LexisNexis® Legal Newsroom
Mealey's Health Law - Class Claims Insurer Misrepresents Quality Of Replacement Plans

LOS ANGELES - Anthem Blue Cross promises Patient Protection and Affordable Care Act (ACA) exchange customers re-enrollment in a similar plans when cancellations occur, while in reality providing far inferior plans with no out-of-network coverage, according to a class action lawsuit filed Oct. 31 in California court, alleging violation of the state unfair competition law (UCL) (Paul Simon, et al. v. Blue Cross of California, d/b/a Anthem Blue Cross; and DOES 1-100, inclusive, No. BC639205, Calif. Super., Los Angeles Co.).

Mealey's Antitrust/Unfair Competition - Class Claims Insurer Misrepresents Quality Of Replacement Plans

LOS ANGELES - Anthem Blue Cross promises Patient Protection and Affordable Care Act (ACA) exchange customers re-enrollment in a similar plans when cancellations occur, while in reality providing far inferior plans with no out-of-network coverage, according to a class action lawsuit filed Oct. 31 in California court, alleging violation of the state unfair competition law (UCL) (Paul Simon, et al. v. Blue Cross of California, d/b/a Anthem Blue Cross; and DOES 1-100, inclusive, No. BC639205, Calif. Super., Los Angeles Co.).

Mealey's Litigation Procedure - Class Claims Insurer Misrepresents Quality Of Replacement Plans

LOS ANGELES - Anthem Blue Cross promises Patient Protection and Affordable Care Act (ACA) exchange customers re-enrollment in a similar plans when cancellations occur, while in reality providing far inferior plans with no out-of-network coverage, according to a class action lawsuit filed Oct. 31 in California court, alleging violation of the state unfair competition law (UCL) (Paul Simon, et al. v. Blue Cross of California, d/b/a Anthem Blue Cross; and DOES 1-100, inclusive, No. BC639205, Calif. Super., Los Angeles Co.).

Mealey's Labor & Employment - Top Court Declines Review In Case Involving ACA-ERISA Appeal Interplay

WASHINGTON, D.C. - The U.S. Supreme Court on Oct. 3 declined to review a woman's case involving, among other issues, the proper way to handle external benefit denial appeal after the Patient Protection and Affordable Care Act (ACA)'s amendments to the Employee Retirement Income Security Act (S.M. v. Oxford Health Plans [NY] Inc., et al., No. 15-1540, U.S. Sup.).

Mealey's Health Law - Top Court Declines Review In Case Involving ACA-ERISA Appeal Interplay

WASHINGTON, D.C. - The U.S. Supreme Court on Oct. 3 declined to review a woman's case involving, among other issues, the proper way to handle external benefit denial appeal after the Patient Protection and Affordable Care Act (ACA)'s amendments to the Employee Retirement Income Security Act (S.M. v. Oxford Health Plans [NY] Inc., et al., No. 15-1540, U.S. Sup.).

Mealey's Insurance - Judge Says ACA Insurer Is Insolvent, Orders Liquidation

CHICAGO - An Illinois judge on Sept. 29 ordered the liquidation of an insolvent Patient Protection and Affordable Care Act (ACA) marketplace insurer and terminated a previously ordered rehabilitation (People of the State of Illinois, ex rel. Anne Melissa Dowling, Acting Director of Insurance of the State of Illinois v. Land of Lincoln Mutual Health Insurance Company, No. 2016CH09210, Ill. Cir., Cook Co., Chanc. Div.).

Mealey's Labor & Employment - Judge Reverses Course, Reinstates Man's ACA Claim Against Government Plan

CENTRAL ISLIP, N.Y. - A man's claims invoke the Patient Protection and Affordable Care Act (ACA), which unlike other regulations does not specifically exclude government-sponsored plans, a federal judge in New York held in granting reconsideration and reinstating the claims on Sept. 6 (Raymond A. Semente, D.C., P.C. v. Empire Healthcare, et al., No. 14-5823, E.D. N.Y.).

Mealey's PI/Product Liability - Judge Bars ACA Testimony; Jury Awards Defense Verdict In Medical Negligence Case

HARRISBURG, Pa. - A federal jury in Pennsylvania on Aug. 19 found no negligence in a doctor's failure to properly diagnose and treat a woman's herpes zoster virus after a judge ruled that the jury would not hear testimony regarding the potential availability of Patient Protection and Affordable Care Act (ACA) benefits (Tami Bernheisel v. Martin Mikaya, M.D., Memorial Hospital Inc., et al., No. 13-1496, M.D. Pa.).

