Court Questions Insurer Behavioral Health Treatment Guidelines
A decision by the U.S. Court of Appeals for the Ninth Circuit questions an insurer’s behavioral health treatment guidelines.
Exercise Your COBRA Rights Without Getting Snake-Bitten
If you lose your health insurance as the result of job loss (resignation or termination), divorce, death of a spouse, or other qualifying event, the Consolidated Omnibus Budget Reconciliation Act of 1985 (“COBRA”) can provide a welcome bridge while you work to secure new health coverage. Yet there are many complexities and pitfalls to COBRA […]
Federal Judge Found Insurance Giant Breached Its ERISA Fiduciary Duties and Violated Illinois Law
Approximately 50 percent of Americans receive health insurance through their employer,1 making most of those plans subject to The Employee Retirement Income Security Act of 1974 (“ERJSA”). After passage of the Mental Health Parity and Addiction Equity Act of2008 (“MHPAEA”), the majority of health plans that cover mental health treatment, including large employer -sponsored plans, […]
A Primer on Behavioral Health Residential Treatment Cases
Our firm recently won the case of Dominic W v. Northern Trust Co. Employee Welfare Benefit Plan, 2019 WL 2576558 (N.D. Ill. June 24, 2019), which took a health benefit plan to task for denying residential treatment behavioral health claim.
Insurers Send Payments Directly to Patients Depriving Providers of Reimbursement for Services
America’s healthcare system is complex. Unlike single-payer systems that exist in virtually all other industrialized countries, the U.S. relies on private health insurers to cover healthcare costs, many of which are for-profit companies. The way health insurance typically works in the U.S. is that when a patient sees a doctor or goes to the hospital […]