October 01, 2018

Trends and Developments in Health Plan Coverage Disputes, Noteworthy Cases on Anti-Assignment Clauses

Jonathan M. Herman, Herman Law Firm, Dallas, TX

I.          Introduction

Managed care litigation is generally described as the tug of war among payors (insurers and self-funded plans), providers (physicians, hospitals, and other medical service providers), and patients (members or beneficiaries of health plans).  Payors strive to adhere to their committed risk under their health plans, providers demand fair payment for services rendered, and patients simply want coverage for their medical expenses.

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