An Overview of FEHBA and the Power of Its Preemption

Size: px
Start display at page:

Download "An Overview of FEHBA and the Power of Its Preemption"

Transcription

1 An Overview of FEHBA and the Power of Its Preemption While the healthcare industry is dominated by a growing number of acronyms, practitioners and clients alike are often unfamiliar with one that has been around for more than 45 years: FEHBA. Originally enacted in 1959, the Federal Employee Health Benefits Act ( FEHBA ) established a program to provide federal employees, federal retirees, and their eligible family members (collectively enrollees ) with subsidized healthcare benefits. See 5 U.S.C With more than nine million participating Americans today, FEHBA is the largest employersponsored group health insurance program in the world. 3 FEHBA is a comprehensive statutory and regulatory scheme that establishes the Federal Health Benefits Program and indictates how claim decisions are to be resolved. In doing so, it provides only limited judicial review, with a broad preemption clause that is similar to the one found in the Employee Retirement Income Security Act of relied, at least in part, on Davila to hold that a cause of action pled as a medical malpractice or mixed treatment/eligibility case was completely preempted by FEHBA. This article provides a comprehensive overview of FEHBA and addresses how courts will likely respond to claimants By Fred A. Smith, III, 1 and David M. Goldhaber 2 Sedgwick, Detert, Moran & Arnold LLP 1974 ( ERISA ). Despite the restrictions set forth by FEHBA, claimants who are dissatisfied with the limitation on their ability to recover damages are increasingly trying to avoid preemption to litigate their claims under more liberal state laws and expand the amount of recovery available. Given the similarity between the preemption clauses found in ERISA and FEHBA and the limited case law discussing FEHBA preemption, courts often look to ERISA preemption decisions for guidance. 4 While some claimants have successfully avoided FEHBA preemption in the past, claimants will likely encounter increased difficulties in circumventing the limited judicial review allowed by FEHBA in light of the United States Supreme Court s decision in Aetna Health, Inc. v. Davila, the new seminal case on ERISA preemption. 5 Indeed, at least one Illinois federal court has now attempts to avoid its sweeping preemption scheme. An Overview of FEHBA Congress first enacted FEHBA after recognizing that a viable solution was needed for the rising costs of medical care in the United States. FEHBA s stated goal was to provide a measure of protection for civilian Government employees against the high, unbudgetable, and, therefore, financially burdensome costs of medical services through a comprehensive government-wide program of insurance for federal employees... the costs of which will be shared by the Government, as employer, and its employees. 6 A broad class of individuals are allowed to enroll in FEHB health plans. 7 The Office of Personnel Management ( OPM ), which serves as the federal government s humanresource agency, is tasked with the overall responsibility for running and enforcing this program. Under FEHBA, the United States does not serve as a healthcare insurer. Rather, the United States, through the OPM, contracts with various private insurers referred to as carriers in the Statute on behalf of enrollees to provide healthcare plans with various coverages and costs. 8 FEHBA requires contracts between the carriers and OPM to contain a detailed Statement of Benefits that includes maximums, limitations and other terms related to benefits. 9 The Statement of Benefits section is in turn incorporated into the federal contract and serves as the official description of benefits and plan terms. 10 The term carrier is broadly defined in FEHBA. 11 Consequently, various private insurers and other health care entities, including health maintenance organizations ( HMO s), participate in this program. In fact, there are currently more than 350 health plans for program enrollees to choose from. 12 The OPM subsidizes the federal program by contributing 60% of the average premium. 13 The health plans contracts are typically for a one-year term and negotiated annually. Enrollees are permitted to switch plans during each open enrollment period. 14 Individual policies or contracts are not issued to program enrollees. FEHBA itself does not outline the specific methods of dispute resolution This article was published in the American Bar Association Health Law Section s The Health Lawyer.

2 An Overview of FEHBA and the Power of Its Preemption Continued or set out what remedies are available under the statute. Instead, FEHBA vested the OPM with the power to promulgate the necessary regulations to carry out the congressional mandate. 15 The OPM in turn created a detailed regulatory scheme for handling claims and resolving disputes over benefit determinations. See 5 C.F.R , et seq. The OPM regulations provide the specific procedures for how medical benefit claims are to be administered. The Administration of FEHBA Claims Under FEHBA, carriers are empowered to make claim decisions pursuant to the terms of their plans. The carriers often subcontract with third-party administrators ( TPA s) to perform the claims handling on their behalf. In resolving claims, the carriers or TPAs determine issues such as medical necessity, length of hospital stay, whether services are covered under the enrollee s plan and whether the claim should be denied. When a carrier denies a claim, an individual has six months in which to seek reconsideration. 16 A carrier then has 30 days to either: (1) affirm the denial; (2) pay the bill; or (3) request additional information in order to reconsider the claim. 17 If the plan requests additional information, it must reach its decision within 30 days from receipt of that information. 18 FEHBA also calls for a mandatory administrative review process through the OPM. The statute s legislative history notes that Congress intended that the OPM s review process would provide an adequate administrative remedy for enrollees and would prevent them from being forced into courts to recover the benefits they are due. 19 If an enrollee believes that the FEHBA insurer, or its TPA, has wrongfully denied medical benefits or simply failed to respond to the claim, the individual may ask the OPM to review the claim s handling and/or the insurer s decision. 20 Congress first enacted FEHBA after recognizing that a viable solution was needed for the rising costs of medical care in the United States. FEHBA s stated goal was to provide a measure of protection for civilian Government employees against the high, unbudgetable, and, therefore, financially burdensome costs of medical services. Thus, under FEHBA, if a plan enrollee challenges a carrier s final claim decision, he/she must first submit the claim to the OPM for a review process. 21 The enrollee must request an OPM review within: (1) 90 days after the carrier s decision; (2) 120 days after the request for benefits to the carrier if it fails to respond; or (3) 120 days after a carrier requests additional information from the enrollee but fails to act on it. 22 The OPM is in turn required to provide the claimant with a written notice of its decision within 90 days after his/her request for the review. 23 After reviewing the claim, the OPM may either: (1) request additional information to further evaluate the claim; (2) obtain an advisory opinion from an independent physician; or (3) reach a decision based solely on the information provided by the individual. 24 Interestingly, the OPM also has the right to reopen its review process if new evidence becomes available at a later time. 25 FEHBA expressly requires participating carriers to comply with the OPM s interpretation of their plans. This enables the OPM to develop a consistent application of the participating health plans. FEHBA also vests the OPM with the authority to compel a carrier to pay an enrollee if the OPM resolves a benefits dispute in his/her favor. 26 Limited Judicial Review What options are available to an enrollee if a carrier denies a claim and the OPM agrees with the denial? If the claimant still disagrees with the OPM s denial, the claimant may then sue the OPM to obtain judicial review of the OPM s decision. However, this judicial review is quite limited. First, judicial review is only allowed after an individual exhausts the review process of both the carrier and the OPM. 27 Second, an individual requesting judicial review may only challenge a final action from the OPM concerning the denial of a benefit. 28 There is no challenge of the insurer s determination. Third, in light of the restriction only allowing review of final action by the OPM, lawsuits can only be brought against the OPM. 29 Neither participating insurers nor their TPAs are proper parties in these actions. Finally, judicial relief is strictly limited to evaluating whether the OPM should require the carrier to pay the benefits in dispute or confirm that the denial was proper. 30 A claimant must initiate a lawsuit against the OPM within three years of when the medical care or service was provided. 31 The United States District Courts have original jurisdiction over the suits. When reviewing the OPM claim decision, courts are strictly limited to the record that existed when the OPM rendered its final decision. 32 [ 2 ] Sedgwick, Detert, Moran & Arnold LLP

3 Because FEHBA does not specifically provide otherwise, the Administrative Procedure Act, 5 U.S.C. 500 through 706, governs judicial review of OPM decisions. 33 Under the Administrative Procedure Act, the court must afford considerable deference to the OPM s findings and set aside an action only if it was arbitrary, capricious, an abuse of discretion, or otherwise not in accordance with law. 5 U.S.C. 706(2)(A). But, unlike the procedures provided for successful ERISA claims, a successful FEHBA litigant cannot recover attorneys fees or costs. 34 As discussed below, state law remedies are also preempted. This limited judicial review scheme effectively prevents claimants from pursuing medical benefit claims against the carriers and their subcontracting TPAs. See, e.g., Botsford v. Blue Cross and Blue Shield of Montana, Inc., 314 F.3d 390, 397 (9th Cir. 2002) (allowing suits against parties other than the OPM would undermine the federal scheme: We conclude that Congress intended to limit the defendant in suits involving disputes over FEHBA benefits to the United States. ). However, attorneys for claimants have long attempted to look for and create ways to avoid FEHBA s limited judicial review and preemption clause to take advantage of the broader remedies available under various state laws. Preemption Under FEHBA Under well-established jurisprudence, a claim may arise under federal law if a federal statute preempts state law in a particular field. 35 Courts typically commence their preemption analysis with a review of the allegations set forth in the complaint often referred to as the well-pleaded complaint rule to determine whether a federal question is presented by the pleadings. However, the complete preemption doctrine serves as an exception to that rule. See, e.g., Jass v. Prudential Health Care Plan Inc, 88 F.3d 1482, 1487 (7th Cir. 1996) (recognizing that a claim pled as a state law claim is properly recharacterized as a complaint arising under federal law when Congress has legislatively displaced the claim). Consequently, federal subject matter jurisdiction exists if the complaint concerns an area of law completely preempted by federal law, even if the complaint fails to mention a federal basis of jurisdiction. 36 FEHBA is intended to be one such statute and should therefore completely preempt certain state law claims. In 1978, Congress amended FEHBA to include a preemption clause. The policy underlying the amendment was to ensure uniformity in the administration of FEHBA plan benefits. 37 The 1978 preemption section stated: The provisions of any contract under this chapter which relate to the nature or extent of coverage or benefits (including payments with respect to benefits) shall supersede and preempt any State or local law, or any regulation issued thereunder, which relates to health insurance or plans to the extent that such law or regulation is inconsistent with such contractual provisions. Act of Sept. 17, 1978, Pub. L. No , 1, 92 Stat. 606 (amended 1998). Congressional legislative history reveals that the purpose of this clause was to supersede and preempt any State or local law, or any regulation issued under such law relating to health insurance or plans, to the extent that such law or regulation is inconsistent with the provisions of the Federal employees health benefits contract. 38 Notwithstanding the legislative history, the preemption clause only specified that state and local laws and regulations were preempted where they were inconsistent with such contractual provisions established under FEHBA. 39 This allowed Courts to reject FEHBA preemption if the state laws were found to be consistent with the FEHBA benefit contract provisions. Court decisions on the extent and scope of FEHBA preemption varied from jurisdiction to jurisdiction, and a split in authority developed. 40 Some courts relied In 1978, Congress amended FEHBA to include a preemption clause. The policy underlying the amendment was to ensure uniformity in the administration of FEHBA plan benefits. upon the preemption clause to thwart state law claims. 41 Many others found exceptions to preemption and allowed plaintiffs to have their day in state court to pursue their state law claims. 42 In another attempt to get around preemption, plaintiffs also argued that their state law claims were not preempted by 8902(m)(1) because they only related to the manner in which the benefit claim was processed (arguing improper claim handling) rather than the nature and extent of coverage. While few courts have been faced with this argument, at least one court has rejected it. 43 Given the scarcity of cases analyzing FEHBA preemption, courts also looked to the body of case law interpreting the ERISA preemption clause for guid- Sedgwick, Detert, Moran & Arnold LLP [ 3 ]

