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Rulings, filings, and settlements of interest

  • Proskauer Rose LLP
  • -
  • USA
  • -
  • October 5 2011

In Franco v. Connecticut General Life Ins. Co., No. 07-cv-6039, 2011 U.S. Dist. LEXIS 109022 (D.N.J. Sept. 23, 2011), plaintiffs, who were plan subscribers, health care providers, and several associations whose members consisted of out-of-network ("ONET") providers who provided ONET services to patients insured by CIGNA, alleged that CIGNA violated its contractual obligations to pay for ONET services at the "usual, customary and reasonable" ("UCR") rate by relying on the flawed database maintained by Ingenix, which generated artificially low UCRs to underpay ONET benefits to CIGNA plan members

Rulings, filings and settlements of interest

  • Proskauer Rose LLP
  • -
  • USA
  • -
  • August 6 2010

In Borrero v. United HealthCare of New York, Inc., 2010 WL 2652456 (11th Cir. July 6, 2010), healthcare providers (and their representative organizations) alleged state law claims against United HealthCare for failing to pay them the agreed upon rate contained in the subscriber agreements rate for services

Rulings, filings and settlements of interest

  • Proskauer Rose LLP
  • -
  • USA
  • -
  • June 7 2010

In Golden Gate Restaurant Assoc. v. City and County of San Francisco, No. 08-1515 (U.S.), the U.S. Solicitor General requested that the Supreme Court deny certiorari in light of the recent enactment of the Patient Protection and Affordable Care Act (PPACA

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