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I Need to do What? Exhaustion of the Administrative Remedies Requirement

Date: Feb 16 2016
Posted by: admin

James L. Moss (Plan Participant) v. Unum Group; Paul Revere Life Insurance Company; New York Life Insurance Company Date Filed 02-03-2016 We know what you’re thinking. “What does Exhaustion of the Administrative Remedies Requirement mean and if it isn’t mentioned in any ERISA/PPACA statutes then why does it matter to me?” Well, it matters to […]

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The Beginning of the End?: Cigna Administered Plan Sued for Allegedly Embezzling Plan Assets

Date: Nov 04 2015
Posted by: admin

True View Surgery Center One, L.P. v Chicago Bridge and Iron Medical Plan, Chicago Bridge and Iron Company, and Dennis Fox Complaint Filed: 10/29/15 Often times, patients receive a letter in the mail from their insurance companies stating that a “discount” was applied to their healthcare provider’s initial charges. While healthcare providers do indeed reduce […]

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The Importance and Meaning of Exhaustion in ERISA Appeals

Date: Oct 19 2015
Posted by: admin

Hues v. Federal Insurance Company (Case No. 2:15-cv-84) Judgment Filed: 10/16/2015 Laws, in general, can be confusing to many people. Healthcare law is no exception. Today many patients find it harder than ever to understand why their claims for benefits under their healthcare plans are denied by insurance companies. Many times patients see no rationality […]

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In-network or out-of-network? Either way, out of business. What’s the solution?

Date: Oct 12 2015
Posted by: admin

Victory Parent Company, LLC Bankruptcy Filed: 06/12/2015 The solution is: expert and appropriate use of ERISA, HSA, and OIG regulations and guidelines. No healthcare provider foresees filing bankruptcy. However, it can happen even to some of the biggest names in the industry–as the following case summary shows: On June 12, 2015, Victory Parent Company, LLC (hereinafter “Victory”) […]

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