David Shillcutt, Senior Counsel in the Health Care & Life Sciences practice, in the firm’s Washington, DC, office, was quoted in Law360, in “5 October Court Hearings Benefits Attys Should Watch,” by Kellie Mejdrich. (Read the full version – subscription required.)
Following is an excerpt:
In October, the Ninth Circuit will consider whether to revive a sweeping 401(k) mismanagement class action against AT&T, the Tenth Circuit will weigh an insurance claim for residential mental health treatment and chipmaker Nvidia will try to escape a 401(k) suit in California district court.
Here's a look at those cases and other upcoming hearings benefits lawyers should keep an eye on. …
Insurer Asks 10th Circ. to Undo Benefits Award
The Tenth Circuit has scheduled oral arguments for Oct. 27 in an appeal brought by an insurer and an employee benefit plan seeking to overturn a Utah district court's order requiring additional benefits for a patient's residential inpatient mental health treatment.
UnitedHealth Group Inc.'s behavioral health unit United Behavioral Health and the Alcatel-Lucent Medical Expense Plan for Active Management Employees hope to overturn a ruling from June 2021 that found the insurer and the benefit plan improperly denied benefits to a family in violation of ERISA.
Identified by their initials D.K., K.K. and A.K., the family first sued United and the plan in December 2017. Parents K.K. and D.K. sought reimbursement for their daughter A.K.'s extended inpatient treatment at the Discovery Ranch for Girls in Utah. D.K. was enrolled in United coverage as an employee of telecommunications company Alcatel-Lucent.
The parties requested relief under ERISA and alleged violations of what's called the Paul Wellstone and Pete Domenici Mental Health Parity and Addiction Equity Act of 2008, which requires equal coverage of mental health and substance use disorder treatments compared to other types of medical care.
In a June 2021 order, U.S. District Judge Dale A. Kimball awarded the plaintiffs summary judgment on their ERISA claim, concluding that United and the Alcatel-Lucent plan were arbitrary and capricious in their denials and ordering payment for A.K's treatment at Discovery.
Judge Kimball denied the family summary judgment on the Parity Act claim and granted it to United and Alcatel-Lucent, however, saying in the order that the plaintiffs abandoned the claim during a summary judgment hearing.
On appeal, United and Alcatel-Lucent argued their denial was proper and said even if the court were to decide otherwise, it should have remanded the claim to the plan instead of directly awarding benefits.
David Shillcutt, senior counsel at Epstein Becker Green, said he was interested to see how the case develops, even though the Parity Act claim is no longer an active issue in the case on appeal.
"In so many of these cases, what you're seeing is that the Parity Act claims are getting dismissed or abandoned, and they're going back to other aspects of ERISA," Shillcutt said.
The case is K. et al. v. United Behavioral Health et al., case number 21-4088, in the U.S. Court of Appeals for the Tenth Circuit.
