Mealeys

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Mealey's Health Law - Judge Remands Insolvent Insurer's Liquidator's Breach Of Fiduciary Duty Case
Posted on 17 Jan 2020 by Mealeys

SALT LAKE CITY - A federal judge in Utah on Jan. 13 remanded to the liquidation court an insolvent health insurer's liquidator's breach of fiduciary and negligence lawsuit against the insurer's executives because the executives failed to establish... Read More

Mealey's Health Law - Part Of Liquidator's Claims Over Offset Under ACA Reinsurance Program Dismissed
Posted on 5 Nov 2019 by Mealeys

WASHINGTON, D.C. - A U.S. Court of Federal Claims judge on Oct. 31 dismissed for lack of jurisdiction insolvent insurer liquidators' state law claims against the U.S. government over violation of South Carolina insurance law following the government's... Read More

Mealey's Health Law - 11th Circuit Affirms Judgment In ERISA Spine Surgery Benefit Case
Posted on 25 Oct 2019 by Mealeys

ATLANTA - An insurer with discretionary authority did not err when it denied coverage for two-level spinal fusion surgery under the plan's exclusion on experimental procedures, an 11th Circuit U.S. Court of Appeals panel held Oct. 24 in rejecting... Read More

Mealey's Health Law - 5th Circuit Doesn't Want Second Look At Dialysis Provider's Suit
Posted on 14 Oct 2019 by Mealeys

NEW ORLEANS - The Fifth Circuit U.S. Court of Appeals denied a motion for rehearing Oct. 10, letting stand a decision finding a health care plan's anti-assignment provision prevented a health care provider from suing an insurer (Dialysis Newco Inc... Read More

Mealey's Health Law - Limited Partnership Action Seeks Labor Department Opinion On Health Care Plan Status
Posted on 9 Oct 2019 by Mealeys

DALLAS - A limited partnership filed suit in Texas federal court on Oct. 4, seeking to force the U.S. Department of Labor (DOL) to issue an advisory opinion declaring that the self-insured health plan it offers common-law employees and limited partners... Read More

Mealey's Health Law - Top Court Denies Review In ERISA Health Care Rights-Assignment Spat
Posted on 7 Oct 2019 by Mealeys

WASHINGTON, D.C. - The U.S. Supreme Court on Oct. 7 denied a health care insurer's petition for review, leaving stand a Fifth Circuit U.S. Court of Appeals ruling finding that direct payments to a provider waived an Employee Retirement Income Security... Read More

Mealey's Health Law - Judge Acquits 1 Executive On Charges In Hedge Scheme, Grants New Trial To Another
Posted on 30 Sep 2019 by Mealeys

BROOKLYN, N.Y. - A federal judge in New York on Sept. 27 acquitted a former executive of securities fraud charges arising from his role in a hedge fund scheme to transfer assets to a reinsurance company and related entities to defraud bondholders in an... Read More

Mealey's Health Law - Provider Seeks Rehearing After Panel Rules On Assignment, ERISA Preemption
Posted on 30 Sep 2019 by Mealeys

NEW ORLEANS - A dialysis provider Sept. 25 asked the Fifth Circuit U.S. Court of Appeals to review a panel ruling finding a health care plan precluded assignment of Employee Retirement Income Security Act (ERISA) rights and that the statute preempted... Read More

Mealey's Health Law - United Wants Judge To Reconsider Facility-Fee Coverage Class Ruling
Posted on 26 Sep 2019 by Mealeys

NEW YORK - Determining whether a class of surgery providers properly obtained an assignment of rights under Employee Retirement Income Security Act plans requires claim-by-claim analysis precluding certification, an insurer tells a New York judge in a... Read More

Mealey's Health Law - Judge: Lack Of Plan Documents Dooms Expanded Health Care Coverage Class
Posted on 21 Aug 2019 by Mealeys

TRENTON, N.J. - A proposed class of self-insured health plans in which Aetna Life Insurance Co. allegedly imposes undisclosed internal standards for coverage would require access to plan documents the plaintiffs have not submitted, a federal judge in... Read More

Mealey's Health Law - Judge: No Jurisdiction To Hear Health Insurer Liquidator's Offset Case
Posted on 14 Aug 2019 by Mealeys

CHICAGO - A federal judge in Illinois on Aug. 13 held that she lacked jurisdiction over a case filed by an insolvent health insurer's liquidator against the Centers for Medicare and Medicaid Services (CMS) and the U.S. government in which the liquidator... Read More

Mealey's Health Law - Parity Act Allegations In ERISA Suit May Proceed, Judge Says
Posted on 17 Jun 2019 by Mealeys

SALT LAKE CITY - Allegations that a health insurer covers subacute care in surgical settings but denies coverage in mental health settings provides a basis for a couple's Parity Act claim under the Employee Retirement Income Security Act, a federal... Read More

Mealey's Health Law - 9th Circuit Reverses Class Denial In Generic Drug Price-Gouging Case
Posted on 17 Jun 2019 by Mealeys

SAN FRANCISCO - Both named and unnamed plaintiffs in a drug-pricing class action allege the same injury from the same conduct, satisfying the typicality requirements for a class action, a Ninth Circuit U.S. Court of Appeals panel held June 14 in reinstating... Read More

Mealey's ACA - 9th Circuit Reverses Class Denial In Generic Drug Price-Gouging Case
Posted on 17 Jun 2019 by Mealeys

SAN FRANCISCO - Both named and unnamed plaintiffs in a drug-pricing class action allege the same injury from the same conduct, satisfying the typicality requirements for a class action, a Ninth Circuit U.S. Court of Appeals panel held June 14 in reinstating... Read More

Mealey's Health Law - Judge: Insurer Shorted Period For Medically Necessary Mental Health Treatments
Posted on 7 Jun 2019 by Mealeys

SALT LAKE CITY - A federal judge in Utah on June 4 affirmed complete denial of coverage for treatment at one mental health treatment facility under the Employee Retirement Income Security Act, but found treatment at a second medically necessary for longer... Read More