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Mealey's Litigation Procedure - Dave & Buster's $7.4M ERISA Settlement Denied By New York Federal Judge

NEW YORK - A New York federal judge, in an order filed Dec. 1, declined preliminary approval of a class settlement worth up to $7,425,000 offered by Dave & Buster's Inc. to end claims that the nationwide restaurant/entertainment chain violated 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 Health Law - Dave & Buster's $7.4M ERISA Settlement Denied By New York Federal Judge

NEW YORK - A New York federal judge, in an order filed Dec. 1, declined preliminary approval of a class settlement worth up to $7,425,000 offered by Dave & Buster's Inc. to end claims that the nationwide restaurant/entertainment chain violated 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 Labor & Employment - Judge Permits ACA, ERISA Claims Challenging Insurer's Lactation Services Coverage

CHICAGO - Three women may largely proceed with their class action claiming that their health insurance company erected insurmountable barriers rendering it impossible to procure in-network lactation services and imposed illegal cost-sharing on out-of-network services in violation of the Patient Protection and Affordable Care Act (ACA) and Employee Retirement Income Security Act (ERISA), a federal judge in Illinois held Dec. 4 (Laura Briscoe, et al. v. Health Care Service Corp., et al., No. 16-10294, N.D. Ill., 2017 U.S. Dist. LEXIS 198452).

Mealey's Labor & Employment - Dave & Buster's $7.4M ERISA Settlement Denied By New York Federal Judge

NEW YORK - A New York federal judge, in an order filed Dec. 1, declined preliminary approval of a class settlement worth up to $7,425,000 offered by Dave & Buster's Inc. to end claims that the nationwide restaurant/entertainment chain violated 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 PI/Product Liability - Pa.: ACA Birth-Control Mandate Exemptions Provide Injury, Standing For Suit

HARRISBURG, Pa. - New rules expanding moral and religious exemptions from the Patient Protection and Affordable Care Act (ACA) contraceptive mandate threaten the health of Pennsylvania women and the commonwealth itself, the state argues in a Nov. 27 brief in support of a preliminary injunction barring the regulations (Commonwealth of Pennsylvania, et al. v. Donald J. Trump, et al., No. 17-4540, E.D. Pa.).

Mealey's Litigation Procedure - Pa.: ACA Birth-Control Mandate Exemptions Provide Injury, Standing For Suit

HARRISBURG, Pa. - New rules expanding moral and religious exemptions from the Patient Protection and Affordable Care Act (ACA) contraceptive mandate threaten the health of Pennsylvania women and the commonwealth itself, the state argues in a Nov. 27 brief in support of a preliminary injunction barring the regulations (Commonwealth of Pennsylvania, et al. v. Donald J. Trump, et al., No. 17-4540, E.D. Pa.).

Mealey's Insurance - 8th Circuit Upholds Dismissal Of Dispute Seeking To Recover ACA Reinsurance Fee

ST. LOUIS - Finding sovereign immunity was not waived, the Eighth Circuit U.S. Court of Appeals on Nov. 27 affirmed the dismissal of a lawsuit filed by trustees of a self-insured group health plan seeking to recoup from the U.S. government a fee paid under the Affordable Care Act's transitional reinsurance program (Paul Batsche, et al. v. Thomas E. Price, No. 16-4305, 8th Cir., 2017 U.S. App. LEXIS 23844).

Mealey's Insurance - Judge Refuses To Reinstate ACA Cost-Sharing Payments To Insurers

SAN FRANCISCO - The Trump administration has the better legal argument in a case challenging the elimination of the Patient Protection and Affordable Care Act (ACA) cost-sharing reduction (CSR) payments, and the relief sought by the plaintiff states would counterproductively harm their own residents, a federal judge in California said Oct. 25 in denying a preliminary injunction (The State of California, et al. v. Donald J. Trump, et al., No. 17-5895, N.D. Calif.).

Mealey's Health Law - ACA, UCL Claims Against Health Care Provider Survive In Transgender Case

SAN DIEGO - Allegations that an emergency health care provider touted its compassion toward those with gender dysphoria and then repeatedly referred to a transgender boy as female support his mother's Patient Protection and Affordable Care Act (ACA) and California unfair competition law claims, a federal judge in California held Sept. 27 (Katharine Prescott, et al. v. Rady Children's Hospital - San Diego, No. 16-2408, S.D. Calif., 2017 U.S. Dist. LEXIS 160259).

