Tenet Healthcare and nineteen of its hospitals filed a complaint against Cigna Health and Life Insurance Company in Connecticut Superior Court, alleging that Cigna had reimbursed its claims at unfair and unreasonable rates. The plaintiffs also allege that Cigna wrongfully denied claims for emergency medical services, although they are legally obligated to provide Cigna plan members with emergency medical Read More

The Russian invasion of Ukraine has led to a wave of public pension funds making divestment pledges from Russian investments. These public pension funds included some of the largest in the country, such as the state pension funds of New York and California. Private employers managing pension plans subject to ERISA should not follow divestment trends without solid financial reasons.  The overall asset holdings of Read More

A Texas federal district court has granted Blue Cross and Blue Shield of Texas, Inc.'s motion to dismiss the state law claims, including a negligence per se claim filed by Brandon Walters, a group health plan participant, concerning a HIPAA violation. The case is Walters v. Blue Cross Blue Shield of Tex., Inc., 2022 WL 902735 (N.D. Tex. 2022).  Blue Cross and Blue Shield received a subpoena directing it to Read More

The city of Chicago has asked an Illinois federal district court judge to dismiss a suit filed by six city employees, challenging a wellness program within the city's health insurance plan. The employees have argued against the dismissal, saying that the city's argument for dismissal is based on a dispute over voluntariness, which is an issue that is unresolvable on a motion to dismiss. The case is Williams et al. v. Read More

President Biden recently released his FY 2023 budget, which includes new and drastically increased funds to enforce the Mental Health Parity and Addiction Equity Act of 2008 (MHPAEA).  From a financial perspective, Biden calls for a $125 million budgetary allotment to the states to assist with MHPAEA enforcement. State regulators can approve plan designs of fully insured group and individual health plan options. Read More

After a Minnesota federal district court judge denied its motion to dismiss a proposed ERISA class action suit in May, Wells Fargo & Co. has agreed to settle the case by paying $32.5 million. The employees claimed that Wells Fargo had violated ERISA by mismanaging their 401(k) plan. More specifically, the workers alleged that Wells Fargo had breached its fiduciary duty by offering expensive proprietary investment Read More

The U.S. Supreme Court’s decision in Rutledge v. Pharmaceutical Care Management Association, 141 S. Ct. 474 (2020), upheld an Arkansas law that regulated pharmacy benefit managers (PBMs). This landmark ruling rejected a trade group's argument that the Employee Retirement Income Security Act (ERISA) preempted the state law. The U.S. Court of Appeals for Eighth Circuit soon followed suit by upholding a North Dakota law Read More

The Coca-Cola Co. has confirmed that it will not move forward with a controversial diversity initiative that would have required its outside counsel to apportion some work to Black attorneys and attorneys from other underrepresented groups. Bradley Gaston, former general counsel for Coca-Cola, announced the diversity initiative in January 2021. Under the initiative, the overarching goal was for diverse billing by Read More

President Biden recently revealed his $5.8 trillion budget for the 2023 fiscal year, which includes $14.6 in discretionary spending for the U.S. Department of Labor (DOL) and mandatory funding. Much of this spending is devoted toward developing new policies to guarantee better health care coverage for mental health and substance abuse disorder treatment. The DOL also would have enhanced enforcement authority against Read More

A panel of the U.S. Court of Appeals for the 9th Circuit has reversed a pair of major rulings by a California federal district court. Those rulings would have required UnitedHealth Group Inc. to reprocess thousands of mental health and substance abuse claims, due to its application of improper coverage guidelines. The 9th Circuit disagreed, finding that the insurance company's claim denials were reasonable under its Read More