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Insights on ERISA

97 total results. Page 3 of 4.

Alerts
Physician Groups Challenge Detrimental Insurer Emergency Room Payment Policy
April 27, 2020
Caroline Turner English, Katie Heilman

“Save the ER for emergencies – or you’ll be responsible for the cost.” This warning was included in a 2017 letter Blue Cross and Blue Shield of Georgia, Inc. (BCBS) sent to its insureds, alerting them to a new policy for reviewing and paying emergency room medical claims. 

Alerts
Supreme Court Opinion Sheds No Light on Elusive Stock-Drop Pleading Standard
February 3, 2020
Caroline Turner English

In January, the Supreme Court issued its highly anticipated opinion in Retirement Plans Committee of IBM v. Jander, No. 18-1165, a case that promised to clarify the pleading standard applicable to ERISA stock-drop cases. But the Court’s decision raised more questions than it answered. 

Press Release
US News and Best Lawyers Rate 25 Arent Fox Practices Among Best in the Country
November 6, 2019

Twenty-five Arent Fox LLP practices have been recognized in the 2020 “Best Law Firms” rankings that are published annually by US News & World Report and Best Lawyers.

Health chart
Alerts
Buyer Beware: Health Plans Need to Exercise Caution in Retaining Third-Party Administrators and Medical Claim Reviewers
October 11, 2019
Caroline Turner English, Katie Heilman, Laurel LaMontagne

A federal court in Nebraska recently rejected a health plan’s fiduciary breach claims under the Employee Retirement Income Security Act of 1974 against third-party service providers, holding that the service providers were not ERISA fiduciaries and did not breach fiduciary duties under ERISA.

Press Release
Fifty Arent Fox Attorneys Named The Best Lawyers in America 2020
August 16, 2019

WASHINGTON — Fifty Arent Fox LLP attorneys have been rated as leaders in their profession by The Best Lawyers in America 2020.

Alerts
Third Circuit Upholds Anti-Assignment Provision Barring Provider’s ERISA Suit Against Insurer
July 2, 2019
Caroline Turner English, Katie Heilman

The US Court of Appeals for the Third Circuit recently confirmed that “anti-assignment” provisions — provisions prohibiting insureds from assigning their rights under a health plan to third parties, including medical providers — are enforceable as long as they are unambiguous.

Press Release
Chambers USA Ranks Thirty-One Attorneys Among Nation’s Best
April 30, 2019

WASHINGTON, DC – Chambers USA: America’s Leading Lawyers for Business has recognized 31 Arent Fox LLP attorneys as leaders in their field.

Alerts
Eighth Circuit Strikes Down Cross-Plan Offsetting
January 22, 2019
Caroline Turner English, Rebecca W. Foreman

In a long-awaited opinion, the Eighth Circuit Court of Appeals struck a blow to UnitedHealth Group. Inc.’s (“United”) sweeping overpayment recovery scheme.

Alerts
Seventh Circuit: Plaintiffs Seeking Plan Benefits Need Not Cite Specific Plan Provisions to Survive Motions to Dismiss
December 14, 2018
Alison Lima Andersen, Laurel LaMontagne

The Defendants moved to dismiss Dr. Griffin’s suit.

Alerts
The Commonality Challenge: Recent Rulings Show Path to Class Certification in ERISA Cases 
November 7, 2018
Alison Lima Andersen

As class action practitioners know, class certification can be difficult to achieve, particularly in the years since the Supreme Court’s decision in Wal-Mart Stores, Inc. v. Dukes. 

Press Release
US News and Best Lawyers Rates 24 Arent Fox Practices Among Best in the Country
November 2, 2018

WASHINGTON — Twenty-four Arent Fox LLP practices have been recognized in the 2019 “Best Law Firms” rankings that are published annually by US News & World Report and Best Lawyers.

Two women talking in an open office
Alerts
Third Circuit Declares Plans May Restrict Providers' ERISA-Assignee Rights
July 26, 2018
Caroline Turner English

The Third Circuit recently affirmed the enforceability of “anti-assignment” provisions in ERISA health plan documents.

