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California Federal Judge Dismisses Conspiracy Claims Against Kaiser, Union
SAN DIEGO - A hospital system failed to allege that a managed care organization and its related entities conspired with a labor union to exclude competition in the markets for emergency and acute care...
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Ark. Federal Judge Declines To Dismiss Wrongful Rescission Of Health Policy Suit
JONESBORO, Ark. - An Arkansas federal judge on April 18 denied a health insurer's motion to dismiss a wrongful rescission of a health insurance policy, saying the plaintiff pleaded a plausible claim...
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9th Circuit: Medicare Does Not Allow Insurer To Recover Survivor's Benefits
SAN FRANCISCO - A Ninth Circuit U.S. Court of Appeals panel on April 19 affirmed that a private Medicare Advantage Organization (MAO) plan cannot sue a plan participant's survivors for reimbursement of...
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6th Circuit Denies Medicaid Appeal As Moot, Affirms Denial Of Bond Motion
CINCINNATI - A Sixth Circuit U.S. Court of Appeals panel on April 24 dismissed as moot an appeal challenging an order granting a temporary injunction in a Medicaid provider dispute and affirmed the...
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6th Circuit Affirms Decision In Medicaid Payment Dispute
CINCINNATI - A Sixth Circuit U.S. Court of Appeals panel on April 22 affirmed that the U.S. Department of Health and Human Services secretary's decision to omit waiver-expansion population patients...
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Supreme Court Denies Review Of 7th Circuit Indiana Medicaid Dental Care Dispute
WASHINGTON, D.C. - The U.S. Supreme Court on April 22 denied a writ of certiorari to the Indiana Family and Social Services Administration's appeal of a federal appeals court decision requiring the...
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California Federal Judge Allows Medicaid Claims To Continue
OAKLAND, Calif. - A California federal judge on April 26 declined to dismiss a federal and state False Claims Act case brought against a nonprofit health center for alleged Medicaid violations (United...
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Judge Finds 'Expense Incurred' Applies To Insured's Medicare-Adjusted Amount
BEAUFORT, S.C. - A health insurance provider properly reimbursed its insured for the actual amount paid to a medical provider after adjustments were made by Medicare, a South Carolina federal judge...
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4th Circuit Affirms Health Care Fraud Conviction Against Doctor
RICHMOND, Va. - The Fourth Circuit U.S. Court of Appeals on April 23 affirmed a federal jury conviction of a Maryland cardiologist for health care fraud, saying there was sufficient evidence that he...
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Va. Provider Must Repay Medicaid For Services By Unqualified Workers
RICHMOND, Va. - The Virginia Court of Appeals on April 16 affirmed a trial court order granting summary judgment to the Virginia Department of Medical Assistance Services (DMAS) ordering the Family...
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Class Action Lawsuit Alleges Antitrust Violations Against Blue Cross Blue Shield
LITTLE ROCK, Ark. - An Arkansas resident filed a class action lawsuit on March 21 in an Arkansas federal court, alleging that agreements between Blue Cross Blue Shield Association (BCBSA) and its...
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Hospital Sues Insurer In S.C. Federal Court For Failure To Pay Benefits
GREENVILLE, S.C. - A South Carolina hospital sued a health insurer in federal court on April 29, alleging that it failed to pay benefits for services provided to the defendant's insured (Greenville...
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Medical Practice Sues Insurer In Federal Court For Wrongful Denial Of Benefits
NEWARK, N.J. - A health care provider that received an assignment of benefits from one of its patients sued a health insurance company on April 11 in a New Jersey federal court for allegedly wrongfully...
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Insured Proves Certain Documents Are Protected, New York Federal Judge Says
NEW YORK - Communications between an insured and its environmental consultant are protected from discovery by the work product doctrine, a New York federal judge said April 22 in denying an insurer's...
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Expert Can Testify About Cleanup Of Oil Spill, Texas Federal Judge Says
HOUSTON - An insured's proposed expert is well qualified to testify about the cleanup of an oil spill that occurred after Hurricane Katrina, but the expert's opinions on the law are not relevant and...
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No Coverage For Damages Caused By Retention Pond, Ill. Appeals Panel Determines
OTTAWA, Ill. - An insurer has no duty to defend its insureds for an underlying suit alleging damages to cropland as a result of the insureds' construction of a holding pond because the policy...
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Louisiana Court Finds Mold Claims Are Excluded Under Policy
BATON ROUGE, La. - A Louisiana appeals court on April 22 affirmed a trial court's ruling that granted summary judgment in favor of an insurer, finding that a homeowner's mold-related claims were...
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Allegations Against Insured Do Not Fall Under EIFS Exclusion, Judge Concludes
SAN ANTONIO - Underlying allegations against an insured do not unambiguously fall within a commercial general liability insurance policy's exterior insulation and finish system (EIFS) exclusion, a...
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Trial Court Properly Considered Indemnity Agreement, Panel Says
SAN FRANCISCO - The First District California Court of Appeal on April 17 rejected an insurer's argument that a trial court erred in taking an indemnity agreement between two parties into consideration...
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Reinsurer Says Reinsured's Motion For Summary Judgment Must Be Denied
MADISON, Wis. - A reinsurer told a Wisconsin federal court on April 23 that genuine issues of material fact remain regarding an asbestos-related reinsurance dispute and therefore its reinsured's motion...
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