4 An Overview of FEHBA and the Power of Its Preemption Continued ance. 44 However, this case law also varied by jurisdiction, and inconsistencies between circuits emerged. This inconsistent case law also helped fuel uncertainty over preemption of FEHBA cases in certain courts. Some authors even called on Congress to amend 8902(m)(1) to provide a more clear statement as to the scope of FEHBA preemption. 45 All of these factors led to the amendment of the FEHBA preemption provision to clarify its reach. In 1998, Congress amended the preemption clause to expand federal jurisdiction over FEHBA claims and cure the inconsistent results in the courts. The broader provision now states: The terms of any contract under this chapter which relate to the nature, provision or extent of coverage or benefits (including payments with respect to benefits) shall supersede and preempt any State or local law, or any regulation issued thereunder, which relates to health insurance or plans. See 5 U.S.C. 8902(m)(1). This amended section eliminated the language concerning inconsistent state laws. Congress designed the new provision to strengthen the ability of national plans to offer uniform benefits and rates to enrollees regardless of where they may live. 46 It also intended to strengthen the case for trying FEHBA program claims disputes in federal courts rather than state courts. 47 Finally, the broader preemption clause is designed to keep cases in federal courts where there will be a more uniform application of FEHBA and its regulatory scheme. This in turn allows the OPM to control the cost of the program and avoid a patchwork quilt of benefits that vary among the states. 48 With this amendment, the FEHBA preemption clause now more closely resembles its counterpart in ERISA. 49 While ERISA preemption decisions often receive a great deal of attention in the courts and media, little is heard about preemption under FEHBA since the claims are not as prevalent. Congress amended FEHBA s preemption clause to expand federal jurisdiction over FEHBA claims and cure the inconsistent results in the courts. Preemption Decisions Following the 1998 amendment to 8902(m)(1), courts almost universally have recognized its broad application. 50 These decisions, and the FEHBA preemption scheme, however, did not stop claimants from trying to advance certain state law claims. The preemption clause is therefore still one of the more litigated aspects of FEHBA. Medical benefit claimants have historically had some success in avoiding preemption by characterizing their claims as involving both questions of eligibility for benefits and the appropriateness of medical care. Such matters have been termed mixed eligibility and treatment cases. The legal authority most often cited by claimants to support these claims has been the Supreme Court s decision in Pegram v. Herdrich. 51 In Pegram, an HMO plan participant consulted a physician for stomach pain resulting from an inflamed abdomen. The physician required the beneficiary to wait eight days for an ultrasound to be performed at a facility staffed by HMO physicians more than 50 miles away. During the waiting period, the participant s appendix ruptured, causing peritonitis. The plan participant then sued the HMO and her treating physician in state court alleging medical malpractice and fraud. Asserting ERISA preemption, the defendants removed the case to federal court and sought a dismissal of the claims in favor of the relief provided under ERISA. In analyzing ERISA preemption, the Supreme Court held that mixed eligibility and treatment decisions made by the HMO, through its physician employee(s), were not fiduciary decisions under ERISA. The state medical malpractice claims therefore survived. Some courts subsequently relied upon the holding in Pegram to carve out medical malpractice and quality of care exceptions to FEHBA preemption. One example occurred in Roach v. Mail Handlers Benefit Plan. 52 There a federal employee allegedly received improper medical treatment from her plan which required her to have ankle surgery. She sued her health plan and its subcontractor in state court alleging medical malpractice, breach of contract and other state law claims. While the employee alleged traditional malpractice claims in her complaint, she also alleged a denial of medical treatment certification under her medical benefits plan. Asserting complete preemption of the claims under FEHBA, the defendants removed the case to federal court and secured a summary judgment. On appeal, the plaintiff argued that the district court erred by characterizing her medical malpractice claim as a denial of benefits preempted by FEHBA. [ 4 ] Sedgwick, Detert, Moran & Arnold LLP

5 After evaluating the factual record, the U.S. Court of Appeals for the Ninth Circuit agreed and held that FEHBA did not preempt the participating health plan participant s medical malpractice claim. 53 The Ninth Circuit explained that FEHBA preemption must be interpreted to protect both the federal interest in the uniform administration of FEHBA benefits and a state s interest in the quality of medical care. 54 The court concluded that the mere reference to the existence of a benefit plan in a state law claim, without more, does not endanger the uniform federal interpretation of a FEHBA plan. 55 Other cases followed the holding in Roach. 56 The import of such mixed eligibility/ treatment decisions has now been significantly limited by Aetna Health, Inc. v. Davila. In Davila, the U.S. Supreme Court reversed two decisions rendered by the Fifth Circuit. In these cases, the Fifth Circuit had rejected ERISA preemption and allowed plan participants to sue their healthcare plans for negligent denial of benefits under the Texas Healthcare Liability Act ( THLA ). Passed in 1997, the THLA allowed patients to sue their HMOs for negligent denial of benefits and provided for compensatory and punitive damages against HMOs for their coverage decisions. At least nine other states, including Arizona, California, Georgia, Maine, New Jersey, North Carolina, Oklahoma, Washington and West Virginia, had enacted similar laws. 57 In one of the consolidated cases in Davila, the plaintiff suffered from bleeding ulcers. He contended that this condition resulted from the plan s decision to restrict his treatment. While the plaintiff s physician had prescribed Vioxx to treat arthritis pain, his HMO plan required two less expensive medications, covered by the plan s formulary, to be used before Vioxx could be approved. Plaintiff maintained that this caused his adverse medical condition; he then sued the plan under the THLA. In the second case, the plaintiff developed post-surgical complications from a hysterectomy which required a second hospital admission. The claimant maintained that this was caused when the nurse from her HMO originally only approved a one-day hospital stay despite her physician s recommendation that she recuperate in the hospital for several days. The plaintiff there, too, brought an action under the THLA. The Fifth Circuit found that ERISA did not preempt the THLA and ruled that these plaintiffs could pursue their state law claims. The Supreme Court reversed. It held that plaintiffs actions against their respective HMOs for alleged failures to exercise ordinary care in handling coverage decisions were completely preempted by ERISA and removable to federal court. It reasoned that any state law cause of action that duplicates, supplements or supplants ERISA s civil enforcement remedies conflicts with the congressional intent to make ERISA remedies exclusive, and any such state law cause of action would be preempted. By its decision, the Supreme Court made it clear that states cannot enact statutes like the THLA in order to circumvent ERISA preemption. The Supreme Court also cautioned courts not to distinguish between preempted and non-preempted claims based on the labels affixed to them by litigants as this would elevate form over substance and allow parties to evade preemption. 58 Significantly, the Supreme Court clarified, and expressly limited, its prior holding in Pegram v. Hendrich. It stated:... the reasoning in Pegram only make[s] sense where the underlying negligence also plausibly constitutes medical treatment by a party who can be deemed to be a treating physician or such a physician s employer. 59 Consequently, pursuant to Davila, the recipients of medical benefits can only pursue a mixed eligibility/treatment malpractice case against a party who is the treating physician or that physician s employer. It did not take long for a court to look to Davila for guidance in deciding a FEHBA preemption decision in a purported mixed eligibility/treatment case. In McCoy v. Unicare Life and Health Ins. Co., a Northern District of Illinois federal court held that FEHBA completely preempted a medical Medical benefit claimants have historically had some success in avoiding preemption by characterizing their claims as involving both questions of eligibility for benefits and the appropriateness of medical care. Such matters have been termed mixed eligibility and treatment cases. malpractice action originally pled as a mixed eligibility/treatment case under Pegram. 60 In denying the plaintiff s motion to remand the case back to state court, the court referenced the Davila decision and ruled that the plaintiff s claims against the HMO and its contracting Independent Physician Association ( IPA ) were completely preempted by FEHBA. This was the first reported decision to apply FEHBA preemption following the Supreme Court s Davila ruling. It is also one of Sedgwick, Detert, Moran & Arnold LLP [ 5 ]

6 An Overview of FEHBA and the Power of Its Preemption Continued only a few reported cases finding that FEHBA completely preempts a complaint with medical malpractice or mixed treatment/eligibility causes of action. The plaintiff in McCoy filed a medical malpractice lawsuit in the Circuit Court of Cook County, Illinois, against his HMO and the IPA that contracted with the HMO to deliver benefits. He alleged that these defendants denied certain medical benefits for his burn injuries. He contended that the managed care defendants were negligent by preventing him from obtaining treatment at the burn center of his choice and refusing to approve and/or cover the costs for certain treatment and occupational therapies. Plaintiff maintained that this prevented him from achieving a full recovery. court denied plaintiff s motion for remand, finding that FEHBA completely preempts plaintiff s claim against the HMO and IPA. 62 In so holding, the court recognized that: A plaintiff cannot circumvent the clear intent of Congress to completely preempt an area of law by phrasing allegations so that they appear to be malpractice allegations and by omitting any reference to the FEHBA. Regardless of titles and jargon included in a complaint, if it is clear from the facts in the action that the allegations are essentially contesting the eligibility of benefits rather than treatment decisions, then the claims should properly be deemed what they truly are and the court should not proceed under the Pursuant to Davila, the recipients of medical benefits can only pursue a mixed eligibility/treatment malpractice case against a party who is the treating physician or that physician s employer. The court also specifically responded to plaintiff s attempt to characterize his claim as one involving mixed plan eligibility and treatment issues under the Pegram decision. The court rejected that contention since the Supreme Court limited the ability of a claimant to state a mixed eligibility and treatment claim in Davila. 63 The court recognized that a mixed issues claim is only applicable to situations where a referring physician is making treatment decisions while simultaneously owning or operating the health plan which is also making eligibility determinations. 64 In the end, the federal court in McCoy concluded that the plaintiff cannot artfully attempt to plead around FEHBA, particularly when, as in this instance, Congress has indicated that the complete preemption doctrine is applicable. 65 At least one other court, Benoti v. First Health, has looked to the decision in McCoy for guidance when conducting a FEHBA preemption analysis. 66 Consequently, it would appear that the uncertainty surrounding preemption under FEHBA that once existed for certain claims may now be a thing of the past. Based on the holding of Davila, and the reasoning set forth in McCoy, it is anticipated that courts facing certain FEHBA preemption challenges in the future are likely to reject them and follow the analysis in McCoy. The defendants removed the case to federal court on the grounds that FEHBA completely preempted and barred plaintiff s state law claims. In response, plaintiff moved to remand and argued that his amended complaint alleged facts sufficient to establish a mixed eligibility/treatment decision that could proceed in state court under Pegram. The defendants responded that FEHBA completely preempts the judicial review of all medical benefit claims and argued that plaintiff had improperly characterized his suit as a medical malpractice action. The Illinois federal court recognized a lower court split on the issue of the applicability of the complete preemption doctrine to FEHBA. 61 However, the pretense that the allegations are legitimate malpractice claims. McCoy, 2004 WL at *5. The court concluded that plaintiff s claims against the HMO, and the IPA that contracted with the HMO to deliver benefits, were completely preempted by FEHBA. Conclusion FEHBA has established the largest employer-sponsored group health insurance program in the world. As such, there are millions of plan participants who must carefully navigate FEHBA s statutory scheme and the OPM regulations to recover medical benefits denied by participating carriers. Plan participants have previously had some success in being allowed to pursue more expansive state law claims relying upon the holding in Pegram by characterizing their causes of action as mixed eligibility/treatment claims. This often allowed them to avoid the limited judicial relief set forth under FEHBA. However, the Supreme Court in Davila has now severely limited the ability to circumvent preemption. Davila restricts [ 6 ] Sedgwick, Detert, Moran & Arnold LLP

7 the right of recipients of medical benefits to pursue a mixed eligibility treatment malpractice case only against the patient s treating physician or that physician s employer. While the Davila decision interprets preemption under ERISA, at least two courts have found that the Supreme Court s preemption analysis applies equally to FEHBA matters. This proposition is supported by the fact that the preemption clauses in ERISA and FEHBA are nearly identical and serve similar purposes. FEHBA s underlying legislative rationale also supports complete preemption. As illustrated by the decision of the Northern District of Illinois in McCoy, courts have already started to rely on Davila, at least in part, to hold that a cause of action pled as a medical malpractice or mixed treatment/eligibility case is completely preempted by FEHBA. It is anticipated that others courts are likely to follow this trend. Thus, when FEHBA insurers and their subcontracting claims handlers make decision about claims, they should be immune from suits for state law medical negligence. Consequently, claimants who are dissatisfied with the level of recovery they can achieve under their FEHBA plan in the future will likely need to find new ways to avoid the broad reach of FEHBA and the power of its preemption. Footnotes 1 Fred A. Smith is a partner in the Chicago office of Sedgwick, Detert, Moran & Arnold. He is a member of the firm s Healthcare Practice Group, and his areas of specialty include healthcare, ERISA, medical device and medical malpractice litigation. He has defended healthcare clients in a variety of settings including class actions, products liability, physician termination litigation and reimbursement disputes. Before his legal career, Mr. Smith was the Director of the Department of Respiratory Therapy at the University of Chicago Hospitals and Clinics. Besides his clinical practice, he was involved in risk management with that allied health field. He is a member of the American, Illinois State and Chicago Bar Associations, the Illinois Association of Healthcare Attorneys and the Defense Research Institute (DRI). Fred Smith can be reached at or (312) David M. Goldhaber is special counsel in Sedgwick s Chicago office and a member of the firm s Healthcare Practice Group. In the healthcare arena, he represents hospitals, MCOs, healthcare professionals and life, health and disability insurers in litigation matters and related insurance coverage issues. Mr. Goldhaber has successfully defended life, health and disability claims, privilege disputes and malpractice actions against physicians, plan administrators and MCOs. He is a member of the ABA Health Law Section, DRI, and the Chicago Bar Association, where he served as a Legislative Liaison for its Health Law Committee. He can be reached at (312) or 3 OFFICE OF PERSONNEL MANAGEMENT, FEHB HANDBOOK (available at (last visited June 7, 2005). 4 See Botsford v. Blue Cross and Blue Shield of Montana, Inc., 314 F.3d 390, 394 (9th Cir. 2002); Hayes v. Prudential Ins. Co. of America, 819 F.2d 921, 922 (9th Cir. 1987). 5 See Aetna Health, Inc. v. Davila, 542 U.S. 200, 124 S.Ct (2004). 6 H.R. Rep. No , at 1 (1959), reprinted in 1959 U.S.C.C.A.N. 2913, See 5 U.S.C See Hayes v. Prudential Ins. Co. of America, 819 F.2d 921, 922 (9th Cir. 1987). 9 Blue Cross and Blue Shield of Illinois v. Cruz, 396 F.3d 793, 795 (7th Cir. 2005) Pursuant to 5 U.S.C. 8901(7), Carrier means a voluntary association, corporation, partnership, or other nongovernmental organization which is lawfully engaged in providing, paying for, or reimbursing the cost of, health services under group insurance policies or contracts, medical or hospital service agreements, membership or subscription contracts, or similar group arrangements, in consideration of premiums or other periodic charges payable to the carrier, including a health benefits plan duly sponsored or underwritten by an employee organization. 12 OFFICE OF PERSONNEL MANAGEMENT, FEHB HANDBOOK, supra note The Health Maintenance Organization of New Jersey, Inc. v. Whitman, 72 F.3d 1123, 1130 (3rd Cir. 1995) (citing 5 U.S.C (1994)). 14 See Hayes v. Prudential Ins. Co. of America, 819 F.2d 921, 922 (9th Cir. 1987) ( After OPM negotiates changes with the carriers all federal enrollees are permitted to switch enrollment from one plan to another, regardless of their state of health, during a period called open season. Each enrollee thus may obtain the most beneficial plan but is not guaranteed the same coverage in future years that had been available the preceding year. ) U.S.C. 8913(a) C.F.R (b) (1998) (b)(2) H.R. Rep. No. 459 (1983) C.F.R (a)(1), (3) (1998). 21 See id (a) (e)(1) (e)(4) (e)(2). 25 See id (e)(5). Such actions are not typically taken by private carriers. 26 See 5 U.S.C. 8902(j). 27 See 5 C.F.R (a)(1) (1998). 28 See id (c). 29 See id (c). 30 See id (c), (d). 31 See id (d). 32 See id (c). 33 See Harris v. Mutual of Omaha Cos., 992 F.2d 74, 79 (7th Cir. 1993)(concluding the Administrative Procedure Act governs review of final OPM decisions); Caudill v. Blue Cross & Blue Shield, 999 F.2d 74, 79 (4th Cir. 1993)(same). 34 See, e.g., Bryan v. Office of Personnel Management, 165 F.3d 1315 (10th Cir. 1999) (affirming the district court s denial of attorneys fees to a claimant). 35 See, e.g., Metro. Life Ins. Co. v. Taylor, 481 U.S. 58, 62-64, 107 S.Ct (1987) (holding that employee s state law claims were preempted by ERISA and were therefore federal causes of action) H.R. Rep. No. 282, at 4 (1977) U.S.C. 8902(m)(1) (amended 1998). 40 See Haller v. Kaiser Found. Health Plan of the Northwest, 184 F.Supp.2d 1040, (D. Or. 2001) (explaining that there is a spit among the district courts and citing various cases for both positions). 41 See, e.g., Blue Cross & Blue Shield of Florida, Inc. v. Departmet of Banking and Sedgwick, Detert, Moran & Arnold LLP [ 7 ]

8 An Overview of FEHBA and the Power of Its Preemption Continued Fin., 791 F.2d 1501 (11th Cir. 1986) (Florida s Unclaimed Property Act preempted to the extent it conflicts with federal employee benefit plan); Myers v. United States, 767 F.2d 1072, 1074 (4th Cir. 1985) (state law which purports to allow recovery of additional benefits not contemplated by a federal insurance contract must be deemed inconsistent with and preempted by FEHBA); and Tackitt v. Prudential Ins. Co., 758 F.2d 1572, 1575 (11th Cir. 1985) ( the interpretation of health insurance contracts is controlled by federal, not state, law ). 42 See, e.g., Howard v. Group Hosp. Serv., 739 F.2d 1508, (10th Cir. 1984) (approving state law interpretation of FEHBA plan); Eidler v. Blue Cross Blue Shield United of Wisconsin, 671 F.Supp (E.D. Wisc. 1987) (holding that plaintiff s state tort claim of bad faith is not barred by FEHBA). 43 See, e.g., Hayes v. Prudential Ins. Co. of America, 819 F.2d 921 (9th Cir. 1987). 44 See id. at 926; Blue Cross & Blue Shield, Inc. v. Department of Banking & Fin., 791 F.2d 1501 (11th Cir. 1986). 45 See Brian Harr, Legislative Reform: FEHBA s Preemption Clause: Is It a Model for Private Employers Subsidized Health Care?, 22 J. LEGIS. 267, 273 (1996) ( Since the courts have been unable to agree upon what Congress true intent was, Congress should amend section 8902(m)(1). ). 46 H.R. Rep. No , at 9 (1998) Wormack v. Southeastern Mutual Ins. Co., 907 S.W.2d 163, 166 (Ky. Ct. App. 1995) (quoting Caudill v. Blue Cross and Blue Shield of North Carolina, 99 F.2d 74, (4th Cir. 1993)). 49 ERISA s preemption clause states: the Fred A. Smith can be reached at: One North Wacker Drive, Suite 4200 Chicago, IL David M. Goldhaber can be reached at: One North Wacker Drive, Suite 4200 Chicago, IL provision of this subchapter... shall supersede any and all state laws insofar as they may now or hereafter relate to any employee benefit plan U.S.C. 1144(a). 50 See, e.g., Botsford v. Blue Cross and Blue Shield of Montana, Inc., 314 F.3d 390, 397 (9th Cir. 2002) (instructing the district court to dismiss plaintiff s claim under the Montana Unfair Trade Practices Act with prejudice after concluding that FEHBA completely preempted the state law claim); Doyle v. Blue Cross Blue Shield of Illinois, 149 F.Supp.2d 427, 432 (N.D. Ill. 2001) (concluding that Congress clearly intended for the terms of FEHBA plan contracts to completely preempt state law causes of action relating to health insurance or plans); Blue Cross and Blue Shield of Illinois v. Cruz, 2003 WL (N.D. Ill. 2003) (recognizing FEHBA preemption for coverage and benefit claims); Kight v. Kaiser Foundation Health Plan of the Mid-Atlantic States, Inc., 34 F.Supp.2d 334, (E.D. Va. 1999) (recognizing that [c]onsidering the language of the statute and the legislative history, there can be no question that Congress has clearly manifested an intent to preempt state law regarding the terms and benefits of FEHBA plans and holding that challenges to benefit determinations, even when cast as state law claims, fall within FEHBA s civil enforcement provisions); Rievely v. Blue Cross Blue Shield of Tennessee, 69 F.Supp.2d 1028, (E.D. Tenn. 1999) (denying motion to remand and finding removal proper based on FEHBA s preemption of state law claims). 51 See Pegram v. Herdrich, 530 U.S. 211, 120 S.Ct (2000). 52 See Roach v. Mail Handlers Benefit Plan, 298 F.3d 847 (9th Cir. 2002) at at See, e.g., Kincade v. Group Health Services of Oklahoma, 945 P.2d 485 (Okla. 1997). 57 Linda Greenhouse, Justices Hear Arguments About H.M.O. Malpractice Lawsuits, THE NEW YORK TIMES (March 24, 2004). 58 Aetna Health, Inc. v. Davila, 542 U.S. 200, 331, 124 S.Ct (2004). 59 at See McCoy v. Unicare Life and Health Ins. Co., 2004 WL , 34 Employee Benefits Cas (N.D.Ill. October 14, 2004). 61 The court cited Haller v. Kaiser Found. Health Plan of the Northwest, 184 F.Supp.2d 1040, (D. Or (explaining that there is a spit among the district courts and citing various cases for both positions). 62 The court followed the reasoning set forth in Doyle v. Blue Cross Blue Shield of Illinois, 149 F.Supp.2d 427 (N.D. Ill. 2001) and Rievley v. Blue Cross Blue Shield of Tennessee, 69 F.Supp.2d 1028 (E.D. Tenn. 1999). In both cases, the courts analyzed the expansive language included in FEHBA and noted that the 1998 amendment to the preemption clause. 63 Davila, 542 U.S McCoy, 2004 WL at at Benotti v. First Health, No. DC (N.J. Super. L. Div.) (finding the rationale expressed in McCoy for complete preemption under FEHBA to be persuasive). This article first appeared in the American Bar Association Health Law Section s The Health Lawyer (vol. 18, no. 1, October 2005). Copyright 2005 American Bar Association. Reprinted with permission. Reproduced with permission. All rights reserved. This information or any portion thereof may not be copied or disseminated in any form or by any means or downloaded or stored in an electronic database or retrieval system without the express written consent of the American Bar Association Sedgwick, Detert, Moran & Arnold LLP. This communication is published as an information service for clients and friends of the firm and does not constitute the rendering of legal advice or other professional service. Chicago Dallas London Los Angeles New York Newark Orange County Paris San Francisco Zurich [ ]

2:04-cv-72741-DPH-RSW Doc # 17 Filed 08/31/05 Pg 1 of 5 Pg ID 160 UNITED STATES DISTRICT COURT EASTERN DISTRICT OF MICHIGAN SOUTHERN DIVISION

2:04-cv-72741-DPH-RSW Doc # 17 Filed 08/31/05 Pg 1 of 5 Pg ID 160 UNITED STATES DISTRICT COURT EASTERN DISTRICT OF MICHIGAN SOUTHERN DIVISION 2:04-cv-72741-DPH-RSW Doc # 17 Filed 08/31/05 Pg 1 of 5 Pg ID 160 UNITED STATES DISTRICT COURT EASTERN DISTRICT OF MICHIGAN SOUTHERN DIVISION STATE FARM MUTUAL AUTOMOBILE INSURANCE COMPANY, v. Plaintiff,

More information

Case 4:09-cv-00575 Document 37 Filed in TXSD on 08/16/10 Page 1 of 6 UNITED STATES DISTRICT COURT SOUTHERN DISTRICT OF TEXAS HOUSTON DIVISION

Case 4:09-cv-00575 Document 37 Filed in TXSD on 08/16/10 Page 1 of 6 UNITED STATES DISTRICT COURT SOUTHERN DISTRICT OF TEXAS HOUSTON DIVISION Case 4:09-cv-00575 Document 37 Filed in TXSD on 08/16/10 Page 1 of 6 UNITED STATES DISTRICT COURT SOUTHERN DISTRICT OF TEXAS HOUSTON DIVISION AMERICAN SURGICAL ASSISTANTS, INC., VS. Plaintiff, CIGNA HEALTHCARE

More information

IN THE UNITED STATES COURT OF APPEALS FOR THE ELEVENTH CIRCUIT. No. 15-10459. D.C. Docket No. 1:14-cv-24098-UU. versus

IN THE UNITED STATES COURT OF APPEALS FOR THE ELEVENTH CIRCUIT. No. 15-10459. D.C. Docket No. 1:14-cv-24098-UU. versus Case: 15-10459 Date Filed: 12/01/2015 Page: 1 of 14 [PUBLISH] IN THE UNITED STATES COURT OF APPEALS FOR THE ELEVENTH CIRCUIT No. 15-10459 D.C. Docket No. 1:14-cv-24098-UU GABLES INSURANCE RECOVERY, INC.,

More information

IN THE UNITED STATES DISTRICT COURT FOR THE EASTERN DISTRICT OF PENNSYLVANIA

IN THE UNITED STATES DISTRICT COURT FOR THE EASTERN DISTRICT OF PENNSYLVANIA IN THE UNITED STATES DISTRICT COURT FOR THE EASTERN DISTRICT OF PENNSYLVANIA CRAIG VAN ARSDEL Plaintiff, CIVIL ACTION NO. 14-2579 v. LIBERTY MUTUAL INSURANCE COMPANY, Defendant. Smith, J. September 5,

More information

Aetna v. Davila. In the summer of 2004, the. A New Look at ERISA Preemption of Medical Malpractice Claims. By Michael Kolosky

Aetna v. Davila. In the summer of 2004, the. A New Look at ERISA Preemption of Medical Malpractice Claims. By Michael Kolosky Aetna v. Davila A New Look at ERISA Preemption of Medical Malpractice Claims By Michael Kolosky In the summer of 2004, the U.S. Supreme Court released a groundbreaking decision, Aetna v. Davila, 1 addressing

More information

HMOs May Be Exposed to State Law Malpractice Actions for Mixed Treatment and Eligibility Decisions. Journal of Pension Benefits Winter 2001

HMOs May Be Exposed to State Law Malpractice Actions for Mixed Treatment and Eligibility Decisions. Journal of Pension Benefits Winter 2001 HMOs May Be Exposed to State Law Malpractice Actions for Mixed Treatment and Eligibility Decisions Journal of Pension Benefits Winter 2001 Tess J. Ferrera Overview Inherent difficulties with prevailing

More information

IN THE COMMONWEALTH COURT OF PENNSYLVANIA

IN THE COMMONWEALTH COURT OF PENNSYLVANIA IN THE COMMONWEALTH COURT OF PENNSYLVANIA Safe Auto Insurance Company, : Appellant : : v. : No. 2247 C.D. 2004 : Argued: February 28, 2005 School District of Philadelphia, : Pride Coleman and Helena Coleman

More information

IN THE UNITED STATES DISTRICT COURT FOR THE EASTERN DISTRICT OF PENNSYLVANIA EXPLANATION AND ORDER

IN THE UNITED STATES DISTRICT COURT FOR THE EASTERN DISTRICT OF PENNSYLVANIA EXPLANATION AND ORDER IN THE UNITED STATES DISTRICT COURT FOR THE EASTERN DISTRICT OF PENNSYLVANIA ARNOLD L. MESHKOV, M.D., : Plaintiff : : v. : 01-CV-2586 : UNUM PROVIDENT CORP., et al., : Defendants : EXPLANATION AND ORDER

More information

2013 IL App (3d) 120130-U. Order filed September 23, 2013 IN THE APPELLATE COURT OF ILLINOIS THIRD DISTRICT A.D., 2013

2013 IL App (3d) 120130-U. Order filed September 23, 2013 IN THE APPELLATE COURT OF ILLINOIS THIRD DISTRICT A.D., 2013 NOTICE: This order was filed under Supreme Court Rule 23 and may not be cited as precedent by any party except in the limited circumstances allowed under Rule 23(e)(1). 2013 IL App (3d) 120130-U Order

More information

UNITED STATES COURT OF APPEALS FOR THE NINTH CIRCUIT

UNITED STATES COURT OF APPEALS FOR THE NINTH CIRCUIT FOR PUBLICATION UNITED STATES COURT OF APPEALS FOR THE NINTH CIRCUIT MATTHEW PRICHARD, Plaintiff-Appellant, v. METROPOLITAN LIFE INSURANCE COMPANY; IBM LONG TERM DISABILITY PLAN, Defendants-Appellees.

More information

ASSEMBLY BILL No. 597

ASSEMBLY BILL No. 597 AMENDED IN ASSEMBLY APRIL 14, 2015 california legislature 2015 16 regular session ASSEMBLY BILL No. 597 Introduced by Assembly Member Cooley February 24, 2015 An act to amend Sections 36 and 877 of, and

More information

ASSEMBLY BILL No. 597

ASSEMBLY BILL No. 597 california legislature 2015 16 regular session ASSEMBLY BILL No. 597 Introduced by Assembly Member Cooley February 24, 2015 An act to amend Sections 36 and 877 of, and to add Chapter 6 (commencing with

More information

Whether Certain Provisions Of The Maryland Insurance Code, In the Health Insurance

Whether Certain Provisions Of The Maryland Insurance Code, In the Health Insurance No. 98, September Term, 2001 CONNECTICUT GENERAL LIFE INSURANCE COMPANY v. INSURANCE COMMISSIONER FOR THE STATE OF MARYLAND Whether Certain Provisions Of The Maryland Insurance Code, In the Health Insurance

More information

Case 8:13-cv-01731-VMC-TBM Document 36 Filed 03/17/14 Page 1 of 11 PageID 134 UNITED STATES DISTRICT COURT MIDDLE DISTRICT OF FLORIDA TAMPA DIVISION

Case 8:13-cv-01731-VMC-TBM Document 36 Filed 03/17/14 Page 1 of 11 PageID 134 UNITED STATES DISTRICT COURT MIDDLE DISTRICT OF FLORIDA TAMPA DIVISION Case 8:13-cv-01731-VMC-TBM Document 36 Filed 03/17/14 Page 1 of 11 PageID 134 JOHN and JOANNA ROBERTS, UNITED STATES DISTRICT COURT MIDDLE DISTRICT OF FLORIDA TAMPA DIVISION Plaintiffs, v. Case No. 8:13-cv-1731-T-33TBM

More information

United States Court of Appeals

United States Court of Appeals In the United States Court of Appeals For the Seventh Circuit No. 14-1984 MARY C. FONTAINE, Plaintiff-Appellee, v. METROPOLITAN LIFE INSURANCE COMPANY, Defendant-Appellant. Appeal from the United States

More information

Illinois Official Reports

Illinois Official Reports Illinois Official Reports Appellate Court Certain Underwriters at Lloyd s London v. The Burlington Insurance Co., 2015 IL App (1st) 141408 Appellate Court Caption CERTAIN UNDERWRITERS AT LLOYD S LONDON,

More information

Case 2:10-cv-02263-JAR Document 98 Filed 05/04/11 Page 1 of 8 IN THE UNITED STATES DISTRICT COURT FOR THE DISTRICT OF KANSAS

Case 2:10-cv-02263-JAR Document 98 Filed 05/04/11 Page 1 of 8 IN THE UNITED STATES DISTRICT COURT FOR THE DISTRICT OF KANSAS Case 2:10-cv-02263-JAR Document 98 Filed 05/04/11 Page 1 of 8 IN THE UNITED STATES DISTRICT COURT FOR THE DISTRICT OF KANSAS SANDRA H. DEYA and EDWIN DEYA, individually and as next friends and natural

More information

2015 IL App (5th) 140227-U NO. 5-14-0227 IN THE APPELLATE COURT OF ILLINOIS FIFTH DISTRICT

2015 IL App (5th) 140227-U NO. 5-14-0227 IN THE APPELLATE COURT OF ILLINOIS FIFTH DISTRICT NOTICE Decision filed 10/15/15. The text of this decision may be changed or corrected prior to the filing of a Petition for Rehearing or the disposition of the same. 2015 IL App (5th 140227-U NO. 5-14-0227

More information

2015 IL App (1st) 141985-U. No. 1-14-1985 IN THE APPELLATE COURT OF ILLINOIS FIRST JUDICIAL DISTRICT

2015 IL App (1st) 141985-U. No. 1-14-1985 IN THE APPELLATE COURT OF ILLINOIS FIRST JUDICIAL DISTRICT 2015 IL App (1st) 141985-U No. 1-14-1985 NOTICE: This order was filed under Supreme Court Rule 23 and may not be cited as precedent by any party except in the limited circumstances allowed under Rule 23(e)(1).

