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Cigna Sued for RICO Violations, “Brazen Embezzlement and Conversion Scheme” -Health Plan Litigation Tsunami: Part 2- UnitedHealthcare Class Action-UHC Sued for Overpayment Offsets in Violation of ERISA and for Misleading Patients and Plan Sponsors
Aetna Class Action-Aetna Sued for Overpayment Offsets in Violation of ERISA and for “Illegal Self Help” Designed to Circumvent ERISA
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September 2012
United States District Court Eastern District of Michigan, Case No: 11-12557 Filed- 9/7/2012 Federal Court Rules Blue Cross Blue Shield Acted As ERISA Fiduciary & Engaged in Self Dealing Borroughs v. BCBS Michigan Ramifications of the Court Case Court determined that Blue Cross acted as an ERISA fiduciary in its role as third-party administrator and more »
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Case No. 10–16840. Argued and Submitted Dec. 8, 2011. Filed on September 12, 2012 United States Court of Appeals, Ninth Circuit Stephan v. Unum [9th Cir] Ramifications of Court Decision: Ninth Circuit Applies ERISA Fiduciary Privilege Exception to Insurer Evaluation of conflict of interest is not limited to administrative record The court held that because more »
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Aetna’s war against the California Medical Association (CMA) for patient’s right to choose provider versus Aetna’s right to save money has spurred the 10th Patient Protection and Affordable Care Act (PPACA) Claims Specialists Certification Program. The timing of the PPACA Program, scheduled for Sept 15, 2012 is appropriate in light of recent CMA Press and LA more »
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UNITED STATES COURT OF APPEALS FOR THE SIXTH CIRCUIT-Nos. 11-3126/3640 TPA Is A Fiduciary of the Plan Subject To Suit By Plan Sponsors GUYAN INTERN’L, INC v. PROFESSIONAL BENEFITS ADMINISTRATORS, INC. Ramifications of Court Decision: What is a Fiduciary? The court reasons: ERISA provides that “a person is a fiduciary with respect to a plan more »
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