Mealey's Litigation Procedure - Judge Bars ACA Testimony; Jury Awards Defense Verdict In Medical Negligence Case

HARRISBURG, Pa. - A federal jury in Pennsylvania on Aug. 19 found no negligence in a doctor's failure to properly diagnose and treat a woman's herpes zoster virus after a judge ruled that the jury would not hear testimony regarding the potential availability of Patient Protection and Affordable Care Act (ACA) benefits (Tami Bernheisel v. Martin Mikaya, M.D., Memorial Hospital Inc., et al., No. 13-1496, M.D. Pa.).

Mealey's Health Law - Judge Bars ACA Testimony; Jury Awards Defense Verdict In Medical Negligence Case

HARRISBURG, Pa. - A federal jury in Pennsylvania on Aug. 19 found no negligence in a doctor's failure to properly diagnose and treat a woman's herpes zoster virus after a judge ruled that the jury would not hear testimony regarding the potential availability of Patient Protection and Affordable Care Act (ACA) benefits (Tami Bernheisel v. Martin Mikaya, M.D., Memorial Hospital Inc., et al., No. 13-1496, M.D. Pa.).

Mealey's Health Law - Judge Places ACA Health Care Marketplace Co-Op Into Rehabilitation

CHICAGO - An Illinois judge on July 14 placed a Patient Protection and Affordable Care Act (ACA) health care marketplace co-op into rehabilitation because, according to the state's acting director of insurance, the insurer will suffer a $68 million loss due to the actions of Congress and the Centers for Medicare & Medicaid Services, which would place the insurer in a hazardous position (People of the State of Illinois, ex rel. Anne Melissa Dowling, Acting Director of Insurance of the State of Illinois v. Land of Lincoln Mutual Health Insurance Company, No. 2016CH09210, Ill. Cir., Cook Co., Chanc. Div.).

Mealey's Insurance - Judge Places ACA Health Care Marketplace Co-Op Into Rehabilitation

CHICAGO - An Illinois judge on July 14 placed a Patient Protection and Affordable Care Act (ACA) health care marketplace co-op into rehabilitation because, according to the state's acting director of insurance, the insurer will suffer a $68 million loss due to the actions of Congress and the Centers for Medicare & Medicaid Services, which would place the insurer in a hazardous position (People of the State of Illinois, ex rel. Anne Melissa Dowling, Acting Director of Insurance of the State of Illinois v. Land of Lincoln Mutual Health Insurance Company, No. 2016CH09210, Ill. Cir., Cook Co., Chanc. Div.).

Mealey's Securities/D&O Liability - Judge: Exchange Company's Post-ACA Guidance Didn't Violate Securities Law

SAN FRANCISCO - A health exchange company's officer's opinions regarding their financial health after passage of the Patient Protection and Affordable Care Act (ACA) and forward-looking statements with adequate warnings do not support class action claims under securities law, a federal judge in California held March 14 (Jeffrey West v. eHealth Inc., et al., No. 15-360, N.D. Calif.; 2016 U.S. Dist. LEXIS 33429).

Mealey's Litigation Procedure - Judge: Exchange Company's Post-ACA Guidance Didn't Violate Securities Law

SAN FRANCISCO - A health exchange company's officer's opinions regarding their financial health after passage of the Patient Protection and Affordable Care Act (ACA) and forward-looking statements with adequate warnings do not support class action claims under securities law, a federal judge in California held March 14 (Jeffrey West v. eHealth Inc., et al., No. 15-360, N.D. Calif.; 2016 U.S. Dist. LEXIS 33429).

Mealey's Banking & Finance - Judge: Exchange Company's Post-ACA Guidance Didn't Violate Securities Law

SAN FRANCISCO - A health exchange company's officer's opinions regarding their financial health after passage of the Patient Protection and Affordable Care Act (ACA) and forward-looking statements with adequate warnings do not support class action claims under securities law, a federal judge in California held March 14 (Jeffrey West v. eHealth Inc., et al., No. 15-360, N.D. Calif.; 2016 U.S. Dist. LEXIS 33429).

Mealey's Labor & Employment - U.S. Supreme Court: ERISA Preempts State's Health Care Database Law

WASHINGTON, D.C. - The U.S. Supreme Court on March 1 ruled 6-2 that the Employee Retirement Income Security Act, as amended by the Patient Protection and Affordable Care Act (ACA), preempts Vermont's health care data collection law, which requires health care payers to report claims and health care services data to a state agency, as applied to ERISA benefit plans (Alfred Gobeille, in his official capacity as chair of the Vermont Green Mountain Care Board v. Liberty Mutual Insurance Co., No. 14-181, U.S. Sup.).

Mealey's Labor & Employment - Dismissal Denied In Suit Accusing Dave & Buster's Of Interference Under ERISA

NEW YORK - A New York federal judge on Feb. 9 denied Dave & Buster's Inc.'s motion to dismiss a lawsuit accusing the nationwide restaurant/entertainment chain of violating the Employee Retirement Income Security Act by reducing the hours of its work force in 2013 to avoid the costs associated with providing health insurance to its full-time employees in compliance with the Patient Protection and Affordable Care Act (ACA) (Maria De Lourdes Parra Marin v. Dave & Buster's, Inc., et al., No. 15-3608, S.D. N.Y.).

