Health Providers Press For ERISA Shield In Insurance Brawls
By Jeff Overley
Law360, New York (July 10, 2013, 6:01 PM EDT) -- Insurance companies are increasingly fighting to claw back allegedly improper payments to health care practitioners, triggering a wave of litigation that has the Obama administration and plaintiffs firms pushing courts to let providers use a federal benefit law to cripple recoupment claims.
At issue is whether efforts to recover money should be viewed as addressing improper billing or denying benefits. If it's the former, insurers have wide berth to act decisively, and providers would face a taller task in challenging payment policies. If it's the latter, insurers...