December 08, 2023
Appellate courts issued a bevy of important decisions applying federal benefits law in 2023, including a recent Second Circuit ruling in favor of Cornell University that deepened a circuit split and a Tenth Circuit finding that an Oklahoma law regulating pharmacy benefit managers was preempted. Here, Law360 looks back at five published circuit court decisions in ERISA litigation from the second half of 2023 that benefits lawyers should know.
August 25, 2023
The Ninth Circuit's third version of its ruling in a consolidated class action pitting United Behavioral Health against patients challenging coverage denials largely came out in UBH's favor, but it reopened the door for health plan participants to demand claim reprocessing on a class basis, experts say.
August 22, 2023
The Ninth Circuit on Tuesday granted a panel rehearing in litigation brought by United Behavioral Health plan participants fighting the denial of claims and instructed a district court to resolve a threshold question over the plans' administrative exhaustion requirement.
June 14, 2023
A Texas federal court ruled against Affordable Care Act preventive care coverage mandates, the Seventh Circuit revived a retirement plan mismanagement case brought by Northwestern University workers and the Tenth Circuit refused to force arbitration of an employee stock ownership plan lawsuit. Here are five rulings from the first six months of 2023 that benefits lawyers should have on their radar.
March 21, 2023
The U.S. Department of Labor urged the full Ninth Circuit to rehear an appeal in a federal benefits lawsuit against United Behavioral Health, joining a coalition of medical associations, health advocates and attorneys general from 15 states and the District of Columbia in calling for rehearing en banc.
March 10, 2023
Thousands of participants in health plans administered by United Behavioral Health who sought reprocessing of 67,000 claims for mental health and substance use disorder treatment urged the full Ninth Circuit on Friday to reconsider a three-judge panel's decision, warning of "dire nationwide consequences" absent rehearing.
January 26, 2023
The Ninth Circuit held Thursday that United Behavioral Health doesn't have to reprocess some 67,000 claims for mental health and substance use disorder treatments from participants in employee health plans who alleged the denials violated federal benefits laws, finding UBH didn't abuse its discretion in interpreting workers' plans.
September 23, 2022
A group of lawsuits percolating up through the courts from patients who say insurers violated federal law by skimping on coverage for mental health and substance use disorder treatments will shed light on what such cases need to survive and what remedies plaintiffs can win, attorneys say.
June 24, 2022
UnitedHealth Group Inc. relied on contradictory arguments in its defense of the Ninth Circuit's decision unraveling court orders requiring the insurer's subsidiary to reprocess thousands of claims for mental health and substance use disorder treatment, plan participants have argued, doubling down on imploring the appeals court to revisit its ruling.
June 17, 2022
UnitedHealth Group's behavioral care unit told the Ninth Circuit not to reconsider blocking lower court orders requiring it to reprocess a slew of claims for mental health and substance use disorder treatment, saying plan participants have exaggerated the ruling's impact.