Alerts
Fifth Circuit: Complaints Seeking Plan Benefits Need Not Quote Provisions, Especially When Insurers Refuse to Provide Documents
June 27, 2018
Caroline Turner English, Alison Lima Andersen

The Fifth Circuit recently held that plaintiffs seeking benefits, under plans governed by the Employee Retirement Income Security Act of 1974 and non-ERISA plans, need not identify and include specific plan provisions in their complaints to survive motions to dismiss.

Press Release
Fifty Arent Fox Attorneys Recognized Among Nation’s Best by Legal 500 in 2018
May 30, 2018

The 2018 edition of Legal 500 US has rated 50 Arent Fox LLP attorneys as national leaders in their field. In addition, 18 of the firm’s practice areas were ranked among the best in the country, including new recognition for the firm’s Trademark Litigation and White Collar groups.

Health Care Counsel Blog
Medical Providers Beware: Ninth Circuit Says Plan Had No Duty to Disclose Anti-Assignment Provision Barring Provider’s ERISA Claims
May 21, 2018
Caroline Turner English, Katie Heilman

In a recent decision, the US Court of Appeals for the Ninth Circuit held that a surgical center lacked standing to bring ERISA claims against a health plan because the plan had a valid anti-assignment provision.

Fashion Counsel
Chambers USA Ranks Thirty Attorneys Among Nation’s Best
May 8, 2018

Chambers USA: America’s Leading Lawyers for Business has recognized 30 Arent Fox LLP attorneys as leaders in their field.

Alerts
ERISA Second Circuit Decision Warns Plan Administrators to Strictly Adhere to ERISA Regulations & Plan Terms
April 5, 2018
Caroline Turner English, Rebecca W. Foreman

Health plans and administrators subject to the Employee Retirement Income and Security Act have been warned: failure to comply with ERISA’s procedural requirements may strip them of the deference their benefit determinations enjoy.

Health Care Counsel Blog
The Fifth Circuit Takes a Fresh Look at ERISA Benefit Claims Review Standard
March 16, 2018
Caroline Turner English

In a recent 8-6 en banc decision, Ariana M. v. Humana Health Plan of Texas, Inc., No. 16-20174, 2018 WL 1096980 (5th Cir. Mar. 1, 2018), the Fifth Circuit Court of Appeals overturned its precedent, to step in line with the majority of other circuits.

Health Care Counsel Blog
Medical Providers & Concepts of Authority Article
November 28, 2017
Caroline Turner English

The world of health care reimbursement can involve many different players on the payer side. Group health plans and health insurers are well-known players, but networks, administrators, repricers, consultants, and others may enter the scene as well.

Press Release
U.S. News and Best Lawyers Rates 22 Arent Fox Practices Among Best in the Country
November 2, 2017

Twenty-two Arent Fox LLP practices have been recognized in the 2018 “Best Law Firms” rankings that are published annually by U.S. News & World Report and Best Lawyers.

Alerts
Can a Healthcare Plan Dictate Where a Medical Provider May Sue It?
September 6, 2017

The issue of where a medical provider with an assignment of benefits may sue an ERISA-governed healthcare plan for unreimbursed medical care is important.

Press Release
The Best Lawyers in America 2018 Recognizes 42 Arent Fox Attorneys
August 16, 2017

Forty-two Arent Fox LLP attorneys have been rated as leaders in their profession by The Best Lawyers in America 2018.

Health Care Counsel Blog
Examining State Law Claims Under ERISA At Second Circuit
June 20, 2017
Caroline Turner English, David S. Greenberg

Medical providers seeking to pursue state law claims for payment from health care payers scored a win in the Second Circuit last month in a holding that affirms providers’ ability to hold health care insurers and other payers to their payment representations and promises.

Health Care Counsel Blog
Church-Affiliated Benefit Plans Exempt from ERISA: What the Supreme Court’s Ruling Means for Healthcare Providers
June 7, 2017
Caroline Turner English, Sylvia G. Costelloe

The Supreme Court issued a stunning ERISA decision on Monday, overturning the law in the three federal circuits as to what constitutes a “church plan” that is exempt from ERISA’s requirements.

Alerts
Church-Affiliated Hospital Pension Plans Exempt from ERISA’s Requirements
June 6, 2017
Caroline Turner English, Sylvia G. Costelloe

The Supreme Court issued a stunning ERISA decision on Monday, overturning the law in the three federal circuits as to what constitutes a “church plan” that is exempt from ERISA’s requirements.

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