LexisNexis® Legal Newsroom
Mealey's Health Law - Judge Finds Jurisdiction Lacking In Insolvent Insurer's Suit Over ACA Payments

ST. LOUIS - An insolvent insurer's suit against the government over its handling of the Patient Protection and Affordable Care Act (ACA) risk corridor and how it offset debts properly belongs before the U.S. Court of Federal Claims, a federal judge in Iowa said March 17 in finding that she lacked jurisdiction and entering judgment (Nick Gerhart, et al. v. United States Department of Health and Human Services, et al., No. 16-151, S.D. Iowa, 2017 U.S. Dist. LEXIS 37620).

Mealey's Insurance - ACA Reinsurance Program Applies To State Employers, 6th Circuit Affirms

CINCINNATI - The Patient Protection and Affordable Care Act (ACA)'s reinsurance program applies to state employers, the Sixth Circuit U.S. Court of Appeals affirmed Feb. 17 (The State of Ohio, et al. v. United States of America, et al., No. 16-3093, 6th Cir., 2017 U.S. App. LEXIS 2844).

Mealey's Health Law - Judge Orders Liquidation Of ACA Health Care Provider

TRENTON, N.J. - A New Jersey judge on Feb. 3 ordered a Patient Protection and Affordable Care Act (ACA) consumer-operated and oriented plan insurer's liquidation and appointed the state's insurance commissioner as liquidator (In the Matter of Freelancers Consumer Operated and Oriented Program of New Jersey d/b/a Health Republic Insurance of New Jersey, No. MCR-C-000063-16, N.J. Super., Mercer Co., Chanc. Div.).

Mealey's Insurance - Judge Orders Liquidation Of ACA Health Care Provider

TRENTON, N.J. - A New Jersey judge on Feb. 3 ordered a Patient Protection and Affordable Care Act (ACA) consumer-operated and oriented plan insurer's liquidation and appointed the state's insurance commissioner as liquidator (In the Matter of Freelancers Consumer Operated and Oriented Program of New Jersey d/b/a Health Republic Insurance of New Jersey, No. MCR-C-000063-16, N.J. Super., Mercer Co., Chanc. Div.).

Mealey's Insurance - In Opening Salvo, Insurer Argues ACA Mandates Yearly Risk-Corridor Payments

WASHINGTON, D.C. - The government did not make an "informed, reasoned decision" in deciding to make the Patient Protection and Affordable Care Act (ACA) risk-corridor program budget-neutral, but instead simply reneged on its promises and ignored the statutory language mandating annual payments, an insurer told a federal appeals court Jan. 31 (Land of Lincoln Mutual Health Insurance Co. v. The United States of America, No. 17-1224, Fed. Cir.).

Mealey's Labor & Employment - Texas Federal Judge Dismisses Gender Identity Discrimination Claims

DALLAS - A Texas federal judge on Jan. 13 dismissed claims alleging gender identity discrimination under Section 1557 of the Patient Protection and Affordable Care Act (ACA) against an insurer and an employer because the plaintiff failed to cite any controlling precedent that recognizes a cause of action under Section 1557 for gender identity discrimination (Charlize Marie Baker v. Aetna Life Insurance Co., et al., No. 15-3679, N.D. Texas; 2017 U.S. Dist. LEXIS 5665).

Mealey's Health Law - Texas Federal Judge Dismisses Gender Identity Discrimination Claims

DALLAS - A Texas federal judge on Jan. 13 dismissed claims alleging gender identity discrimination under Section 1557 of the Patient Protection and Affordable Care Act (ACA) against an insurer and an employer because the plaintiff failed to cite any controlling precedent that recognizes a cause of action under Section 1557 for gender identity discrimination (Charlize Marie Baker v. Aetna Life Insurance Co., et al., No. 15-3679, N.D. Texas; 2017 U.S. Dist. LEXIS 5665).

Mealey's Insurance - Texas Federal Judge Dismisses Gender Identity Discrimination Claims

DALLAS - A Texas federal judge on Jan. 13 dismissed claims alleging gender identity discrimination under Section 1557 of the Patient Protection and Affordable Care Act (ACA) against an insurer and an employer because the plaintiff failed to cite any controlling precedent that recognizes a cause of action under Section 1557 for gender identity discrimination (Charlize Marie Baker v. Aetna Life Insurance Co., et al., No. 15-3679, N.D. Texas; 2017 U.S. Dist. LEXIS 5665).

