• New York Law Journal | Analysis

    Acupuncture Fee Schedule, '8-Unit Rule', Preclusion

    February 11, 2020

    In his No-Fault Insurance Law Wrap-Up, David M. Barshay discusses recent decisions in the field, including what rates apply for acupuncture and cupping services.

  • New York Law Journal | Analysis

    Medical Professional Reimbursement and ‘Fraudulent Incorporation’

    August 7, 2019

    In his No-Fault Insurance Law Wrap-Up, David M. Barshay discusses the regulations and landmark decisions pertaining to insurance carriers withholding payment for medical services provided by fraudulently incorporated enterprises to which patients have assigned their claims.

  • Andrew Carothers, M.D., P.C., &c., Appellant, v. Progressive Insurance Company, Respondent.

    Publication Date: 2019-06-12
    Practice Area: Health Care Law | Insurance Litigation
    Industry: Health Care
    Court: Court of Appeals, New York State
    Judge: Associate Judge Eugene M. Fahey
    Attorneys: For plaintiff: Bruce H. Lederman, for appellant.
    for defendant: Barry I. Levy, for respondent.

    Case Number: No. 39

    Carothers v. Progressive Insurance

  • Berry v. ETX Successor

    Publication Date: 2019-03-11
    Practice Area: Civil Rights | Health Care Law | Personal Injury
    Industry:
    Court: Court of Appeals
    Judge: Justice Neeley
    Attorneys: For plaintiff:
    for defendant:

    Case Number: 12-18-00095-CV

    Berry sought and received emergency medical treatment from East Texas Medical Center as a result of a tortious car accident.

  • Huddle et al. v. Heindel

    Publication Date: 2018-12-06
    Practice Area: Health Care Law | Medical Malpractice
    Industry: Health Care
    Court: Georgia Court of Appeals
    Judge: Judge Reese
    Attorneys: For plaintiff: Jennifer Ivey, (Linley, Jones PC), Atlanta, Lloyd Hoffspiegel, Alexander Hoffspiegel, (Hoffspiegel & Associates), Atlanta, for appellant.
    for defendant: John Hall, Beth Kanik, (Hall, Booth, Smith, & Slover, P.C.), Atlanta, for appellee.

    Case Number: A18A1154

    Court Affirms in Part and Reverses in Part Dismissal on Motion for Summary Judgment of Suit Against Therapist by Former Patient Who Had Sexual Relationship with Therapist

  • State Farm Mut. Auto. Ins. Co. v. Cavoto

    Publication Date: 2018-10-30
    Practice Area: Health Care Law | Insurance Litigation
    Industry: Health Care | Insurance
    Court: Superior Court
    Judge: Judge Shogan
    Attorneys: For plaintiff:
    for defendant:

    Case Number: 18-1303

    Trial court reasonably found that therapeutic exercise could not be delegated to unlicensed support personnel under the chiropractic practice act and the decision was supported by ample testimony. Affirmed.

  • New York Law Journal | Expert Opinion

    Insurers Overcome Defendants' Efforts to Delay or Avoid Judgment Day

    September 6, 2018

    In his column on Insurance Fraud, Evan H. Krinick, looks at how insureds are raising a variety of arguments in an effort to delay—and sometimes to significantly delay—the insurers' actions.

  • Daily Report Online | News

    Judge Sanctions Insurer After Crash Victim's Doctor 'Co-opted' by Defense

    December 6, 2017

    A Douglas County judge barred defense attorneys from offering any causation defenses after a radiologist who reviewed the plaintiff's MRI was hired by State Farm Insurance to bolster its case.

