ERISA Doesn't Sink No-Pay Suit Against Aetna, 3rd Circ. Says

Law360 (July 17, 2020, 8:11 PM EDT) -- The Third Circuit partially revived a New Jersey plastic surgery practice's suit accusing Aetna Health Inc. of reneging on its promise to reimburse it for out-of-network surgeries, ruling in a precedential decision Friday that certain claims weren't preempted by ERISA because they had nothing to do with insurance plans covered by the federal law.

In a decision deeming the matter an issue of first impression for the court and of "great importance" to the health care industry, a three-judge panel said the insurance giant must face claims by the Plastic Surgery Center PA that it breached its contract to cover medical...

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