Health Care Class Actions
Zuckerman Spaeder has developed a groundbreaking and nationally recognized practice focused on expanding provider and patient rights in their never ending struggle with commercial insurers.
From representing doctors, ambulatory surgical centers, hospitals, and other health care providers in disputes concerning wrongful denials, reimbursement rates, and recoupments and offsets, to standing up for patients living with mental health and substance abuse issues who are being denied coverage by their insurer, we represent a number of classes with the purpose of holding insurers accountable to those they serve.
Craft et al v. Health Care Service Corporation
Managing Attorneys: Dan Moylan, Adam Abelson, D. Brian Hufford, Jason Cowart
Settled class action against Health Care Service Corporation (HCSC), which alleged that it wrongfully denied claims for mental health and substance abuse residential treatment based on a plan exclusion that violated applicable mental health parity laws.
Wit v. UnitedHealthcare Insurance Company
Managing Attorneys: Caroline Reynolds, Adam Abelson, D. Brian Hufford, Jason Cowart
Class action against United Behavioral Health – a subsidiary of UnitedHealth and the country’s largest managed behavioral health care organization – alleging that it wrongfully denied claims for mental health and substance abuse treatment based on the application of flawed internal “medical necessity” criteria that, among other things, overemphasize acute mental health and substance use disorders and symptoms, while disregarding chronic disorders and symptoms.
Class Notices – Wit (re: denials of coverage for residential treatment)
- Notice of Pendency - WIT Guideline Class
- Notice of Pendency - Wit State Mandate Class
Notice of Partial Decertification of Class Action – Wit State Mandate Class - Illinois denials post 1/1/16 - Notice of Partial Decertification of Class Action – Appeal-only Guideline Denials
- Notice of Partial Decertification of Class Action – Fully Successful Admin. Appeal
- Notice of Non-Class Membership – Wit Administrative Denials
- Notice of Non-Class Membership – Wit State Mandate Class – Texas Denials
Class Notices – Alexander (re: denials of coverage for outpatient or intensive outpatient treatment)
- Notice of Pendency - Alexander Guideline Class
- Notice of Partial Decertification of Class Action – Appeal-only Guideline Denials
- Notice of Partial Decertification of Class Action – Fully Successful Admin. Appeal
- Notice of Non-Class Membership – Alexander Administrative Denials
Bushell v. Unitedhealth Group Inc.
Managing Attorneys: Shawn Naunton, Nell Zora Peyser, D. Brian Hufford, Jason Cowart
A class action lawsuit currently before a federal court against United Healthcare (United), in particular its subsidiary Oxford, alleging that it violated federal mental health parity laws by denying coverage for nutritional counseling for the treatment of eating disorders.
Carol Lietz v. Cigna Corporation et al.
Managing Attorneys: Nell Zora Peyser, Jason Cowart, D. Brian Hufford,
Class action against Cigna and American Specialty Health alleging that they violated ERISA by adopting and applying a scheme that misrepresented ASH’s administrative fees as medical expenses and thereby caused plan sponsors and their beneficiaries to improperly pay those administrative fees.
Sandra M. Peters, et al. v. Aetna Inc., et al.
Managing Attorneys: Nell Zora Peyser, Jason Cowart, D. Brian Hufford
Class action against Aetna and Optum alleging that they violated ERISA by adopting and applying a scheme that misrepresented Optum’s administrative fees as medical expenses and thereby caused plan sponsors and their beneficiaries to improperly pay those administrative fees.
Jane Doe v. UnitedHealth Group Inc. et al.
Managing Attorneys: Shawn Naunton, Nell Zora Peyser, Jason Cowart, D. Brian Hufford
Class action against UnitedHealth alleging that it violated state and federal parity laws and the anti-discrimination provision of the Affordable Care Act by adopting and applying a policy of reducing out-of-network benefits for services rendered by psychologists (25% reduction) and social workers (35% reduction).
Louis J. Peterson, D.C. on behalf of Patients E, I, K, L, N, P, Q, and R, and on behalf of all others similarly situated, Plaintiff, v. UnitedHealth Group INC.; United Healthcare Services, Inc.; United Healthcare Insurance Company; and United Healthcare Service LLC, et al.
Managing Attorneys: Andrew Goldfarb, D. Brian Hufford, Jason Cowart
Class action against UnitedHealth Group (UHG) alleging that it violated ERISA by adopting and applying a policy of “cross plan offsetting,” pursuant to which it refuses to pay out-of-network benefits owed by one plan in order to recover over payments allegedly made by another plan, in violation of ERISA.
Meidl v. Aetna Inc. et al.
Managing Attorneys: Andrew Goldfarb, D. Brian Hufford, Jason Cowart
Class action against Aetna Inc. alleging that it violated ERISA by adopting and applying a categorical policy to deny coverage for Transcranial Magnetic Stimulation (TMS) therapy as a treatment for Major Depressive Disorder.
Medical Society of New York et al.
Managing Attorneys: Cy Smith, Jason Cowart, D. Brian Hufford
Class action against United Health Group and its subsidiaries alleging that it violated ERISA by adopting and applying a categorical policy to deny coverage for office-based surgery facility fees.