Blue Cross Dealt Setbacks In Provider ERISA Benefit Suit

Law360, New York (November 8, 2013, 8:08 PM EST) -- An Illinois federal judge issued a pair of provider-friendly decisions Thursday in litigation from chiropractors accusing Blue Cross Blue Shield Association health plans of clawing back payments in violation of the Employee Retirement Income Security Act, ruling the plaintiffs were denied ERISA beneficiary rights.

U.S. District Judge Matthew F. Kennelly held that chiropractors suing several Blue Cross entities for retroactively denying benefits had standing under ERISA based on assignments from their insured patients and had proven they were subject to arbitrary and capricious benefit determinations without...
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