Apollo Educ. Grp. Inc. v. Henry, 150 F.Supp.3d 1078, 1083-84 (D. Ariz. 2015).
Aug 12, 2016OUTCOME: We prevailed; application for fees pending.
Concerned enforceability of an ERISA plan's subrogation / reimbursement provisions.
Phoenix, AZ
Motorcycle accident Lawyer at Phoenix, AZ
Practice Areas: Motorcycle Accident, Wrongful Death, Car Accidents
OUTCOME: We prevailed; application for fees pending.
Concerned enforceability of an ERISA plan's subrogation / reimbursement provisions.
OUTCOME: Supreme Court adopted the original tortfeasor rule consistent with UCATA.
Retained to handle the appeal to the Arizona Supreme Court as to the viability of the original tortfeasor rule under UCATA,
OUTCOME: We prevailed in the court of appeals; awarded attorneys' fees. The Arizona Supreme Court reversed on other grounds. Appeal pending to the United States Supreme Court.
Class action against Arizona hospitals for unlawfully balance billing AHCCCS patients.
OUTCOME: We prevailed; awarded attorneys' fees.
LT received a favorable decision from Division One in Puch v. Key Health Medical Solutions. The case represents a years-long battle on behalf of an indigent client who was being ruthlessly and unlawful ... ly pursued by “Key Health Medical Solutions,” a company that buys medical receivables from actual medical providers. The case confirms that (a) a registered AHCCCS healthcare provider (i.e., a provider that has signed a Program Participation Agreement (“PPA”) with AHCCCS) may not bill, collect or “demand payment” from an AHCCCS eligible patient or person claiming to be eligible and (b) that this prohibition applies to third-party companies who buy medical receivables from AHCCCS registered providers. The case concerned Gregory Puch who was seriously injured in an accident and qualified for AHCCCS, which is a federal-state program that is limited to those who have income at or below the federal poverty threshold. As part of his treatment, Puch was sent to Insight-Biltmore for radiology studies. While at Insight-Biltmore he presented his AHCCCS card and was given a one-page form to sign entitled “Assignment of Proceeds / Lien” that incorrectly said Puch did not have “government insurance” and that he agreed to pay Key Health — the assignee of the radiology center — for the medical treatment he received. That is, the document Puch signed purported to make Puch “personally liable” for these expenses to Key Health even though he had AHCCCS available to pay for his care. The document Puch was asked to sign was unenforceable because federal law, state regulations, and the applicable PPA prohibit AHCCCS registered providers from billing, collecting or “demanding payment” from AHCCCS eligible patients. Insight-Biltmore could not demand money from Puch and neither could anyone else, including Key Health. Sometime later, Puch recovered the policy limits — $15,000 — from the person who injured him. Though Puch’s case was worth much more, this was all the available insurance. Key Health demanded $4,435.90 from this recovery. On behalf of Puch, LT explained that, under the PPA Section 15 (which is standard in all AHCCCS PPAs) and AHCCCS regulation R9-22-702(A), Key Health stood in the shoes of Insight-Biltmore and, because Insight-Biltmore was not legally allowed to bill Puch, Key Health had bought a “pig in a poke.” That is, that Key Health was not allowed to collect from Puch either. Key Health refused to back down and after particularly nasty litigation and briefing by Key Health, whose attorneys threatened sanctions and even a bar complaint against LT, the trial judge found for Puch and awarded him $23,455 in attorneys’ fees plus additional sanctions of $1,339.92 against Key Health. Key Health appealed. The Court of Appeals agreed with the trial court, citing ACC R9-22-702 that states that “Registered providers must accept payment from the [AHCCCS] Administration or contractor as payment in full.” And once again, Puch was awarded his attorneys’ fees. This case highlights LT’s expertise in lien-related matters and its commitment to help clients who are being unlawfully pursued by third-party lien claimants, a problem that is exceedingly common and widespread.
OUTCOME: We prevailed; awarded attorneys' fees.
This was a consolidated set of cases holding that AHCCCS "may recover no more than the portion of the victim's settlement that represents recovery of the plan's payments on behalf of the victim, less a ... deduction for litigation expenses." That is, in applying the Supreme Court's Ahlborn decision, AHCCCS must use the "bills paid," not the "total bills."
OUTCOME: We prevailed; awarded attorneys' fees.
Court of Appeals holding that a "tire tread" was an "integral part of a motor vehicle" for the purposes of triggering Uninsured Motorist coverage.
OUTCOME: We prevailed; trial court reversed.
Court of Appeals holding that, while plaintiffs could not claim wrongful death, they could maintain an action under several other theories for the loss of their frozen embryos. These theories included ... negligent loss of things, breach of bailment contract and breach of fiduciary duty.
OUTCOME: We prevailed; case settled.
Widow of deceased husband’s estate brought action against employer and life insurance company for failure to pay on late husband's life insurance contract.
OUTCOME: GRANTED
Petition the Supreme Court to permit service to be made upon an administrative assistant or employee of a chief executive officer, secretary, clerk, or recording officer of a public entity's governing ... group.
OUTCOME: GRANTED
Petition R-12-0032 to amend ER 1.15 to provide a mechanism, when a dispute arises between a client and third party over the third party's interest in property in the lawyer's possession, for shifting t ... he burden to the third party to take action to protect the alleged property claim.