(United States Seventh Circuit) – Held that an insurance company was not liable for bad faith for failing to settle a medical malpractice claim for the policy limit. Affirmed a JMOL against the claims of an outpatient surgical center.
(United States Fifth Circuit) – Affirmed a judgment in favor of a medical supplier in its lawsuit against a health insurance company that refused to pay for covered services. The supplier, which provides equipment and staffing to doctors who perform surgery in their own offices,…
(United States Ninth Circuit) – Held that a health insurance company did not violate the Affordable Care Act’s Medical Loss Ratio provision, which requires an insurer to pay a rebate to enrollees if it uses less than 80 percent of the revenue it takes in…
(United States First Circuit) – In a qui tam action alleging, among other things, that defendant violated the False Claims Act (FCA), 31 U.S.C. section 3729 et seq., and related state statutes, by promoting medically unnecessary replacements of batteries in nerve stimulator devices used to…
(United States Fourth Circuit) – In an insurance coverage dispute in an underlying medical malpractice action brought by a former patient against the hospital and several of its doctors and nurses, the district court’s grant of summary judgment to the hospital’s insurer is vacated and…
(California Court of Appeal) – In a suit brought by a disabled veteran alleging his life insurer breached the insurance contract by failing to pay him benefits for the full 109 days of his hospital stay and that the insurer breached the implied covenant of…
(United States First Circuit) – In a dispute between the Secretary of Health and Human Services and eight Maine hospitals, involving the ‘often surreal’ Medicare reimbursement regime and the system through which the federal government reimburses hospitals for charity care, so-called disproportionate share payments (DSH…
(California Court of Appeal) – In a negligence action arising out of a car collision, the trial court’s judgment in favor of uninsured plaintiff is affirmed where: 1) Howell v. Hamilton Meats & Provisions, Inc. (2011) does not cap a plaintiff’s damages to the amount…
(California Court of Appeal) – In a suit brought by a doctor against health insurers, arising out of denied payment for bills for the provision of emergency medical services to two patients insured by defendant, asserting breach of contract and quantum meruit, the trial court’s…
(United States Ninth Circuit) – In a qui tam action alleging that defendant Medicare Advantage organizations submitted false certifications in violation of the False Claims Act, the District Court’s judgment dismissing without leave to amend qui tam relator’s third amended complaint is remanded with instructions…
