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Court Awards ERISA Penalties for Plan's Failure to Disclose Administrative Services Agreement and Claims Criteria
Thomson Reuters Practical Law Aug. 16, 2021 "[T]he court held that the plan, employer, and claims administrator violated MHPAEA by using the InterQual Criteria to determine whether the dependent's residential treatment center benefits were medically necessary.... The court held that, because the InterQual Criteria and the ASA are instruments under which the plan is operated under ERISA, the claimants were eligible for ERISA statutory penalties for the plan's failure to provide these two documents within 30 days of the claimants' request." [M. S. v. Premera Blue Cross, No. 19-0199 (D. Utah Aug. 10, 2021)] |
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