K&l Gates Health Care Triage

In this episode, Gary Qualls provides an overview of a recent case out of the Fifth Circuit Court of Appeals, Encompass Office Solutions, Inc. v. Louisiana Health Service & Indemnity Company d/b/a BlueCross BlueShield of Louisiana. This episode discusses the issues raised by an unconventional provider of surgical equipment and staff necessary for in-office outpatient surgeries related to the denial of separate claims it submitted under out-of-network ERISA plans. This episode also outlines the analysis of the court as well as key takeaways, particularly including the importance of plan language for interpretation of ERISA plans. Presenters: Gary S. Qualls and Zachary W. Ernst Download Presentation Materials