In Wit v. United Behavioral Health, the Ninth Circuit recently rejected a lower court’s order certifying a class of participants in a dispute over behavioral health guidelines used to process claims for benefits. A California district court recently rejected Aetna’s motion to decertify an existing...
As we recently suggested, ERISA disputes over the fees and expenses charged to employer or union sponsored group health plans may well become the next wave in ERISA litigation. At minimum, the Consolidated Appropriations Act of 2021 creates new disclosure obligations on service providers of...
On June 30, 2023, Kraft Heinz raised a novel ERISA breach of fiduciary duty lawsuit against Aetna, the former third-party administrator for its own group health plan. The case alleges that Aetna improperly managed Kraft’s self-funded plan—which paid out over $1 billion in claims during...
While social distancing restrictions associated with COVID-19 are on the wane, lawsuits seeking reimbursement for COVID-19 testing are on the rise. The issue is whether federal legislation passed at the onset of the Pandemic allows out-of-network test providers essentially to name their price for the...
The Ninth Circuit just reversed decisions from the U.S. District Court for the Northern District of California in Wit v. United Behavioral Health, which had ordered United Behavioral Health (“UBH”) to reprocess thousands of claims for behavioral and mental health treatment. Wit is an ERISA...
One of the more fascinating developments in group health plan law has been the growth of antitrust claims by group health plans against drug manufactures who allegedly agree to delay the production of generic drugs once a patent has expired. A federal judge in California...
Lawsuits by out-of-network medical providers against ERISA plans and their third party administrators rank as one of the most common ERISA-type cases being raised these days. In these cases, out-of-network medical providers purport to provide services to patients—often substance use or mental health treatments—and then...
The United States Supreme Court’s constitutional standing decision in Thole continues to reverberate throughout ERISA litigation. In Scott v. UnitedHealth Group, Inc., the United States District Court for the District of Minnesota dismissed challenges to United’s cross-plan offsetting practices because the plaintiffs, plan participants, themselves...
In Negron v. Cigna Health and Life Ins., the Plaintiffs alleged that CIGNA misinterpreted their standardized group health plans and caused pharmacies to charge participants with higher copays than was proper. Plaintiffs sought to certify a class of all participants in the various group health...
Under ERISA, group health plans are legal entities that can sue and be sued. Often overlooked, these plans have the ability to raise lawsuits under not only ERISA, but state law, antitrust, and other legal theories. On May 11, the United States District Court for...
In a unanimous 8-0 decision (with Justice Barret not participating), the U.S. Supreme Court once again entered the thicket of ERISA preemption in Rutledge v. Pharm. Care Mgmt. Ass’n, No. 18-540, 2020 U.S. LEXIS 5988 (Dec. 10, 2020). The Court held that ERISA preempts an...
The Supreme Court’s standing decision in Thole v. U.S. Bank N.A., 140 S. Ct. 1615 (2020) continues to have consequences in the lower courts. Applying Thole, a New York federal court recently dismissed a putative class action because the health plan in question was overfunded,...
The U.S. District for the District of Minnesota has denied class certification to putative classes of ERISA plan participants challenging rising EpiPen prices. The participants alleged that four of the largest pharmacy benefit managers (“PBMs”) owned and breached ERISA fiduciary duties to health plan participants...
For insight into the ongoing “war” between “out-of-network” medical providers and the entities that insure and administer group health plans, see a recent article by Nick Bullard and Andrew Holly.
Andrew HollyAndrew represents clients in a wide range of complex civil matters.
Nick BullardNick is a trial partner in Dorsey’s office in Minneapolis. ...
Tim ArendsChair of the Benefits and Compensation practice group, Tim devot...
Shannon BjorklundShannon provides advice and litigation assistance to companies...
Tim GoodmanTim Goodman works with employers on medical plans, retirement pl...
Alan IversonAlan is a litigator in Dorsey’s trial group with a focus on cli...
Stephen P. LuckeSteve represents businesses, employers, insurers, and fiduciarie...
Marianne O'BaraMarianne works regularly with numerous non-U.S. companies and t...
Kirsten SchubertKirsten helps clients large and small navigate all aspects of com...
Michael VovesEmployee Benefits, Minneapolis
