Healthcare and Pension Cases
Blue Cross & Blue Shield – Medicare; Insurance Law; Administrative Law
Health Insurance Association of America v. Shalala, No. 92-5196-97(U.S. District Court for the District of Columbia Circuit) (decision reported 23 F.3d 412 (DC Cir. 1994))
Mr. Cynkar, while at another firm, was part of a team representing the Blue Cross & Blue Shield Association challenging Medicare regulations promulgated under a federal statute that makes Medicare a payer secondary to private insurers in certain circumstances, and requires reimbursement of Medicare when it has improperly made a primary payment. Mr. Cynkar successfully argued in the U.S. Court of Appeals for the DC Circuit that regulations that purported to allow Medicare to secure reimbursement from the third party administrators of insurance plans, and to ignore the claims filing deadlines in insurance contracts, was unlawful.
Fremont General - Pension Plan Investment in Company Stock
On May 31, 2007, Cuneo Gilbert & LaDuca, LLP filed a ERISA class action in the United States District Court for the Central District of California against Fremont General Corporation ("Fremont"). The lawsuit seeks class action status on behalf of participants in two of Fremont's pension plans, the Fremont General Corporation Employee Stock Ownership Plan ("ESOP") and the Fremont General Corporation and Affiliated Companies Investment Incentive Plan ("401(k) Plan"). The class period alleged in the complaint is from January 1, 2005 to the present time.
The seven named plaintiffs in the case claim that Fremont and the other named Defendants in the case breached their fiduciary duties with respect to the retirement plans by allowing the investment of employee-participant account balances in Fremont stock and by other related acts. The complaint alleges that employee-participants have suffered millions of dollars in losses to their retirement savings.
If you have further questions, please contact Jon Tostrud at 310-556-9621 or at jtostrud@cuneolaw.com.
MSP Tobacco – Medicare; “Private Attorney General” Enforcement
United Seniors Association v. Philip Morris USA, Inc., Case No. 06-2447 (U.S. Court of Appeals for the First Circuit)
We are lead counsel to the United Seniors Association, a non-profit taxpayer protection organization with a nationwide network of over 1.5 million members. This case was brought against the major cigarette companies on behalf of Medicare, as a “private attorney general,” under a federal statute that requires the insurers of those who injure Medicare beneficiaries to pay for the medical expenses necessitated by those injuries first, with Medicare being an insurer of last resort. This suit contends that these companies concealed and manipulated the biochemically addictive character of nicotine in their cigarettes in order to “hook” smokers. When smokers who are now Medicare beneficiaries chose to smoke, they thus were not aware that smoking would expose them to such an addictive chemical. United Seniors claims that taxpayers, through Medicare, have paid for billions of dollars of medical costs for which the cigarette companies should have been responsible. Jurisdictional questions under the federal statute have dominated the litigation, which is now on appeal to the U.S. Court of Appeals for the First Circuit.
For additional information, please contact Robert J. Cynkar.
New York Life Insurance – Medicare; Employment
New York Life Insurance Co. v. United States, No. 98-5108(U.S. Court of Appeals for the Federal Court) (decision reported at 190 F.3d 1372 (Fed. Cir. 1999))
Mr. Cynkar, while at another firm, was lead counsel representing New York Life in a case against the federal government to recover medical expenses of New York Life’s older agents that should have been paid by Medicare. Under Medicare, employers who provide health insurance to their employees are required to pay for their older employees’ medical expenses first, before Medicare. New York Life had erroneously paid for the medical expenses of its older agents and sought reimbursement from Medicare. The Court of Appeals for the Federal Circuit held that these agents were not “employees” under the Medicare statute, so that New York Life was entitled to reimbursement. The case settled with a significant payment by the federal government to New York Life.