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Your ERISA Watch – What a Difference Discretion Makes

Your ERISA Watch – What a Difference Discretion MakesMayer v. Ringler Assocs. Inc., No. 20-1281, __, F.4th __, 2021 WL 3556473 (2d Cir. Aug. 12, 2021) (Before Circuit Judges Walker, Sack, and Menashi).This week’s notable decision demonstrates the uphill battle ERISA claimants face in litigation with insurers over their employee benefits, particularly where courts apply […]

In Proton Beam Cancer Treatment Denial Case, Kantor & Kantor Prevails in Discovery Dispute Against Blue Cross Blue Shield Health Care Plan of Georgia

Our firm is involved in litigating a proton beam cancer treatment denial case in Georgia, Ghattas v. Blue Cross Blue Shield Health Care Plan of Georgia, Inc., Case No. 1:20-CV-03157-ELR, 2020 WL 6867155 (N.D. Ga. Nov. 18, 2020). Defendants Blue Cross Blue Shield Health Care Plan of Georgia (BCBSGA) answered Plaintiff Christopher Ghattas’ Complaint alleging […]

Kantor & Kantor’s Health Team Scores Another Victory in a Denial of Residential Treatment Matter

Kantor & Kantor’s health team recently scored another victory in a matter involving the denial of residential treatment.In Doe v. Blue Cross Blue Shield of Illinois, No. CV-19-05044-PHX-SMB, __F.Supp.3d__, 2020 WL 5891723 (D. Ariz. Oct. 5, 2020), Jane Doe was a dependent beneficiary of an ERISA-governed health plan insured and administered by Defendant Blue Cross […]

Ninth Circuit Declines to Bar Healthcare Provider’s Lawsuit Based on Anti-assignment Provision in ERISA Health Plan

As many healthcare providers have experienced, anti-assignment provisions in ERISA health plans can be a full stop to recovering unpaid claims. In good news, the Ninth Circuit Court of Appeals recently decided Martin Luther King, Jr. Community Hospital v. Community Insurance Company dba Anthem Blue Cross Blue Shield, et al., No. 19-55053, __F.App’x__, 2020 WL […]

Kantor & Kantor Partner Gives Perspective on 1 of the 3 ERISA Retirement Plan Cases Before The Supreme Court, November 2019

The Supreme Court heard arguments yesterday, November 6, 2019, in Retirement Plans Committee of IBM v. Jander, an ERISA case challenging the prudence of fiduciary decisions with respect to an employee stock ownership plan (ESOP). The Court granted certiorari to review whether the Second Circuit correctly applied the Court’s “more harm than good” standard set […]

Why ERISA Class Actions and Not Big Jury Trial Awards May Induce Payer Change on Proton Therapy

As we continue to learn about efforts to challenge proton therapy denials by groups such as the Proton Therapy Law Coalition, the fundamental question becomes: Will the insurers actually get the message and change their ways? A recent article suggests that even when a jury awards a large punitive damages figure against a health insurer, […]