Mealey's Antitrust/Unfair Competition - ACA, UCL Claims Against Health Care Provider Survive In Transgender Case

SAN DIEGO - Allegations that an emergency health care provider touted its compassion toward those with gender dysphoria and then repeatedly referred to a transgender boy as female support his mother's Patient Protection and Affordable Care Act (ACA) and California unfair competition law claims, a federal judge in California held Sept. 27 (Katharine Prescott, et al. v. Rady Children's Hospital - San Diego, No. 16-2408, S.D. Calif., 2017 U.S. Dist. LEXIS 160259).

Mealey's Insurance - Insurer Files Answer, Wants Immediate Review Of ACA Lactation Coverage Ruling

SAN FRANCISCO - In a motion seeking interlocutory review, an insurer argues that whether the Patient Protection and Affordable Care Act (ACA) requires an insurer to provide access to lactation services or merely forbids financial barriers to obtaining such services is exactly the type of question the Ninth Circuit U.S. Court of Appeals should address and, in an answer to the complaint filed Sept. 19 in a California federal court, the insurer says the plaintiffs' fail to state a claim under either the Employee Retirement Income Security Act (ERISA) and the ACA on which relief can be based (Rachel Condry, et al. v. UnitedHealth Group Inc., et al., No. 17-183, N.D. Calif.).

Mealey's Health Law - Insurer Files Answer, Wants Immediate Review Of ACA Lactation Coverage Ruling

SAN FRANCISCO - In a motion seeking interlocutory review, an insurer argues that whether the Patient Protection and Affordable Care Act (ACA) requires an insurer to provide access to lactation services or merely forbids financial barriers to obtaining such services is exactly the type of question the Ninth Circuit U.S. Court of Appeals should address and, in an answer to the complaint filed Sept. 19 in a California federal court, the insurer says the plaintiffs' fail to state a claim under either the Employee Retirement Income Security Act (ERISA) and the ACA on which relief can be based (Rachel Condry, et al. v. UnitedHealth Group Inc., et al., No. 17-183, N.D. Calif.).

Mealey's Labor & Employment - Insurer Files Answer, Wants Immediate Review Of ACA Lactation Coverage Ruling

SAN FRANCISCO - In a motion seeking interlocutory review, an insurer argues that whether the Patient Protection and Affordable Care Act (ACA) requires an insurer to provide access to lactation services or merely forbids financial barriers to obtaining such services is exactly the type of question the Ninth Circuit U.S. Court of Appeals should address and, in an answer to the complaint filed Sept. 19 in a California federal court, the insurer says the plaintiffs' fail to state a claim under either the Employee Retirement Income Security Act (ERISA) and the ACA on which relief can be based (Rachel Condry, et al. v. UnitedHealth Group Inc., et al., No. 17-183, N.D. Calif.).

Mealey's Insurance - Court: ACA Lifetime Benefit Cap Provision Doesn't Cover ERISA Retiree Plan

PASADENA, Calif. - The Patient Protection and Affordable Care Act (ACA)'s ban on lifetime benefit maximums does not apply to retiree plans governed by the Employee Retirement Income Security Act, but the plan documents are sufficiently confusing to state a cause of action, a Ninth Circuit U.S. Court of Appeals held Sept. 8 (Gary King, et al. v. Blue Cross and Blue Shield of Illinois, et al., No. 15-55880, 9th Cir., 2017 U.S. App. LEXIS 17387).

Mealey's Litigation Procedure - Judge Allows Portions Of ACA Lactation Coverage Suit To Proceed

DES MOINES, Iowa - A pair of women may continue with their class action lawsuit claiming that their insurer violated the Patient Protection and Affordable Care Act (ACA) by charging for lactation consultation services, but nothing in the Employee Retirement Income Security Act requires insurers to list such providers separately, and the sex discrimination claims fail as well, a federal judge in Iowa held Sept. 6 (Jillian York, et al. v. Wellmark Inc., et al., No. 16-627, S.D. Iowa).

Mealey's Insurance - Judge Allows Portions Of ACA Lactation Coverage Suit To Proceed

DES MOINES, Iowa - A pair of women may continue with their class action lawsuit claiming that their insurer violated the Patient Protection and Affordable Care Act (ACA) by charging for lactation consultation services, but nothing in the Employee Retirement Income Security Act requires insurers to list such providers separately, and the sex discrimination claims fail as well, a federal judge in Iowa held Sept. 6 (Jillian York, et al. v. Wellmark Inc., et al., No. 16-627, S.D. Iowa).

