Legal Opinion

N. Cypress Med. Ctr. Operating Co. v. Aetna Life Ins. Co.

Court of Appeals for the Fifth Circuit

Decided July 31, 2018No. 16-20674PublishedCited by 132 opinions

1Opinion of the Court

DON R. WILLETT, Circuit Judge:

*468 Under Aetna's insurance plans, patients are responsible for a portion of their bills. That is not to say insurance companies are off the hook: They cover the remainder. But how much is Aetna obligated to pay for medical services provided to its members by an out-of-network hospital?

Houston medical services provider North Cypress Medical Center Operating Co., Ltd. and North Cypress Medical Center Operating Co. GP, LLC (collectively "NCMC") alleged Aetna underpaid out-of-network providers like NCMC in violation of the Employee Retirement Income Security Act of…

2Cases cited55 opinions

  1. Firestone Tire & Rubber Co. v. BruchSupreme Court of the United States · 1989
  2. Schiller v. Physicians Resource Group Inc.Court of Appeals for the Fifth Circuit · 2003
  3. Ruckelshaus v. Sierra ClubSupreme Court of the United States · 1983
  4. Italian Cowboy Partners, Ltd. v. Prudential Insurance Co. of AmericaTexas Supreme Court · 2011
  5. Ernst & Young, L.L.P. v. Pacific Mutual Life Insurance Co.Texas Supreme Court · 2001

50 more not listed; retrieve them via the Exa API.

3Cited by132 opinions

  1. The Depot, Inc. v. Caring for Montanans, Inc.Court of Appeals for the Ninth Circuit · 2019
  2. Certain Underwriters v. Cameron Intl Corp.Court of Appeals for the Fifth Circuit · 2020
  3. Clarence Brown v. Allison TaylorCourt of Appeals for the Fifth Circuit · 2018
  4. Ruben Molina-Aranda v. Black Magic EnterpriCourt of Appeals for the Fifth Circuit · 2020
  5. Michael Manuel v. Turner Industries Group, LLC, etCourt of Appeals for the Fifth Circuit · 2018

127 more not listed; retrieve them via the Exa API.

Showing a preview — retrieve the full document via the Exa API.

Powered by the Exa API