Litigating Out-of-Network Provider Claims

Jackson Lewis LLP

Out-of-network provider ERISA litigation has exploded in the last few years, as out-of-network reimbursements have largely moved to a Medicare-based model. This webinar will focus on the most common claims out-of-network providers file and the core defenses insurers and self-funded plans typically raise.

Topics

• Common adverse benefit determinations (administrative and medical)
• Limitations on provider standing under ERISA
• Other core defenses (articulating the benefit sought, exhaustion and contractual limitations)
• Interplay with state and federal laws against “surprise bills” 

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