Managed Care Litigation Update Volume 219: February 28, 2023

• Jurisdiction: United States,Federal,Texas,Illinois,Florida,New York,Connecticut,California,New Jersey,Utah
• Publication year: 2023
• Citation: Vol. 219

NEWSWORTHY

Fifth Circuit reverses district court and dismisses claims of emergency care providers who assert a cause of action for violation of Texas emergency care statutes, following response to certified question from Texas Supreme Court. ACS Primary Care Physicians Southwest, P.A., USAC 5^th Cir., No. 21-20168, 2023 WL 2034543, (Doc. 102, filed Feb. 16, 2023). Previously reported at MCLU Vol. 150.

District court dismisses underpayment claims of provider on grounds of plan's anti-assignment provisions under FRCP 12(b)(6). Advanced Physical Medicine of Yorkville, Ltd. V. Allied Benefit Systems, Inc., et al., USDC ND IL, No. 22-cv-2969, 2023 WL 2058315, (Doc. 25, filed Feb. 16, 2023).

District court grants, in part, motion to dismiss claims of provider that ERISA plan's payments were below the amounts agreed to in a repricing agreement, dismissing the claims without prejudice to clarify how the contractual claims are separate and distinct from the ERISA plan. Surgery Center of Viera, LLC v. UnitedHealthcare Insurance Company, USDC MD FL, No. 6:22-cv-793-PGB-DAB, 2023 WL 2078554, (Doc. 31, filed Feb. 17, 2023). Previously reported at MCLU Vol. 199.

District court denies motion to dismiss of ASA defendants who asserted 4-year statute of limitations in defense of antitrust claims involving allegation that ASAs used geographically defined areas to restrict competition and drive-up costs to self-insured plans. Alaska Air Group, Inc., et al. v. Anthem, et al., USDC ND AL, No. 2:22-cv-558-RDP, (Doc. 190, filed Feb. 21, 2023).

RECENTLY FILED ACTIONS

Northwell Health, Inc. v. Carefirst BCBS National Capital Area, U.S.D.C. E.D. NY, Doc. No. 2:23-cv-1268-LDH-ARL, (filed Feb. 16, 2023). Removed action in which physician group seeks $1,132,058 in benefits associated with claims from 2019 through 2021. Other actions by this provider reported at MCLU Vol. 157, 168, 217, 218.

SEE ALSO:
? Northwell Health, Inc. v. Horizon Healthcare Services, Inc., U.S.D.C. E.D. NY, Doc. No. 1:23-cv-1255, (filed Feb. 16, 2023).

Murphy Medical Associates, LLC, et al. v. Aetna Health, Inc., et al., U.S.D.C. D. CT, Doc. No. 3:23-cv-201-JAM, (filed Feb. 16, 2023). Testing center alleges $670,000 underpayment of claims associated with COVID testing and asserts violations of CARES Act and FFCRA. Plaintiff asserts it used high-quality equipment such as the BioFire Film Array to provide more accurate results.

Michael H. v. United Behavioral Health, et al., U.S.D.C. N.D. CA, Doc. No....