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Seventh Circuit Rejects In-Network Providers' Bid For ERISA Claims Procedures
Seyfarth Shaw LLP Link to more items from this source
Oct. 13, 2015

"[T]he court observed that ERISA's claims procedures are available only to 'participants' and 'beneficiaries.' The plaintiffs conceded they are not participants, and the court rejected plaintiffs' arguments that they are beneficiaries.... The providers did not have assignments of claims from their patients and could not point to any plan term that would make them beneficiaries.... The dismissive tone of the Seventh Circuit's decision, which relied on little more than the text of the statute, also suggests that the court did not view the decision as a close one." [Pennsylvania Chiropractic Assoc. v. Independence Hospital Indemnity Plan, Inc., Nos. 14-2322, 14-3174 and 15-1274 (7th Cir. Oct. 1, 2015)]

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