  • United Sates v. Allstate Insurance, 16-705

    Publication Date: 2017-04-07
    Practice Area: Whistleblower Laws | Health Care Law
    Industry: Health Care
    Court: U.S. Court of Appeals, Second Circuit
    Judge: Before: Katzmann, C.J., Pooler and Lynch, C.JJ.
    Attorneys: For plaintiff: For Plaintiff-Appellant: Peter M. Jasen, Buffalo, NY, on the brief, J. Michael Hayes.
    for defendant: For Defendants-Appellees FedEx Corporation, Federal Express Corporation, FedEx Ground Package System Inc., FedEx Freight Corporation, FedEx Office and Print Services, Inc., FedEx Custom Critical, Inc., FedEx Trade Networks Inc., FedEx Supply Chain Systems, Inc., and FedEx Corporate Services, Inc.: John W. Campbell, Federal Express Corporation, Memphis, TN. For Defendants-Appellees Farmers Insurance Exchange, Truck Insurance Exchange, Fire Insurance Exchange, and Foremost Property and Casualty Insurance Company: Lori L. Pines and John P. Mastando III, on the brief, David L. Yohai Weil, Gotshal & Manges LLP, New York, NY. For Defendants-Appellees Travelers Insurance Group Holding, Inc., Travelers Property Casualty Corporation, and The Travelers Companies, Inc.: Bryce L. Friedman, Simpson Thatcher & Bartlett LLP, New York, NY; Deborah L. Stein, Simpson Thatcher & Bartlett LLP, Los Angeles, CA. For Defendant-Appellee Hartford Financial Services Group, Inc.: Jonathan M. Freiman, Wiggin and Dana LLP, New Haven, CT. For Defendants-Appellees J.B. Hunt Transport Services Inc., Founders Insurance Company, Founders Insurance Company of Michigan, Graphic Arts Mutual Insurance Company, Republic-Franklin Insurance Company, Utica Mutual Insurance Company, Utica National Insurance Company of Texas, Utica National Insurance Company of Ohio, Utica National Assurance Company, Utica Lloyd's of Texas, Utica Specialty Risk Insurance Company, and Utica National Insurance Group.: Sharon Angelino, Goldberg Segalla LLP, Buffalo, NY. For Defendants-Appellees Erie Insurance Company of New York, Erie Insurance Exchange, Inc., Erie Indemnity Company, and The Erie Insurance Company: Heath J. Szymczak, Bond, Schoeneck & King, PLLC, Buffalo, NY. For Defendants-Appellees Allstate Insurance Company, Allstate Indemnity Company, Kemper Independence Insurance Company, Metropolitan Group Property and Casualty Insurance Company, Metropolitan Property and Casualty Insurance Company; and Defendants Kemper Corporation and The Allstate Corporation: Steven M. Levy and Alan S. Gilbert, Dentons US LLP, Chicago IL; Sean C. Cenawood, Dentons US LLP, New York, NY; Sharon Angelino, Goldberg Segalla LLP, Buffalo, NY. For Defendant-Appellee Preferred Mutual Insurance Company: Suzanne O. Galbato, Bond, Schoeneck & King, PLLC, Syracuse, NY. For Defendants-Appellees Progressive Insurance Company and The Progressive Corporation, Inc.: Terrance M. Connors, Connors LLP, Buffalo, NY; Michael K. Loucks, Skadden, Arps, Slate, Meagher & Flom LLP, Boston, MA. For Defendant-Appellee State Farm Mutual Automobile Insurance Company: Douglas W. Baruch and Anayansi Rodriquez Carbo, Fried, Frank, Harris, Shriver & Jacobson LLP, Washington, D.C.; Dan David Kohane, Hurwitz & Fine, P.C., Buffalo, NY. For Defendant-Appellee Zurich North America: Michael J. Willett, Gibson, McAskill & Crosby, LLP, Buffalo, NY. For Defendants-Appellees Nationwide General Insurance Company, Nationwide Financial Services Incorporated, and Nationwide Mutual Insurance Company: Stephen Sozio, Jones Day, Cleveland, OH, Matthew Corcoran, Jones Day, Columbus, OH, Mark C. Davis, Lippes Mathias Wexler Friedman LLP, Buffalo, NY. For Defendant-Appellee New York Central Mutual Fire Insurance Company: Eric Dranoff, Saretsky Katz & Dranoff, LLP, New York, NY. For Defendant-Appellee CorePointe Insurance Company f/k/a Daimler Chrysler Insurance Company: Susan L. Swatski, Hill Wallack LLP, Princeton, NJ. For Defendant-Appellee Geico, Insurance.: Barry I. Levy, Cheryl F. Korman, and Brian L. Bank, Rivkin Radler LLP, Uniondale, NY. For Defendants-Appellees Liberty Mutual Insurance Company, Liberty Mutual Group, and Liberty Mutual Holding Company, Inc.: Kevin J. Fee and Amy C. Gross, Duane Morris LLP, New York, NY, Dennis R. McCoy, Barclay Damon, LLP, Buffalo, NY. For Defendant-Appellee U-Haul International: Kevin M. Hogan, Phillips Lytle LLP, Buffalo, NY.

    Case Number: 16-705

    Appeals Court Upholds Dismissal of Suit by Lawyer Who Acted in Bad

  • New York Law Journal

    Whistleblowers Play Key Role in Fight Against Federal Health Insurance Fraud

    November 3, 2016

    The federal False Claims Act (FCA)1 is a powerful tool in the fight against fraud involving federal health insurance programs such as Medicare and Medicaid. Indeed, one of the gre