Insights

On January 8, 2019, the U.S. Supreme Court in Henry Schein, Inc. v. Archer and White Sales, Inc.,586 U.S. ___ (2019) (Slip Op.), unanimously held that a federal court cannot decide whether a contract’s arbitration clause applies to a dispute if the contract gives that authority to an arbitrator – even when the argument for arbitration is “wholly groundless.”

This summary of key lawsuits affecting managed care is provided by the Health Care Group of Crowell & Moring. If you have questions or need assistance on managed care law matters, please contact Chris Flynn, Peter Roan, or any member of the Health Care Group.

This summary of key lawsuits affecting managed care is provided by the Health Care Group of Crowell & Moring. If you have questions or need assistance on managed care law matters, please contact Chris Flynn, Peter Roan, or any member of the Health Care Group.

On September 23, Governor Brown signed into law Assembly Bill 72 (AB 72) that will significantly alter the relationship between non-contracted providers of professional services and commercial health plans and insurers. The new law, which does not apply to Medi-Cal managed care plans, aims to combat surprise medical bills by out-of-network professionals at in-network facilities. AB 72 does not impact provision of emergency services by such non-contracted professionals. The Association of American Physicians and Surgeons has already challenged the constitutionality of AB 72 in federal court, asserting that the new law violates the due process, takings, and equal protection clauses of the U.S. Constitution.

This summary of key lawsuits affecting managed care is provided by the Health Care Group of Crowell & Moring. If you have questions or need assistance on managed care law matters, please contact Chris Flynn, Peter Roan, or any member of the Health Care Group.

This summary of key lawsuits affecting managed care is provided by the Health Care Group of Crowell & Moring. If you have questions or need assistance on managed care law matters, please contact Chris Flynn, Peter Roan, or any member of the Health Care Group.

This summary of key lawsuits affecting managed care is provided by the Health Care Group of Crowell & Moring. If you have questions or need assistance on managed care law matters, please contact Chris Flynn, Peter Roan, or any member of the Health Care Group.

This summary of key lawsuits affecting managed care is provided by the Health Care Group of Crowell & Moring. If you have questions or need assistance on managed care law matters, please contact Chris Flynn, Peter Roan, or any member of the Health Care Group.

This summary of key lawsuits affecting managed care is provided by the Health Care Group of Crowell & Moring. If you have questions or need assistance on managed care law matters, please contact Chris Flynn, Peter Roan, or any member of the health law group.

On January 30, 2015, the Office of Administrative Law approved the emergency regulations for provider network adequacy standards proposed by the California Department of Insurance (CDI). The emergency regulations apply to CDI-regulated insurers offering health insurance; they do not modify existing requirements for plans licensed by the California Department of Managed Care that are subject to California's Knox-Keene Act.

On April 24, 2014, the California Court of Appeal issued a decision in Consumer Watchdog v. DMHC that likely expands the scope of services that certain plans are required to cover in treating autism. This opinion follows a petition of rehearing by Consumer Watchdog after the Court of Appeal unanimously decided these issues on September 10, 2013, Consumer Watchdog v. Dep't of Managed Health Care, 162 Cal.Rptr.3d 85, 2014 WL 1618367 (Cal. Ct. App. Apr. 23, 2014).  

The Patient Protection and Affordable Care Act ("PPACA") requires all health plans offered through Health Insurance Exchanges ("Exchanges") and small group and individual products offered outside of the Exchanges to offer a core package of items and services, known as essential health benefits, and to meet specified actuarial value levels. On November 20, 2012, the U.S. Department of Health and Human Services ("HHS") issued a proposed rule for the purpose of clarifying and elaborating on the requirements for offering essential health benefits and for meeting actuarial value levels. The proposed rule also sets a timeline for qualified health plans ("QHPs") to be accredited in the Exchanges and a process for recognition of additional accrediting entities for purposes of certifying QHPs. The comment period expires December 26, 2012.

This summary of key lawsuits affecting managed care is provided by the Health Care Group of Crowell & Moring LLP. If you have questions or need assistance on managed care law matters, please contact Art Lerner or any member of the health law group. Please click to view the full Crowell & Moring Managed Care Lawsuit Watch archive. Cases in this issue: