Nothing mandates that health insurance policies incorporate Patient Protection and Affordable Care Act (ACA) protections or state law governing emergency care payments, and a hospital's suit seeking unpaid bills largely fails, a federal magistrate... Read More

Mealey's ACA - CalPERS Escapes Hospital's Payment Suit, Court Says
Posted on 6 Feb 2020 by Mealeys

LOS ANGELES - A contract between California's public retirement system and an insurer does not confer benefits on a health care provider, and the provider's own contract with the insurer does not create a payment obligation on the part of the... Read More

Mealey's ACA - Respondents: Supreme Court Should Wait To Review ACA Individual Mandate Case
Posted on 5 Feb 2020 by Mealeys

WASHINGTON, D.C. - There is no need for the U.S. Supreme Court to weigh in on an interlocutory order finding standing and that the individual mandate is unconstitutional when it can simply bide its time and address a more full record later, three respondents... Read More

Mealey's ACA - More Briefs Sought In Dispute Over Out-Of- Pocket Nursing Home Costs
Posted on 31 Jan 2020 by Mealeys

HARTFORD, Conn. - A class of Medicare recipients and the Secretary of Health and Human Services (HHS) were asked by a federal judge in Connecticut on Jan. 28 to brief a new series of questions in a lawsuit over out-of-pocket costs for admission to a skilled... Read More

Mealey's ACA - 5th Circuit Won't Take ACA Individual Mandate Case En Banc
Posted on 30 Jan 2020 by Mealeys

NEW ORLEANS - The Fifth Circuit U.S. Court of Appeals on Jan. 29 declined en banc rehearing in a Patient Protection and Affordable Care Act (ACA) individual mandate case after one of its members asked that the court be polled on the question. A pair of... Read More

Mealey's ACA - ACA Discrimination Claim Untimely Under Borrowed Statute, Judge Says
Posted on 29 Jan 2020 by Mealeys

BATON ROUGE, La. - The Patient Protection and Affordable Care Act (ACA) borrows from other statutes to ban discrimination, and this borrowing includes the underlying statutes of limitations, a federal judge in Louisiana held Jan. 24 in granting summary... Read More

Mealey's ACA - Magistrate Judge Finds Insurer Violated ERISA, Improperly Denied Coverage
Posted on 24 Jan 2020 by Mealeys

CLEVELAND - An insurer's procedural errors violated the Employee Retirement Income Security Act, and it improperly denied coverage for spinal surgery, a federal magistrate judge in Ohio said Jan. 22 (Keith W. Canter v. Alkermes Blue Care Elect Preferred... Read More

Mealey's ACA - Judge: Forum Clause Needs Briefing In Toxicology Provider's ERISA Suit
Posted on 23 Jan 2020 by Mealeys

FORT LAUDERDALE, Fla. - Anti-assignment provisions largely doom a toxicology service provider's suit seeking payment, but the parties must brief the court on how to handle one surviving defendant's forum-selection clause requiring litigation in... Read More

Mealey's ACA - Lactation Services Plaintiffs Lose Expert Testimony, Class Certification Motion
Posted on 23 Jan 2020 by Mealeys

CHICAGO - An Illinois federal judge on Jan. 21 stripped plaintiffs suing their insurer over lactation services coverage under the Patient Protection and Affordable Care Act (ACA) of their expert witness testimony for lack of reliability and then denied... Read More

Mealey's ACA - U.S. Supreme Court Won't Expedite ACA Individual Mandate Case
Posted on 21 Jan 2020 by Mealeys

WASHINGTON, D.C. - The U.S. Supreme Court on Jan. 21 declined to expedite consideration of a ruling finding the Patient Protection and Affordable Care Act (ACA) unconstitutional after being told that the underlying ruling presented no immediate impact... Read More

Mealey's ACA - U.S. Supreme Court Accepts ACA Birth Control Case
Posted on 21 Jan 2020 by Mealeys

WASHINGTON, D.C. - Six years after partially punting on the issue and in the face of new regulations, the U.S. Supreme Court on Jan. 17 agreed to once again wade into the debate involving abortion and the Patient Protection and Affordable Care Act (ACA... Read More

Mealey's ACA - U.S. Supreme Court Told Not To Rush To Judgment In ACA Individual Mandate Case
Posted on 14 Jan 2020 by Mealeys

WASHINGTON, D.C. - Rulings that found the Patient Protection and Affordable Care Act (ACA) individual mandate unconstitutional present no immediate impact and do not need to be addressed in an expedited fashion, a trio of Supreme Court respondents told... Read More