Mealey's Insurance - Vermont, Insurer Square Off Before Top Court Over Preemption Of Reporting Rules

WASHINGTON, D.C. - The State of Vermont and an insurer squared off before the U.S. Supreme Court Dec. 2 in oral arguments over whether the Employee Retirement Income Security Act, as amended by the Patient Protection and Affordable Care Act (ACA), preempts state level collection of health insurance data (Alfred Gobeille, in his official capacity as chair of the Vermont Green Mountain Care Board v. Liberty Mutual Insurance Co., No. 14-181, U.S. Sup.).

Mealey's Health Law - Vermont, Insurer Square Off Before Top Court Over Preemption Of Reporting Rules

WASHINGTON, D.C. - The State of Vermont and an insurer squared off before the U.S. Supreme Court Dec. 2 in oral arguments over whether the Employee Retirement Income Security Act, as amended by the Patient Protection and Affordable Care Act (ACA), preempts state level collection of health insurance data (Alfred Gobeille, in his official capacity as chair of the Vermont Green Mountain Care Board v. Liberty Mutual Insurance Co., No. 14-181, U.S. Sup.).

Mealey's Banking & Finance - 6th Circuit Affirms Dismissal Of RESPA And HAMP Claims Against Lender

CINCINNATI - The Sixth Circuit U.S. Court of Appeals on Sept. 28 affirmed a district court's dismissal of claims asserted by property owners against a bank, finding that the Real Estate Settlement Procedures Act (RESPA) was not in effect at the relevant time and that the Home Affordable Mortgage Program (HAMP) does not impose a legal duty of care on lender (Roderick Ray, et al. v. U.S. Bank National Association, Successor Trustee to Bank of America, Successor by Merger to LaSalle Bank, N.A., No. 15-1241, 6th Cir.; 2015 U.S. App. LEXIS 17220).

Mealey's PI/Product Liability - Judge Allows Expert Opinion On ACA Impact On Class Status, Decertifies Class

PHILADELPHIA - An expert may opine regarding, among other things, how Patient Protection and Affordable Care Act (ACA) medical loss ratio (MLR) regulations affect class ascertainability, a federal judge held June 30 in decertifying a class of indirect purchasers of Wellbutrin XL (In re: Wellbutrin XL Antitrust Litigation, No. 08-2433, E.D. Pa.; 2015 U.S. Dist. LEXIS 84444).

Mealey's Litigation Procedure - Judge Allows Expert Opinion On ACA Impact On Class Status, Decertifies Class

PHILADELPHIA - An expert may opine regarding, among other things, how Patient Protection and Affordable Care Act (ACA) medical loss ratio (MLR) regulations affect class ascertainability, a federal judge held June 30 in decertifying a class of indirect purchasers of Wellbutrin XL (In re: Wellbutrin XL Antitrust Litigation, No. 08-2433, E.D. Pa.; 2015 U.S. Dist. LEXIS 84444).

Mealey's Insurance - Judge Allows Expert Opinion On ACA Impact On Class Status, Decertifies Class

PHILADELPHIA - An expert may opine regarding, among other things, how Patient Protection and Affordable Care Act (ACA) medical loss ratio (MLR) regulations affect class ascertainability, a federal judge held June 30 in decertifying a class of indirect purchasers of Wellbutrin XL (In re: Wellbutrin XL Antitrust Litigation, No. 08-2433, E.D. Pa.; 2015 U.S. Dist. LEXIS 84444).

Mealey's Health Law - Judge Allows Expert Opinion On ACA Impact On Class Status, Decertifies Class

PHILADELPHIA - An expert may opine regarding, among other things, how Patient Protection and Affordable Care Act (ACA) medical loss ratio (MLR) regulations affect class ascertainability, a federal judge held June 30 in decertifying a class of indirect purchasers of Wellbutrin XL (In re: Wellbutrin XL Antitrust Litigation, No. 08-2433, E.D. Pa.; 2015 U.S. Dist. LEXIS 84444).

Mealey's Insurance - High Court Affirms Availability Of Tax Credits In ACA Federal Exchange

WASHINGTON, D.C. - The Patient Protection and Affordable Care Act (ACA)'s structure suggests the availability of tax subsidies in the federal exchange, and Congress could not have intended the state insurance market "death spirals" likely to result from barring such subsidies, a divided U.S. Supreme Court held June 25 (David King, et al. v. Sylvia Mathew Burwell, et al., No. 14-114, U.S. Sup.).