More information

IN THE COURT OF APPEALS OF INDIANA

IN THE COURT OF APPEALS OF INDIANA FOR PUBLICATION ATTORNEY FOR APPELLANT: ROBERT M. EDWARDS, JR. Jones Obenchain, LLP South Bend, Indiana ATTORNEY FOR APPELLEE: KATHRYN A. MOLL Nation Schoening Moll Fortville, Indiana IN THE COURT OF APPEALS

More information

Employee Relations. Howard S. Lavin and Elizabeth E. DiMichele

Employee Relations. Howard S. Lavin and Elizabeth E. DiMichele VOL. 34, NO. 4 SPRING 2009 Employee Relations L A W J O U R N A L Split Circuits Does Charging Party s Receipt of a Right-to-Sue Letter and Commencement of a Lawsuit Divest the EEOC of its Investigative

More information

The Appeals Process For Medical Billing

The Appeals Process For Medical Billing The Appeals Process For Medical Billing Steven M. Verno Professor, Medical Coding and Billing What is an Appeal? An appeal is a legal process where you are asking the insurance company to review it s adverse

More information

Arizona State Senate Issue Paper June 22, 2010 MEDICAL MALPRACTICE. Statute of Limitations. Note to Reader: INTRODUCTION

Arizona State Senate Issue Paper June 22, 2010 MEDICAL MALPRACTICE. Statute of Limitations. Note to Reader: INTRODUCTION Arizona State Senate Issue Paper June 22, 2010 Note to Reader: The Senate Research Staff provides nonpartisan, objective legislative research, policy analysis and related assistance to the members of the

More information

COURT OF APPEAL, FOURTH APPELLATE DISTRICT DIVISION ONE STATE OF CALIFORNIA

COURT OF APPEAL, FOURTH APPELLATE DISTRICT DIVISION ONE STATE OF CALIFORNIA Filed 4/11/13 CERTIFIED FOR PUBLICATION COURT OF APPEAL, FOURTH APPELLATE DISTRICT DIVISION ONE STATE OF CALIFORNIA BATTAGLIA ENTERPRISES, INC., D063076 Petitioner, v. SUPERIOR COURT OF SAN DIEGO COUNTY,

More information

IN THE UNITED STATES DISTRICT COURT FOR THE DISTRICT OF MARYLAND

IN THE UNITED STATES DISTRICT COURT FOR THE DISTRICT OF MARYLAND IN THE UNITED STATES DISTRICT COURT FOR THE DISTRICT OF MARYLAND JOAN FALLOWS KLUGE, Plaintiff, v. Civil No. L-10-00022 LIFE INSURANCE COMPANY OF NORTH AMERICA Defendant. MEMORANDUM Plaintiff, Joan Fallows

More information

The two sides disagree on how much money, if any, could have been awarded if Plaintiffs, on behalf of the class, were to prevail at trial.

The two sides disagree on how much money, if any, could have been awarded if Plaintiffs, on behalf of the class, were to prevail at trial. SUPERIOR COURT OF THE COUNTY OF LOS ANGELES If you are a subscriber of Kaiser Foundation Health Plan, Inc. and you, or your dependent, have been diagnosed with an autism spectrum disorder, you could receive

More information

IN THE APPELLATE COURT OF ILLINOIS FIRST DISTRICT

IN THE APPELLATE COURT OF ILLINOIS FIRST DISTRICT 2016 IL App (1st) 150810-U Nos. 1-15-0810, 1-15-0942 cons. Fourth Division June 30, 2016 NOTICE: This order was filed under Supreme Court Rule 23 and may not be cited as precedent by any party except in

More information

PEOs Deemed MEWAs Have State and Federal Regulatory Concerns. PEO Insider Autumn 2007. Tess J. Ferrera

PEOs Deemed MEWAs Have State and Federal Regulatory Concerns. PEO Insider Autumn 2007. Tess J. Ferrera PEOs Deemed MEWAs Have State and Federal Regulatory Concerns PEO Insider Autumn 2007 Tess J. Ferrera The Employee Retirement Income Security Act of 1974 (ERISA), with exceptions not relevant here, defines

More information

NORTHWESTERN NATIONAL LIFE INSURANCE COMPANY v. Bruce A. HESLIP 91-300 832 S.W.2d 463 Supreme Court of Arkansas Opinion delivered May 11, 1992

NORTHWESTERN NATIONAL LIFE INSURANCE COMPANY v. Bruce A. HESLIP 91-300 832 S.W.2d 463 Supreme Court of Arkansas Opinion delivered May 11, 1992 ARK.] INS. CO. V. HESLIP 319 NORTHWESTERN NATIONAL LIFE INSURANCE COMPANY v. Bruce A. HESLIP 91-300 832 S.W.2d 463 Supreme Court of Arkansas Opinion delivered May 11, 1992. MOTIONS MOTION DENIED BY TRIAL

More information

Case 3:07-cv-01180-TEM Document 56 Filed 04/27/2009 Page 1 of 12 UNITED STATES DISTRICT COURT MIDDLE DISTRICT OF FLORIDA JACKSONVILLE DIVISION

Case 3:07-cv-01180-TEM Document 56 Filed 04/27/2009 Page 1 of 12 UNITED STATES DISTRICT COURT MIDDLE DISTRICT OF FLORIDA JACKSONVILLE DIVISION Case 3:07-cv-01180-TEM Document 56 Filed 04/27/2009 Page 1 of 12 UNITED STATES DISTRICT COURT MIDDLE DISTRICT OF FLORIDA JACKSONVILLE DIVISION JAMES E. TOMLINSON and DARLENE TOMLINSON, his wife, v. Plaintiffs,

More information

AN ACT. To amend chapter 383, RSMo, by adding thereto thirteen new sections relating to the Missouri health care arbitration act.

AN ACT. To amend chapter 383, RSMo, by adding thereto thirteen new sections relating to the Missouri health care arbitration act. 3721L.01I AN ACT To amend chapter 383, RSMo, by adding thereto thirteen new sections relating to the Missouri health care arbitration act. BE IT ENACTED BY THE GENERAL ASSEMBLY OF THE STATE OF MISSOURI,

More information

UNITED STATES DISTRICT COURT WESTERN DISTRICT OF WASHINGTON AT SEATTLE I. INTRODUCION

UNITED STATES DISTRICT COURT WESTERN DISTRICT OF WASHINGTON AT SEATTLE I. INTRODUCION Case :-cv-00-rsm Document Filed 0// Page of UNITED STATES DISTRICT COURT WESTERN DISTRICT OF WASHINGTON AT SEATTLE CGI TECHNOLOGIES AND SOLUTIONS, INC., in its capacity as sponsor and fiduciary for CGI

More information

INTRODUCTION TO ERISA LONG-TERM DISABILITY CLAIMS

INTRODUCTION TO ERISA LONG-TERM DISABILITY CLAIMS INTRODUCTION TO ERISA LONG-TERM DISABILITY CLAIMS By: Clay Williams SinclairWilliams LLC 2100A SouthBridge Parkway, Suite 336 Birmingham, AL 35209 (p) 205.868.0818 (f) 205.868.0894 e-mail: mcw@sinclairwilliams.com

More information

UNITED STATES DISTRICT COURT EASTERN DISTRICT OF MISSOURI EASTERN DIVISION

UNITED STATES DISTRICT COURT EASTERN DISTRICT OF MISSOURI EASTERN DIVISION Case: 4:12-cv-02030-DDN Doc. #: 42 Filed: 06/19/13 Page: 1 of 8 PageID #: UNITED STATES DISTRICT COURT EASTERN DISTRICT OF MISSOURI EASTERN DIVISION MARY HAYDEN, ) individually and as plaintiff

More information

JUSTICE HOFFMAN delivered the opinion of the court: The plaintiff, Melissa Callahan, appeals from an order of the

JUSTICE HOFFMAN delivered the opinion of the court: The plaintiff, Melissa Callahan, appeals from an order of the SECOND DIVISION FILED: July 3, 2007 No. 1-06-3178 MELISSA CALLAHAN, ) APPEAL FROM THE ) CIRCUIT COURT OF Plaintiff-Appellant, ) COOK COUNTY ) v. ) ) No. 05 L 006795 EDGEWATER CARE & REHABILITATION CENTER,

More information

UNITED STATES DISTRICT COURT SOUTHERN DISTRICT OF CALIFORNIA

UNITED STATES DISTRICT COURT SOUTHERN DISTRICT OF CALIFORNIA -BGS Francis v. Anacomp, Inc. et al Doc. 1 UNITED STATES DISTRICT COURT SOUTHERN DISTRICT OF CALIFORNIA ROBERT FRANCIS, CASE NO.cv BEN (BGS) Plaintiff, ORDER: vs. ANACOMP, INC. ACCIDENTAL DEATH AND DISMEMBERMENT

More information

grouped into five different subject areas relating to: 1) planning for discovery and initial disclosures; 2)

grouped into five different subject areas relating to: 1) planning for discovery and initial disclosures; 2) ESI: Federal Court An introduction to the new federal rules governing discovery of electronically stored information In September 2005, the Judicial Conference of the United States unanimously approved

More information

IN THE UNITED STATES COURT OF APPEALS FOR THE FIFTH CIRCUIT

IN THE UNITED STATES COURT OF APPEALS FOR THE FIFTH CIRCUIT IN THE UNITED STATES COURT OF APPEALS United States Court of Appeals FOR THE FIFTH CIRCUIT Fifth Circuit F I L E D November 19, 2009 No. 09-20049 Charles R. Fulbruge III Clerk DEALER COMPUTER SERVICES

