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Category: Health Insurance

Your ERISA Watch – Fifth Circuit Holds that Anthem Did Not Abuse Its Discretion in Denying Coverage for Bariatric Surgery

This week’s notable decision is Rittinger v. Healthy All. Life Ins. Co., No. 17-20646, __F.3d__, 2019 WL 391771 (5th Cir. Jan. 31, 2019), a case involving the denial of coverage for bariatric surgery and follow-up surgery for complications.  The Fifth…

Your ERISA Watch – Healthcare Providers Lack Standing Due to Enforceable Anti-assignment Clause in ERISA-governed Plans

This week’s notable decision is Howard Bloom, D.C. v. Independence Blue Cross et al., No. CV 14-2582, __F.Supp.3d__, 2018 WL 5275227 (E.D. Pa. Oct. 24, 2018), a case challenging the enforceability of anti-assignment clauses in ERISA-governed health insurance plans.  Unfortunately…

Your ERISA Watch – Circuit Courts Tackle Issues of First Impression and Preemption

Last week was quite a busy week with notable Circuit Court decisions.  In Hager v. DBG Partners, Inc., No. 17-11147, __F.3d__, 2018 WL 4258968 (5th Cir. Sept. 6, 2018), the court addressed an issue of first impression for the Fifth…

Your ERISA Watch – Sixth Circuit Rules That Indian Tribe Can Pursue Breach of Fiduciary Duty Claim Against Health Plan Administrator

This week’s notable decision is the Sixth Circuit’s most recent decision in Saginaw Chippewa Indian Tribe of Michigan v. Blue Cross Blue Shield of Michigan, No. 17-1932, __F’Appx__ (6th Cir. Aug. 30, 2018), one of many cases against BCBSM for…

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