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District Court Ruling Gives Providers Ammunition in Fights Over Health Insurer Clawbacks
Bloomberg LawLink to more items from this source
June 29, 2021

"[A] recent ruling from a federal district court in New Jersey gives ammunition to providers fighting to stop insurers from engaging in this routine billing practice, known as cross-plan offsetting. The court ruled the practice violates [ERISA].... The court [also] held that provisions in health plan documents that prevent patients from allowing a provider to sue on their behalf over an unpaid benefit are enforceable." [Lutz Surgical Partners PLLC v. Aetna, Inc., No. 15-2595 (D.N.J. Jun. 21, 2021)]

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