More information

kaiser medicaid and the uninsured commission on September 2011

kaiser medicaid and the uninsured commission on September 2011 P O L I C Y B R I E F kaiser commission on medicaid and the uninsured September 2011 Explaining Douglas v. Independent Living Center: Questions about the Upcoming United States Supreme Court Case Regarding

More information

) ) ) ) ) ) ) ) ) ) ) )

) ) ) ) ) ) ) ) ) ) ) ) Case :0-cv-000-JAT Document Filed 0/0/0 Page of 0 WO Cindy Loza, et al, vs. Plaintiffs, Native American Air Ambulance, et al, Defendants. IN THE UNITED STATES DISTRICT COURT FOR THE DISTRICT OF ARIZONA

More information

Present: Carrico, C.J., Compton, Stephenson, Lacy, Keenan, Koontz, JJ., and Whiting, Senior Justice NORTHBROOK PROPERTY AND CASUALTY INSURANCE COMPANY

Present: Carrico, C.J., Compton, Stephenson, Lacy, Keenan, Koontz, JJ., and Whiting, Senior Justice NORTHBROOK PROPERTY AND CASUALTY INSURANCE COMPANY Present: Carrico, C.J., Compton, Stephenson, Lacy, Keenan, Koontz, JJ., and Whiting, Senior Justice VIRGINIA ELECTRIC AND POWER COMPANY OPINION BY JUSTICE LAWRENCE L. KOONTZ, v. Record No. 951919 September

More information

Case: 1:14-cv-06113 Document #: 45 Filed: 03/22/16 Page 1 of 9 PageID #:299

Case: 1:14-cv-06113 Document #: 45 Filed: 03/22/16 Page 1 of 9 PageID #:299 Case: 1:14-cv-06113 Document #: 45 Filed: 03/22/16 Page 1 of 9 PageID #:299 UNITED STATES DISTRICT COURT NORTHERN DISTRICT OF ILLINOIS EASTERN DIVISION MARIE RODGERS, ) ) Plaintiff, ) ) v. ) No. 14 C 6113

More information

IN THE COURT OF APPEAL OF THE STATE OF CALIFORNIA SECOND APPELLATE DISTRICT DIVISION EIGHT

IN THE COURT OF APPEAL OF THE STATE OF CALIFORNIA SECOND APPELLATE DISTRICT DIVISION EIGHT Filed 10/11/13 CERTIFIED FOR PUBLICATION IN THE COURT OF APPEAL OF THE STATE OF CALIFORNIA SECOND APPELLATE DISTRICT DIVISION EIGHT ED AGUILAR, Plaintiff and Respondent, v. B238853 (Los Angeles County

More information

57 of 62 DOCUMENTS. No. 5-984 / 05-0037 COURT OF APPEALS OF IOWA. 2006 Iowa App. LEXIS 172. March 1, 2006, Filed

57 of 62 DOCUMENTS. No. 5-984 / 05-0037 COURT OF APPEALS OF IOWA. 2006 Iowa App. LEXIS 172. March 1, 2006, Filed Page 1 57 of 62 DOCUMENTS JAMES C. GARDNER, JR., Plaintiff-Appellant, vs. HEARTLAND EXPRESS, INC., and NATIONAL UNION FIRE INSURANCE COMPANY, Defendants-Appellees. No. 5-984 / 05-0037 COURT OF APPEALS

More information

IN THE UNITED STATES DISTRICT COURT FOR THE DISTRICT OF MARYLAND : : : : : : : MEMORANDUM

IN THE UNITED STATES DISTRICT COURT FOR THE DISTRICT OF MARYLAND : : : : : : : MEMORANDUM IN THE UNITED STATES DISTRICT COURT FOR THE DISTRICT OF MARYLAND CATHERINE HOWELL, et al. Plaintiffs v. STATE FARM INSURANCE COMPANIES, et al. Defendants Civil No. L-04-1494 MEMORANDUM This is a proposed

More information

IN THE UNITED STATES DISTRICT COURT FOR THE EASTERN DISTRICT OF PENNSYLVANIA

IN THE UNITED STATES DISTRICT COURT FOR THE EASTERN DISTRICT OF PENNSYLVANIA IN THE UNITED STATES DISTRICT COURT FOR THE EASTERN DISTRICT OF PENNSYLVANIA HOWARD MEDICAL, INC. t/a CIVIL ACTION ADVANCE AMBULANCE SERVICE, NO. 00-5977 Plaintiff, v. TEMPLE UNIVERSITY HOSPITAL, t/a TEMPLE

More information

ERISA Causes of Action *

ERISA Causes of Action * 1 ERISA Causes of Action * ERISA authorizes a variety of causes of action to remedy violations of the statute, to enforce the terms of a benefit plan, or to provide other relief to a plan, its participants

More information

Case 3:09-cv-01222-MMH-JRK Document 33 Filed 08/10/10 Page 1 of 8 UNITED STATES DISTRICT COURT MIDDLE DISTRICT OF FLORIDA JACKSONVILLE DIVISION

Case 3:09-cv-01222-MMH-JRK Document 33 Filed 08/10/10 Page 1 of 8 UNITED STATES DISTRICT COURT MIDDLE DISTRICT OF FLORIDA JACKSONVILLE DIVISION Case 3:09-cv-01222-MMH-JRK Document 33 Filed 08/10/10 Page 1 of 8 UNITED STATES DISTRICT COURT MIDDLE DISTRICT OF FLORIDA JACKSONVILLE DIVISION PHL VARIABLE INSURANCE COMPANY, Plaintiff, vs. Case No. 3:09-cv-1222-J-34JRK

More information

No. 2--07--1205 Filed: 12-19-08 IN THE APPELLATE COURT OF ILLINOIS SECOND DISTRICT

No. 2--07--1205 Filed: 12-19-08 IN THE APPELLATE COURT OF ILLINOIS SECOND DISTRICT Filed: 12-19-08 IN THE APPELLATE COURT OF ILLINOIS SECOND DISTRICT WESTPORT INSURANCE Appeal from the Circuit Court CORPORATION, of McHenry County. Plaintiff and Counterdefendant-Appellee, v. No. 04--MR--53

More information

Third District Court of Appeal State of Florida, July Term, A.D. 2012

Third District Court of Appeal State of Florida, July Term, A.D. 2012 Third District Court of Appeal State of Florida, July Term, A.D. 2012 Opinion filed September 19, 2012. Not final until disposition of timely filed motion for rehearing. No. 3D12-353 Lower Tribunal No.

More information

Anderson Brothers, Inc. v. St. Paul Fire and Marine Insurance Co.

Anderson Brothers, Inc. v. St. Paul Fire and Marine Insurance Co. Public Land and Resources Law Review Volume 0 Fall 2013 Case Summaries Anderson Brothers, Inc. v. St. Paul Fire and Marine Insurance Co. Katelyn J. Hepburn University of Montana School of Law, katelyn.hepburn@umontana.edu

More information

NORTHWESTERN NATIONAL LIFE INSURANCE COMPANY v. Bruce A. HESLIP 89-267 790 S.W.2d 152 Supreme Court of Arkansas Opinion delivered May 21, 1990

NORTHWESTERN NATIONAL LIFE INSURANCE COMPANY v. Bruce A. HESLIP 89-267 790 S.W.2d 152 Supreme Court of Arkansas Opinion delivered May 21, 1990 310 Co. v. HESLIP [302 NORTHWESTERN NATIONAL LIFE INSURANCE COMPANY v. Bruce A. HESLIP 89-267 790 S.W.2d 152 Supreme Court of Arkansas Opinion delivered May 21, 1990 ESTOPPEL EQUITABLE ESTOPPEL MAY BE

More information

2014 IL App (1st) 130250-U. No. 1-13-0250 IN THE APPELLATE COURT OF ILLINOIS FIRST JUDICIAL DISTRICT

2014 IL App (1st) 130250-U. No. 1-13-0250 IN THE APPELLATE COURT OF ILLINOIS FIRST JUDICIAL DISTRICT 2014 IL App (1st) 130250-U FIFTH DIVISION September 12, 2014 No. 1-13-0250 NOTICE: This order was filed under Supreme Court Rule 23 and may not be cited as precedent by any party except in the limited

More information

IN THE SUPREME COURT OF TEXAS

IN THE SUPREME COURT OF TEXAS IN THE SUPREME COURT OF TEXAS NO. 13-1006 IN RE ESSEX INSURANCE COMPANY, RELATOR ON PETITION FOR WRIT OF MANDAMUS PER CURIAM Rafael Zuniga sued San Diego Tortilla (SDT) for personal injuries and then added

More information

FILED May 21, 2015 Carla Bender 4 th District Appellate Court, IL

FILED May 21, 2015 Carla Bender 4 th District Appellate Court, IL NOTICE This order was filed under Supreme Court Rule 23 and may not be cited as precedent by any party except in the limited circumstances allowed under Rule 23(e(1. 2015 IL App (4th 140713-U NO. 4-14-0713

More information

PART III MEDICAID LIEN RECOVERY. 1) From the estate of the Medicaid recipient.

PART III MEDICAID LIEN RECOVERY. 1) From the estate of the Medicaid recipient. PART III MEDICAID LIEN RECOVERY 1. Basics: 1) For Medicaid benefits that are correctly paid, there are two major instances in which Medicaid may seek to impose and recover liens: 1) From the estate of

More information

Case 5:14-cv-00141-XR Document 37 Filed 08/13/14 Page 1 of 7

Case 5:14-cv-00141-XR Document 37 Filed 08/13/14 Page 1 of 7 Case 5:14-cv-00141-XR Document 37 Filed 08/13/14 Page 1 of 7 IN THE UNITED STATES DISTRICT COURT FOR THE WESTERN DISTRICT OF TEXAS SAN ANTONIO DIVISION TAMMY FABIAN, v. Plaintiffs, CAROLYN COLVIN, Commissioner

More information

THE GAVEL. litigating employee benefit insurance claims [page 14]

THE GAVEL. litigating employee benefit insurance claims [page 14] OCTLA THE GAVEL A QUARTERLY PUBLICATION of the Orange County Trial Lawyers Association Nuts & Bolts post-mortem detection of thc proving financial condition the impact of impact make em answer on being

More information

IN THE UNITED STATES COURT OF APPEALS FOR THE FIFTH CIRCUIT

IN THE UNITED STATES COURT OF APPEALS FOR THE FIFTH CIRCUIT Case: 15-10510 Document: 00513424063 Page: 1 Date Filed: 03/15/2016 IN THE UNITED STATES COURT OF APPEALS FOR THE FIFTH CIRCUIT United States Court of Appeals Fifth Circuit FILED March 15, 2016 Lyle W.

