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2 Matching News Items |
| 1. |
Arent Fox via Lexology; registration required
Nov. 13, 2018
"As recent decisions from federal courts in New Jersey and California illustrate, where plaintiff classes seek to challenge decisions by ERISA healthcare plan administrators, commonality is best achieved when the same benefit plan provision is at issue, as well as the same reason for denial of claims. Each of the cases discussed below involved a putative class pursuing claims against health plans based on denials and alleged underpayments for out-of-network services, and the classes in both cases failed to achieve certification."
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| 2. |
Arent Fox via Lexology; registration required
Oct. 18, 2015
"First, for a medical provider to state a claim under ERISA, it must have a valid assignment of benefits from the patient.... Second, to assert a claim for benefits under ERISA, that claim must be lodged against an ERISA plan.... Third, to file an ERISA claim for benefits in court, a provider with a valid assignment of benefits must first have exhausted its administrative remedies under the ERISA plan." [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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