Mealey's Litigation Procedure - California Women Files Class Action Over Denial Of Breastfeeding Support

OAKLAND, Calif. - A California woman on Jan. 13 filed a class action complaint in federal court alleging that she and other women have been wrongfully denied access to and coverage for a vital women's preventive service - breastfeeding support, supplies and counseling - for which coverage is mandated by the Patient Protection and Affordable Care Act (ACA) (Rachel Condry, et al. v. UnitedHealth Group Inc., et al., No. 4:17-cv-00183, N.D. Calif.).

Mealey's Health Law - California Women Files Class Action Over Denial Of Breastfeeding Support

OAKLAND, Calif. - A California woman on Jan. 13 filed a class action complaint in federal court alleging that she and other women have been wrongfully denied access to and coverage for a vital women's preventive service - breastfeeding support, supplies and counseling - for which coverage is mandated by the Patient Protection and Affordable Care Act (ACA) (Rachel Condry, et al. v. UnitedHealth Group Inc., et al., No. 4:17-cv-00183, N.D. Calif.).

Mealey's Labor & Employment - California Woman Files Class Action Over Denial Of Breastfeeding Support

OAKLAND, Calif. - A California woman on Jan. 13 filed a class action complaint in federal court alleging that she and other women have been wrongfully denied access to and coverage for a vital women's preventive service - breastfeeding support, supplies and counseling - for which coverage is mandated by the Patient Protection and Affordable Care Act (ACA) (Rachel Condry, et al. v. UnitedHealth Group Inc., et al., No. 4:17-cv-00183, N.D. Calif.).

Mealey's Health Law - 6th Circuit Panel: Insureds Lack Sufficient Injury To Claim Insurer Shirked ERISA Duties

CINCINNATI - A Sixth Circuit U.S. Court of Appeals panel on Dec. 21 affirmed an Ohio federal judge's ruling that hypothetical situations lack the necessary concrete injury required to pursue claims that an insurer shirked its obligations under the Employee Retirement Income Security Act and the Patient Protection and Affordable Care Act (ACA) (Daniel Soehnlen, et al. v. Fleet Owners Insurance Fund, et al., No. 16-3124, 6th Cir.; 2016 U.S. App. LEXIS 22914).

Mealey's Labor & Employment - 6th Circuit Panel: Insureds Lack Sufficient Injury To Claim Insurer Shirked ERISA Duties

CINCINNATI - A Sixth Circuit U.S. Court of Appeals panel on Dec. 21 affirmed an Ohio federal judge's ruling that hypothetical situations lack the necessary concrete injury required to pursue claims that an insurer shirked its obligations under the Employee Retirement Income Security Act and the Patient Protection and Affordable Care Act (ACA) (Daniel Soehnlen, et al. v. Fleet Owners Insurance Fund, et al., No. 16-3124, 6th Cir.; 2016 U.S. App. LEXIS 22914).

Mealey's Health Law - Rehabilitator Asks Court To Order ACA Insurer Into Liquidation

TRENTON, N.J. - New Jersey's banking and insurance commissioner on Dec. 15 asked a state court to order an insolvent Patient Protection and Affordable Care Act (ACA) consumer-operated and oriented plan insurer's liquidation (Richard J. Badolato, Commissioner of the Department of Banking and Insurance of New Jersey v. Freelancers Consumer Operated and Oriented Program of New Jersey d/b/a Health Republic Insurance of New Jersey, No. MCR-C-000063-16, N.J. Super., Mercer Co., Chancery Div.).

Mealey's Insurance - Rehabilitator Asks Court To Order ACA Insurer Into Liquidation

TRENTON, N.J. - New Jersey's banking and insurance commissioner on Dec. 15 asked a state court to order an insolvent Patient Protection and Affordable Care Act (ACA) consumer-operated and oriented plan insurer's liquidation (Richard J. Badolato, Commissioner of the Department of Banking and Insurance of New Jersey v. Freelancers Consumer Operated and Oriented Program of New Jersey d/b/a Health Republic Insurance of New Jersey, No. MCR-C-000063-16, N.J. Super., Mercer Co., Chancery Div.).

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.).