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In The News
On November 7, 2013, the United States District Court for the Northern District of Illinois granted in Summary Judgment against BCBS in an overpayment ERISA class action for certain plaintiff providers. The court clarified among other issues that: Providers are entitled to sue under ERISA; Certain BCBS entities completely violated ERISA; These providers are not more »
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A Federal Court in Tennessee orders United Healthcare of Tennessee, Inc (United) to pay $99,000 in ERISA penalties for failing to provide a patient with treatment guidelines for 900 days. The $99,000 ERISA penalty is almost 3 times the amount of the medical claim benefits owed of $35,724.80 The US District Court Eastern District of more »
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A recent case may help out of network providers, which have complete valid ERISA assignments regarding appeal and reimbursement rights, receive checks directly from insurers. For the first time federal courts have rendered the clearest answers to date: managed care network participation is immaterial, ERISA assignment is the critical controlling factor to health-care benefits reimbursement. more »
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The 7th circuit panel, citing a recent Supreme Court decision, seems to have established new insurance verification laws under ERISA, in a case where a patient is entitled to a $77,974 monetary damage award after her health plan falsely verified coverage for a procedure when none existed thereby creating an ERISA fiduciary breach, holding the more »
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