Mealey's Labor & Employment - Court: ACA Lifetime Benefit Cap Provision Doesn't Cover ERISA Retiree Plan

PASADENA, Calif. - The Patient Protection and Affordable Care Act (ACA)'s ban on lifetime benefit maximums does not apply to retiree plans governed by the Employee Retirement Income Security Act, but the plan documents are sufficiently confusing to state a cause of action, a Ninth Circuit U.S. Court of Appeals held Sept. 8 (Gary King, et al. v. Blue Cross and Blue Shield of Illinois, et al., No. 15-55880, 9th Cir., 2017 U.S. App. LEXIS 17387).

Mealey's Insurance - Federal Court Stays Insolvent Insurer's ACA Risk-Corridor Suit

WASHINGTON, D.C. - Judgment on any ruling that the government improperly withheld funds from a bankrupt Patient Protection and Affordable Care Act (ACA) insurer would need to wait until resolution of pending appeals of risk-corridor rulings, a federal claims court judge held Sept. 5 in staying the case (Doug Ommen, et al. v. United States, No. 17-957, Fed. Clms., 2017 U.S. Claims LEXIS 1081).

Mealey's Litigation Procedure - Judge Declines Reconsideration Of ACA Out-Of-Network Lactation Coverage Ruling

WASHINGTON, D.C. - An insurer's alternative interpretation of the Patient Protection and Affordable Care Act (ACA)'s lactation services mandate did not require consideration of an affidavit stating that the company complied with the law, a federal judge in the District of Columbia held Aug. 14 in declining to reconsider a motion to dismiss (Lindsay Ferrer, et al. v. CareFirst Inc., et al., No. 16-2162, D. D.C., 2017 U.S. Dist. LEXIS 110304).

Mealey's Litigation Procedure - Judge Largely Allows ACA Lactation Insurance Coverage Suit To Proceed

SAN FRANCISCO - To the extent an insurer covers lactation services required by the Patient Protection and Affordable Care Act (ACA), allegations that it makes finding or using those providers impossible support a class action, a federal judge in California held Aug. 15 in largely denying a motion to dismiss (Rachel Condry, et al. v. UnitedHealth Group Inc., et al., No. 17-183, N.D. Calif., 2017 U.S. Dist. LEXIS 130089).

Mealey's Insurance - Health Plan's Claim Over Reinsurance Contributions Under ACA Fails, Judge Says

BALTIMORE - A self-funded, self-administered group health plan failed to allege a claim over which jurisdiction would exist under the Patient Protection and Affordable Care Act's (ACA) "internal revenue tax" or "any sum" provisions, a Maryland federal judge ruled July 21, dismissing the health plan's lawsuit alleging that it was improperly required to pay reinsurance contributions under the ACA (Electrical Welfare Trust Fund v. United States of America, et al., No. 16-2186, D. Md., 2017 U.S. Dist. LEXIS 113687).

Mealey's Health Law - Government Says Failed ACA Insurer Should File Case In Federal Claims Court

COLUMBIA, S.C. - A failed Patient Protection and Affordable Care Act (ACA) co-operative insurer's liquidator should file his lawsuit challenging a federal loan repayment demand in the U.S. Court of Federal Claims, the government says in a July 19 motion filed in South Carolina federal court (Raymond G. Farmer v. United States of America, et al., No. 17-cv-00956, D. S.C.).

Mealey's Insurance - Government Says Failed ACA Insurer Should File Case In Federal Claims Court

COLUMBIA, S.C. - A failed Patient Protection and Affordable Care Act (ACA) co-operative insurer's liquidator should file his lawsuit challenging a federal loan repayment demand in the U.S. Court of Federal Claims, the government says in a July 19 motion filed in South Carolina federal court (Raymond G. Farmer v. United States of America, et al., No. 17-cv-00956, D. S.C.).

Mealey's Health Law - Judge Finds Standing In ACA Out-Of-Network Lactation Coverage Suit

WASHINGTON, D.C. - A trio of women successfully allege standing in their class action claiming that an insurer improperly charged them for out-of-network lactation services in violation of the Patient Protection and Affordable Care Act (ACA), a federal judge in the District of Columbia held July 17 (Lindsay Ferrer, et al. v. CareFirst Inc., et al., No. 16-2162, D. D.C., 2017 U.S. Dist. LEXIS 110304.)

Mealey's Litigation Procedure - Judge Finds Standing In ACA Out-Of-Network Lactation Coverage Suit

WASHINGTON, D.C. - A trio of women successfully allege standing in their class action claiming that an insurer improperly charged them for out-of-network lactation services in violation of the Patient Protection and Affordable Care Act (ACA), a federal judge in the District of Columbia held July 17 (Lindsay Ferrer, et al. v. CareFirst Inc., et al., No. 16-2162, D. D.C., 2017 U.S. Dist. LEXIS 110304.)