Legal Opinion
McCulloch Orthopaedic Surgical Services, PLLC v. Aetna Inc.
Court of Appeals for the Second Circuit
Decided May 18, 2017No. 15-2150-cvPublishedCited by 107 opinions
1Opinion of the Court
JOHN M. WALKER, JR., Circuit Judge:
We consider in this case whether the Employee Retirement Income Security Act of 1974 (“ERISA”), 29 U.S.C. §§ 1001 et seq., completely preempts an “out-of-network” health care provider’s promissory-estoppel claim against a health insurer where the provider (1) did not receive a valid assignment for payment under the health care plan and (2) received an independent promise from the insurer that he would be paid for certain medical services provided to the insured. We hold that ERISA does not completely preempt such a claim.
BACKGROUND
Plaintiff-appellant…
2Cases cited16 opinions
- Aetna Health Inc. v. DavilaSupreme Court of the United States · 2004
- Memorial Hospital System v. Northbrook Life Insurance CompanyCourt of Appeals for the Fifth Circuit · 1990
- Montefiore Medical Center v. Teamsters Local 272Court of Appeals for the Second Circuit · 2011
- Marin General Hospital v. Modesto & Empire Traction Co.Court of Appeals for the Ninth Circuit · 2009
- American Psychiatric Ass'n v. Anthem Health Plans, Inc.Court of Appeals for the Second Circuit · 2016
11 more not listed; retrieve them via the Exa API.
3Cited by107 opinions
- Am. Orthopedic & Sports Med. v. Independence Blue Cross Blue ShieldCourt of Appeals for the Third Circuit · 2018
- Plastic Surgery Center, P.A. v. Aetna Life Insurance CoCourt of Appeals for the Third Circuit · 2020
- Aesthetic & Reconst. Breast v. United HealthcareDistrict Court, D. Connecticut · 2019
- Abbo-Bradley v. City of Niagara FallsCourt of Appeals for the Second Circuit · 2023
- Murphy Med. Assocs., LLC v. Yale Univ.Court of Appeals for the Second Circuit · 2024
102 more not listed; retrieve them via the Exa API.