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Federal Appeals Court Sides with Out-Of-Network Doctors Against UnitedHealth
AVYM Healthcare Revenue Consultants 
Jan. 16, 2019 "[This] decision ... should act as a wake-up call to all self-insured health plans for potential rewards in the trillions of dollars in plan assets recovery for all self-insured ERISA plans nationwide, from cross plan overpayment recoupments and offsets done by all plan TPAs.... The appeals court [stated]: 'To adopt United's argument that the plan language granting it broad authority to administer the plan is sufficient to authorize cross-plan offsetting would be akin to adopting a rule that anything not forbidden by the plan is permissible.' " [Peterson v. UnitedHealth Group Inc., No. 17-1744 (8th Cir. Jan. 15, 2019)] MORE >> |
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