More information

Reed Armstrong Quarterly

Reed Armstrong Quarterly Reed Armstrong Quarterly January 2009 http://www.reedarmstrong.com/default.asp Contributors: William B. Starnes II Tori L. Cox IN THIS ISSUE: Joint and Several Liability The Fault of Settled Tortfeasors

More information

UNITED STATES DISTRICT COURT SOUTHERN DISTRICT OF FLORIDA WEST PALM BEACH DIVISION COMPLAINT FOR DECLARATORY JUDGMENT I.

UNITED STATES DISTRICT COURT SOUTHERN DISTRICT OF FLORIDA WEST PALM BEACH DIVISION COMPLAINT FOR DECLARATORY JUDGMENT I. UNITED STATES DISTRICT COURT SOUTHERN DISTRICT OF FLORIDA WEST PALM BEACH DIVISION JANICE LEE, ) ) Case No. Plaintiff, ) ) vs. ) ) BETHESDA HOSPITAL, INC. ) ) Defendant. ) ) COMPLAINT FOR DECLARATORY JUDGMENT

More information

UNITED STATES COURT OF APPEALS FOR THE NINTH CIRCUIT

UNITED STATES COURT OF APPEALS FOR THE NINTH CIRCUIT FOR PUBLICATION UNITED STATES COURT OF APPEALS FOR THE NINTH CIRCUIT KATHRYN MCOMIE-GRAY, Plaintiff-Appellant, No. 10-16487 v. D.C. No. 2:09-cv-02422- BANK OF AMERICA HOME LOANS, FKA Countrywide Home Loans,

More information

Case: 2:04-cv-01110-JLG-NMK Doc #: 33 Filed: 06/13/05 Page: 1 of 7 PAGEID #:

Case: 2:04-cv-01110-JLG-NMK Doc #: 33 Filed: 06/13/05 Page: 1 of 7 PAGEID #: <pageid> Case: 2:04-cv-01110-JLG-NMK Doc #: 33 Filed: 06/13/05 Page: 1 of 7 PAGEID #: IN THE UNITED STATES DISTRICT COURT FOR THE SOUTHERN DISTRICT OF OHIO EASTERN DIVISION ALVIN E. WISEMAN, Plaintiff,

More information

2014 IL App (1st) 141707. No. 1-14-1707 IN THE APPELLATE COURT OF ILLINOIS FIRST JUDICIAL DISTRICT

2014 IL App (1st) 141707. No. 1-14-1707 IN THE APPELLATE COURT OF ILLINOIS FIRST JUDICIAL DISTRICT 2014 IL App (1st) 141707 FIRST DIVISION AUGUST 31, 2015 No. 1-14-1707 NOTICE: This order was filed under Supreme Court Rule 23 and may not be cited as precedent by any party except in the limited circumstances

More information

Arbitration in Seamen Cases

Arbitration in Seamen Cases Arbitration in Seamen Cases Recently, seamen have been facing mandatory arbitration provisions in their employment agreements which deny them their rights to a jury trial under the Jones Act, and also

More information

IN THE SUPREME COURT OF THE STATE OF KANSAS. No. 99,491. KANSAS DEPARTMENT OF REVENUE, Appellant, JILL POWELL, Appellee. SYLLABUS BY THE COURT

IN THE SUPREME COURT OF THE STATE OF KANSAS. No. 99,491. KANSAS DEPARTMENT OF REVENUE, Appellant, JILL POWELL, Appellee. SYLLABUS BY THE COURT IN THE SUPREME COURT OF THE STATE OF KANSAS No. 99,491 KANSAS DEPARTMENT OF REVENUE, Appellant, v. JILL POWELL, Appellee. SYLLABUS BY THE COURT 1. Under the Kansas Act for Judicial Review and Civil Enforcement

More information

Current Legal Issues Facing Managed Care

Current Legal Issues Facing Managed Care Crowell & Moring Current Legal Issues Facing Managed Care Presenters: Chris Flynn, Esq. Crowell & Moring LLP April 15, 2011 14995921 1 Provider Disputes Arising Out Of SIUs And Anti-Fraud Efforts A. Background

More information

Colorado s Civil Access Pilot Project and the Changing Landscape of Business Litigation

Colorado s Civil Access Pilot Project and the Changing Landscape of Business Litigation Colorado s Civil Access Pilot Project and the Changing Landscape of Business Litigation On January 1, 2012, new rules approved by the Colorado Supreme Court entitled the Civil Access Pilot Project ( CAPP

More information

Yarick v. PacifiCare: Claims Against Patient s Medicare Advantage HMO Preempted By Federal Law

Yarick v. PacifiCare: Claims Against Patient s Medicare Advantage HMO Preempted By Federal Law Yarick v. PacifiCare: Claims Against Patient s Medicare Advantage HMO Preempted By Federal Law By Craig A. Conway, J.D., LL.M. (Health Law) caconway@central.uh.edu Last month, a California appeals court

More information

Matter of Marcos Victor ORDAZ-Gonzalez, Respondent

Matter of Marcos Victor ORDAZ-Gonzalez, Respondent Matter of Marcos Victor ORDAZ-Gonzalez, Respondent Decided July 24, 2015 U.S. Department of Justice Executive Office for Immigration Review Board of Immigration Appeals A notice to appear that was served

More information

Should Claimant s Lawyers Have a Monopoly on Informal Communications with Treating Physicians in Workers Compensation Cases?

Should Claimant s Lawyers Have a Monopoly on Informal Communications with Treating Physicians in Workers Compensation Cases? Should Claimant s Lawyers Have a Monopoly on Informal Communications with Treating Physicians in Workers Compensation Cases? Prepared by Robert D. Ingram and Preston D. Holloway Moore Ingram Johnson &

More information

ADMINISTRATIVE ASSESSMENT OF CIVIL PENALTIES AGAINST FEDERAL AGENCIES UNDER THE CLEAN AIR ACT

ADMINISTRATIVE ASSESSMENT OF CIVIL PENALTIES AGAINST FEDERAL AGENCIES UNDER THE CLEAN AIR ACT ADMINISTRATIVE ASSESSMENT OF CIVIL PENALTIES AGAINST FEDERAL AGENCIES UNDER THE CLEAN AIR ACT The Clean Air Act authorizes the Environmental Protection Agency administratively to assess civil penalties

More information

UNITED STATES DISTRICT COURT EASTERN DISTRICT OF WISCONSIN. v. Case No. 14-mc-0052 DECISION AND ORDER

UNITED STATES DISTRICT COURT EASTERN DISTRICT OF WISCONSIN. v. Case No. 14-mc-0052 DECISION AND ORDER EEOC v. Union Pacific Railroad Company Doc. 13 UNITED STATES DISTRICT COURT EASTERN DISTRICT OF WISCONSIN EQUAL EMPLOYMENT OPPORTUNITY COMMISSION, Petitioner, v. Case No. 14-mc-0052 UNION PACIFIC RAILROAD

More information

Case 5:06-cv-00503-XR Document 20 Filed 09/28/06 Page 1 of 7 UNITED STATES DISTRICT COURT WESTERN DISTRICT OF TEXAS SAN ANTONIO DIVISION

Case 5:06-cv-00503-XR Document 20 Filed 09/28/06 Page 1 of 7 UNITED STATES DISTRICT COURT WESTERN DISTRICT OF TEXAS SAN ANTONIO DIVISION Case 5:06-cv-00503-XR Document 20 Filed 09/28/06 Page 1 of 7 UNITED STATES DISTRICT COURT WESTERN DISTRICT OF TEXAS SAN ANTONIO DIVISION UNITED STATES OF AMERICA, VS. Plaintiff, HENRY D. GOLTZ, EVANGELINA

More information

IN THE COURT OF APPEAL OF THE STATE OF CALIFORNIA SECOND APPELLATE DISTRICT DIVISION FIVE B254585

IN THE COURT OF APPEAL OF THE STATE OF CALIFORNIA SECOND APPELLATE DISTRICT DIVISION FIVE B254585 Filed 2/26/15 Vega v. Goradia CA2/5 NOT TO BE PUBLISHED IN THE OFFICIAL REPORTS California Rules of Court, rule 8.1115(a), prohibits courts and parties from citing or relying on opinions not certified

More information

IN THE UNITED STATES COURT OF APPEALS FOR THE ELEVENTH CIRCUIT. No. 14-11987 Non-Argument Calendar. Docket No. 1:13-cv-02128-WSD.

IN THE UNITED STATES COURT OF APPEALS FOR THE ELEVENTH CIRCUIT. No. 14-11987 Non-Argument Calendar. Docket No. 1:13-cv-02128-WSD. Case: 14-11987 Date Filed: 10/21/2014 Page: 1 of 11 [PUBLISH] IN THE UNITED STATES COURT OF APPEALS FOR THE ELEVENTH CIRCUIT No. 14-11987 Non-Argument Calendar Docket No. 1:13-cv-02128-WSD PIEDMONT OFFICE

More information

Case: 1:07-cv-04110 Document #: 44 Filed: 03/12/09 Page 1 of 5 PageID #:

Case: 1:07-cv-04110 Document #: 44 Filed: 03/12/09 Page 1 of 5 PageID #:<pageid> Case: 1:07-cv-04110 Document #: 44 Filed: 03/12/09 Page 1 of 5 PageID #: MARIO R. ALIANO, SR., IN THE UNITED STATES DISTRICT COURT FOR THE NORTHERN DISTRICT OF ILLINOIS EASTERN DIVISION Plaintiff,

More information

NOT TO BE PUBLISHED IN THE OFFICIAL REPORTS IN THE COURT OF APPEAL OF THE STATE OF CALIFORNIA SECOND APPELLATE DISTRICT DIVISION TWO

NOT TO BE PUBLISHED IN THE OFFICIAL REPORTS IN THE COURT OF APPEAL OF THE STATE OF CALIFORNIA SECOND APPELLATE DISTRICT DIVISION TWO Filed 8/27/14 Tesser Ruttenberg etc. v. Forever Entertainment CA2/2 NOT TO BE PUBLISHED IN THE OFFICIAL REPORTS California Rules of Court, rule 8.1115(a), prohibits courts and parties from citing or relying

More information

In the Court of Appeals of Georgia

In the Court of Appeals of Georgia WHOLE COURT NOTICE: Motions for reconsideration must be physically received in our clerk s office within ten days of the date of decision to be deemed timely filed. http://www.gaappeals.us/rules/ March

More information

THE IMPACT OF HIPAA ON PERSONAL INJURY PRACTICE

THE IMPACT OF HIPAA ON PERSONAL INJURY PRACTICE THE IMPACT OF HIPAA ON PERSONAL INJURY PRACTICE JEFFREY B. McCLURE Andrews & Kurth L.L.P. Copyright 2003 by Jeffrey B. McClure; Andrews & Kurth State Bar of Texas 19 TH ANNUAL ADVANCED PERSONAL INJURY

