Attorney Anthony F. Maul represents patients, providers and professional associations in heath care and insurance litigation. Mr. Maul's cases have broken new ground with respect to the Employee Retirement Income Security Act ("ERISA") and related federal and state statutes.
- Pennsylvania Chiropractic Association v. Blue Cross Blue Shield Association (N.D. Ill.): Mr. Maul and his co-counsel successfully tried claims brought by the Pennsylvania Chiropractic Association ("PCA") challenging insurer Independence Blue Cross's ("IBC") practice of issuing repayment demands to in-network providers without providing ERISA-compliant notice and appeal rights. After a 3-day bench trial, U.S. District Judge Matthew Kennelly held that the PCA was entitled to a permanent injunction requiring IBC to comply with ERISA when recouping money from providers. Read the trial decision here. Mr. Maul is counsel in similar litigation against United Healthcare, Aetna and other insurance companies.
- Blue Cross & Blue Shield of Rhode Island v. Korsen (D.R.I.): As a member of the trial team, Mr. Maul defeated allegations of fraudulent billing brought by BCBSRI against a Rhode Island chiropractor and occupational therapist. Moreover, Mr. Maul's team won their clients' ERISA counterclaim, which challenged BCBSRI's unlawful recoupment of funds. As a result, the Court ordered BCBSRI to repay over $30,000 it had recouped from Mr. Maul's clients. Read the trial decision here.
- New York State Psychiatric Association, Inc. v. UnitedHealth Group (S.D.N.Y.): In this case, the Maul Firm represents patients, providers and professional associations bringing claims under the Mental Health Parity and Addiction Equity Act and related statutes. Mr. Maul's clients challenge United's use of more restrictive criteria for approval of mental and behavioral health services than for medical and surgical care.
- Lipstein v. United HealthCare Insurance Co. (D.N.J.): This class action alleged that United's method of estimating Medicare payments when coordinating benefits systematically under-reimburses patients. The Maul Firm continues to investigate similar claims against United.