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Sixth Circuit Upholds Application of Probate Exception to Medical Plan’s ERISA Suit Seeking Equitable Lien on Settlement Proceeds

Sixth Circuit Upholds Application of Probate Exception to Medical Plan’s ERISA Suit Seeking Equitable Lien on Settlement Proceeds

American Electric Power Service Corporation v. John K. Fitch et al., No. 22-3005, 2022 WL 3794841 (6th Cir. Aug. 30, 2022) (Before: Guy, Moore, and Clay, Circuit Judges). American Electric…

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Fifth Circuit Finds Unlawful the Department of Labor’s Advisory Opinion Regarding ERISA Status of Health Plan

Data Mktg. P’ship, LP v. United States Dep’t of Lab., No. 20-11179, __F.4th__, 2022 WL 3440652 (5th Cir. Aug. 17, 2022) (Before: Smith, Elrod, and Oldham, Circuit Judges). This dispute…

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Ninth Circuit Holds ERISA Health Plan’s Self-Help Provision Is Enforceable

The Ninth Circuit Court of Appeals recently decided Mull v. Motion Picture Indus. Health Plan, No. 20-56315, __F.4th__, 2022 WL 2912475 (9th Cir. July 25, 2022). This matter involves a…

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Ninth Circuit Affirms Denial of Air Ambulance Transportation Claim for Lack of Medical Necessity

In Cont’l Med. Transp. LLC v. Health Care Serv. Corp., No. 21-35481, 2022 WL 2045385 (9th Cir. June 7, 2022), Plaintiff-Appellant Continental Medical Transport LLC, d/b/a Jet Rescue (“Jet Rescue”)…

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Sixth Circuit: Plan Had Subrogation Right Even Though Pre-Approval of Surgery Was Not Consistent with Plan Terms

In Zahuranec v. Cigna Healthcare, Inc., et al., No. 21-3695, 2022 WL 1619493 (6th Cir. May 23, 2022), Plaintiff-Appellant Lisa Zahuranec appealed the district court’s dismissal of her ERISA lawsuit…

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Second Circuit: HHS Rule for Embedded Individual Out-of-Pocket Limits Does Not Apply to Pre-2016 Health Insurance Plans

In Fisher v. Aetna Life Ins. Co., No. 20-3148, __F.4th__, 2022 WL 1193999 (2d Cir. Apr. 22, 2022), the Second Circuit considered three separate but related appeals concerning Plaintiff-Appellant Jacqueline…

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