More information

TORT AND INSURANCE LAW REPORTER. Informal Discovery Interviews Between Defense Attorneys and Plaintiff's Treating Physicians

TORT AND INSURANCE LAW REPORTER. Informal Discovery Interviews Between Defense Attorneys and Plaintiff's Treating Physicians This article originally appeared in The Colorado Lawyer, Vol. 25, No. 26, June 1996. by Jeffrey R. Pilkington TORT AND INSURANCE LAW REPORTER Informal Discovery Interviews Between Defense Attorneys and

More information

REAL PROPERTY QUESTION CORNER: (By Kraettli Q. Epperson) THE ELUSIVE LEGAL MALPRACTICE STATUTE OF LIMITATIONS FOR ATTORNEY TITLE OPINIONS

REAL PROPERTY QUESTION CORNER: (By Kraettli Q. Epperson) THE ELUSIVE LEGAL MALPRACTICE STATUTE OF LIMITATIONS FOR ATTORNEY TITLE OPINIONS REAL PROPERTY QUESTION CORNER: (By Kraettli Q. Epperson) THE ELUSIVE LEGAL MALPRACTICE STATUTE OF LIMITATIONS FOR ATTORNEY TITLE OPINIONS (PARTS I AND II OF II PARTS) PUBLISHED IN THE OKLAHOMA COUNTY BAR

More information

NOT RECOMMENDED FOR FULL-TEXT PUBLICATION File Name: 14a0331n.06. No. 12-1887 UNITED STATES COURT OF APPEALS FOR THE SIXTH CIRCUIT

NOT RECOMMENDED FOR FULL-TEXT PUBLICATION File Name: 14a0331n.06. No. 12-1887 UNITED STATES COURT OF APPEALS FOR THE SIXTH CIRCUIT NOT RECOMMENDED FOR FULL-TEXT PUBLICATION File Name: 14a0331n.06 No. 12-1887 ARTHUR HILL, JR., Plaintiff-Appellant, UNITED STATES COURT OF APPEALS FOR THE SIXTH CIRCUIT v. CITIZENS INSURANCE COMPANY OF

More information

Case 2:14-cv-01214-DGC Document 38 Filed 08/25/14 Page 1 of 7 IN THE UNITED STATES DISTRICT COURT FOR THE DISTRICT OF ARIZONA

Case 2:14-cv-01214-DGC Document 38 Filed 08/25/14 Page 1 of 7 IN THE UNITED STATES DISTRICT COURT FOR THE DISTRICT OF ARIZONA Case :-cv-0-dgc Document Filed 0// Page of 0 WO Wintrode Enterprises Incorporated, v. PSTL LLC, et al., IN THE UNITED STATES DISTRICT COURT FOR THE DISTRICT OF ARIZONA Plaintiff, Defendants. No. CV--0-PHX-DGC

More information

Cook v. Lowes Home Ctrs., Inc. NO. COA10-88. (Filed 18 January 2011)

Cook v. Lowes Home Ctrs., Inc. NO. COA10-88. (Filed 18 January 2011) Cook v. Lowes Home Ctrs., Inc. NO. COA10-88 (Filed 18 January 2011) Workers Compensation foreign award subrogation lien in North Carolina reduced no abuse of discretion The trial court did not abuse its

More information

SETTLEMENT AGREEMENT. of America, acting through the United States Department of Justice and the United States

SETTLEMENT AGREEMENT. of America, acting through the United States Department of Justice and the United States SETTLEMENT AGREEMENT This Settlement Agreement (Agreement) is entered into among the United States of America, acting through the United States Department of Justice and the United States Attorney s Office

More information

2013 IL App (1st) 120546-U. No. 1-12-0546 IN THE APPELLATE COURT OF ILLINOIS FIRST JUDICIAL DISTRICT

2013 IL App (1st) 120546-U. No. 1-12-0546 IN THE APPELLATE COURT OF ILLINOIS FIRST JUDICIAL DISTRICT 2013 IL App (1st) 120546-U Third Division March 13, 2013 No. 1-12-0546 NOTICE: This order was filed under Supreme Court Rule 23 and may not be cited as precedent by any party except in the limited circumstances

More information

IN THE COURT OF COMMON PLEAS FIRST JUDICIAL DISTRICT OF PENNSYLVANIA TRIAL DIVISION CIVIL SECTION

IN THE COURT OF COMMON PLEAS FIRST JUDICIAL DISTRICT OF PENNSYLVANIA TRIAL DIVISION CIVIL SECTION IN THE COURT OF COMMON PLEAS FIRST JUDICIAL DISTRICT OF PENNSYLVANIA TRIAL DIVISION CIVIL SECTION LOUISE FOSTER Administrator of the : AUGUST TERM 2010 Estate of GEORGE FOSTER : and BARBARA DILL : vs.

More information

jurisdiction is DENIED and plaintiff s motion for leave to amend is DENIED. BACKGROUND

jurisdiction is DENIED and plaintiff s motion for leave to amend is DENIED. BACKGROUND IN THE UNITED STATES DISTRICT COURT FOR THE NORTHERN DISTRICT OF CALIFORNIA 1 1 1 1 1 TRICIA LECKLER, on behalf of herself and all others similarly situated v. Plaintiffs, CASHCALL, INC., Defendant. /

More information

John T. Seybert Partner, New York, New York

John T. Seybert Partner, New York, New York John T. Seybert Partner, New York, New York Insurance Litigation Healthcare Life, Health & Disability Managed Care JOHN T. SEYBERT 212.422.0202 tel 212.422.0925 fax john.seybert@sedgwicklaw.com Current

More information

Case 2:08-cv-01740-MLCF-DEK Document 37 Filed 05/21/08 Page 1 of 6 UNITED STATES DISTRICT COURT EASTERN DISTRICT OF LOUISIANA

Case 2:08-cv-01740-MLCF-DEK Document 37 Filed 05/21/08 Page 1 of 6 UNITED STATES DISTRICT COURT EASTERN DISTRICT OF LOUISIANA Case 2:08-cv-01740-MLCF-DEK Document 37 Filed 05/21/08 Page 1 of 6 UNITED STATES DISTRICT COURT EASTERN DISTRICT OF LOUISIANA ARTHUR MONTEGUT, SR. CIVIL ACTION v. NO. 08-1740 BUNGE NORTH AMERICA, INC.,

More information

UNITED STATES COURT OF APPEALS FOR THE NINTH CIRCUIT

UNITED STATES COURT OF APPEALS FOR THE NINTH CIRCUIT FOR PUBLICATION UNITED STATES COURT OF APPEALS FOR THE NINTH CIRCUIT JOHN FAULKNER, on behalf of himself and all others similarly situated, Plaintiff-Appellant, v. ADT SECURITY SERVICES, INC.; ADT SECURITY

More information

2012 IL App (1st) 120754-U. No. 1-12-0754 IN THE APPELLATE COURT OF ILLINOIS FIRST JUDICIAL DISTRICT

2012 IL App (1st) 120754-U. No. 1-12-0754 IN THE APPELLATE COURT OF ILLINOIS FIRST JUDICIAL DISTRICT 2012 IL App (1st) 120754-U FIRST DIVISION December 3, 2012 No. 1-12-0754 NOTICE: This order was filed under Supreme Court Rule 23 and may not be cited as precedent by any party except in the limited circumstances

More information

Determining Jurisdiction for Patent Law Malpractice Cases

Determining Jurisdiction for Patent Law Malpractice Cases Determining Jurisdiction for Patent Law Malpractice Cases This article originally appeared in The Legal Intelligencer on May 1, 2013 As an intellectual property attorney, the federal jurisdiction of patent-related

More information

UNITED STATES COURT OF APPEALS FOR THE NINTH CIRCUIT

UNITED STATES COURT OF APPEALS FOR THE NINTH CIRCUIT FOR PUBLICATION UNITED STATES COURT OF APPEALS FOR THE NINTH CIRCUIT DONALD LYLE STRATTON, Plaintiff-Appellant, v. JULIE BUCK, in her individual capacity; DALE BROWN, in his individual capacity; JOHN DOE,

More information

A. For the consideration agreed below to be paid to Contractor by City, Contractor shall provide

A. For the consideration agreed below to be paid to Contractor by City, Contractor shall provide STATE OF TEXAS CONTRACT FOR SERVICES COUNTY OF DALLAS THIS CONTRACT is made and entered into by and between the CITY OF DALLAS, a Texas municipal corporation, located in Dallas County, Texas (hereinafter

More information

HARRIS v AUTO CLUB INSURANCE ASSOCIATION. Docket No. 144579. Argued March 6, 2013 (Calendar No. 7). Decided July 29, 2013.

HARRIS v AUTO CLUB INSURANCE ASSOCIATION. Docket No. 144579. Argued March 6, 2013 (Calendar No. 7). Decided July 29, 2013. Michigan Supreme Court Lansing, Michigan Syllabus This syllabus constitutes no part of the opinion of the Court but has been prepared by the Reporter of Decisions for the convenience of the reader. Chief

More information

IN THE UNITED STATES COURT OF APPEALS FOR THE ELEVENTH CIRCUIT. No. 11-10294 Non-Argument Calendar. D.C. Docket No. 8:09-cv-02628-JDW-TBM.

IN THE UNITED STATES COURT OF APPEALS FOR THE ELEVENTH CIRCUIT. No. 11-10294 Non-Argument Calendar. D.C. Docket No. 8:09-cv-02628-JDW-TBM. Case: 11-10294 Date Filed: 03/01/2012 Page: 1 of 6 EMMANUEL EBEH, IN THE UNITED STATES COURT OF APPEALS FOR THE ELEVENTH CIRCUIT No. 11-10294 Non-Argument Calendar D.C. Docket No. 8:09-cv-02628-JDW-TBM

More information

IN COURT OF APPEALS. DECISION DATED AND FILED July 16, 2015. Appeal No. 2014AP157 DISTRICT IV DENNIS D. DUFOUR, PLAINTIFF-APPELLANT-CROSS-RESPONDENT,

IN COURT OF APPEALS. DECISION DATED AND FILED July 16, 2015. Appeal No. 2014AP157 DISTRICT IV DENNIS D. DUFOUR, PLAINTIFF-APPELLANT-CROSS-RESPONDENT, COURT OF APPEALS DECISION DATED AND FILED July 16, 2015 Diane M. Fremgen Clerk of Court of Appeals NOTICE This opinion is subject to further editing. If published, the official version will appear in the

More information

December 16, 2010 UNITED STATES COURT OF APPEALS

December 16, 2010 UNITED STATES COURT OF APPEALS FILED United States Court of Appeals Tenth Circuit December 16, 2010 UNITED STATES COURT OF APPEALS Elisabeth A. Shumaker Clerk of Court FOR THE TENTH CIRCUIT DOUG HAMBELTON, Plaintiff Appellee, v. CANAL

More information