Navigation Links
New Free Webinars Announced to Discuss the Latest Federal Court Overpayment Lawsuit Ruling and New Obama Health Laws for the Skyrocketing $6 Trillion Overpayment Recoupment Market

New Free Webinars Announced From To Discuss The Latest And The First Federal Court Ruling On March 18, 2010 That A PPO Participating Provider's Lawsuit Against Anthem BCBS, For The Alleged Wrongful Overpayment Recoupment and Even Withholding From Different Patients, Is Completely Governed By Federal Law, ERISA, Rather Than PPO Contracts And State Laws. The Court Decision Was Mainly Relied Upon U.S. Supreme Court Rulings, the Federal Court Ruling Is Timely Consistent With New Obama Health Reform Laws That Mandate ERISA Appeals For All Group Health Plans And Health Providers. The Federal Court Timely Ruling and New Health Reform Law Mandates Are Vital and Crucial Guidance for a Potentially $6 Trillion Overpayment Market for Every One In Healthcare Delivery System.

Hanover Park, IL (PRWEB) March 29, 2010 -- As an industry leader in compliance and reimbursement, announced the special free Webinars in the wake of the latest and first federal court ruling on March 18, 2010 that that a PPO participating provider's lawsuit against Anthem BCBS, for the alleged wrongful overpayment recoupment and even withholding from different patients, is completely governed by federal law, ERISA, rather than PPO contracts and state laws. The Court decision was mainly relied upon the U.S. Supreme Court rulings. The healthcare overpayment recoupment and withholding crisis, with or without fraud allegations, has been the most expensive and detrimental financial crisis for most healthcare providers, yet embraced by health plans and every managed care entities, for a potential market as large as $6 trillion in dispute, as many health plans or TPA's are going back 5 - 6 years for allegedly overpaid claims, especially from ERISA plans. The stake is extremely high for every one. The industry has been in total chaos without clear legal guidance to follow as the governing laws for this $6 trillion market. At the same time, historical new Obama Health Reform Laws now require all group health plan and health care providers to comply with ERISA Appeals Regulations for all claims disputes.

The new overpayment Webinars will discuss in details the Federal Court ruling, and its profound impact to providers and health plans as well as managed care entities, especially the U.S. Supreme Court ruling upon which the court made its final decision. The Webinar will also review the new Obama Healthcare Reform Law mandates in claims appeals and reviews. The webinars are free to public, providers, health plans and TPA's, starting the first webinar on April 2, 2010, at 1:30 pm CST for 30 minutes each session. More dates, schedules and registration can be found at

"It is extremely important for all health plans, TPA's, managed care operators and healthcare providers to comply with governing federal laws in resolving and prevailing all overpayment claims disputes and overpayment recoupment and withholding," said Dr. Jin Zhou, President of, a national ERISA expert, and reimbursement compliance consultant.

In the case of Porter v. Anthem Health Plans Of Kentucky, Inc, a PPO participating provider sued the Anthem BCBS for alleged wrongful overpayment recoupment in the state court. "Defendant argues that this case could have been brought under ERISA and is thus subject to federal jurisdiction. The Court agrees." The Federal Court reasoned that "Plaintiffs' claim sounds in ERISA. Absent ERISA, there would be no obligation between the parties. Of note in this regard is United States Supreme Court decision ....Aetna Health, Inc. v. Davilla, 542 U.S. 200 (2004). ….As in Davilla, that Porter and his practice have a provider contract with Anthem does not, in and of itself, create an independent legal duty for Anthem to make payments to Porter. What is payable, and, more importantly, what is not is defined by the terms of the benefit plans and, thus, governed by ERISA."

An official copy of the Federal Court record with decision for Porter v. Anthem Health Plans Of Kentucky, Inc is available at:

Civil Action No. 10-8-HRW, March 18, 2010.


United States District Court, E.D. Kentucky, Northern Division, Ashland.

On March 23, 2010, President Obama signed into law the Senate Bill passed in the House of Representatives, making this year-long debated healthcare legislation into the law of land for more than 95% of Americans, with most significant overhaul to U.S. healthcare delivery system and reimbursement laws.

According to Dr. Jin Zhou, contrary to popular misinformation, the Obama health law, Patient Protection and Affordable Care Act, has established significant consumer protections and plan claim processing and appeal simplification to reduce administrative costs and enhance provider reimbursement rights and patient protections. New Obama health law incorporates or adopts existing ERISA claim regulation in its entirety as internal ERISA appeal mandates, and Uniform External Review Model Act promulgated by the National Association of Insurance Commissioners as external ERISA appeal mandates as final and binding authority to all parties, in absence of judicial appeals.

"After the legislation becomes the law of land for America health care, it is time for everyone who truly cares about reimbursement and compliance to forget about yesterday's legislation enthusiasm, set aside personal emotions and political preferences, to get hands on today's new reality, statutory and regulatory compliance and reimbursement by learning and mastering new rule of the game for health care reimbursement through compliance", said Dr. Jin Zhou.

In the past 10 years, has been the only ERISA Specialized Company offering the most practical and comprehensive ERISA education, consulting and publishing services for healthcare providers in administrative ERISA appeals for real problem oriented denials under the most mysterious 35-year-old federal law, ERISA. Dr. Jin Zhou, president has been regarded as the Godfather of ERISA claims for healthcare providers by some in Professional billing and coding industry.

For more information or to arrange an interview, please contact Dr. Jin Zhou, president of at 630-808-723 or visit:


Read the full story at

Source: PRWeb
Copyright©2010 Vocus, Inc.
All rights reserved

Related medicine news :

1. International Pelvic Floor Muscle Expert Presents Live Webinars on Telemedecine
2. Autism Research Study Announced By Children's Health Council
3. International Iridoid Research Council Announced
4. $250,000 Bioactive Beverage Challenge Announced By Tahitian Noni International
5. Five New Tahitian Noni Bioactive Beverages™ Announced
6. CieAura has Announced the Release of a New Holographic Chip
7. Pharmahelper Pleased To Recognize Online Pharmacy Practice Standards Announced By Google Adwords
8. Shark Attack Study Announced: Politics of Bite Incidents Under Review
9. New Speakers Announced for the 2010 Personalized Medicine Partnerships Conference
10. Dates Announced for IntertechPira's 8th Color Cosmetics Summit
11. New Dean of School of Medicine and Dentistry Announced
Post Your Comments:
(Date:6/25/2016)... FL (PRWEB) , ... June 25, 2016 , ... The temporary closing of Bruton Memorial ... Plant City Observer , brings up a new, often overlooked aspect of head lice: the ... closing for fumigation is not a common occurrence, but a necessary one in the event ...
(Date:6/25/2016)... ... June 25, 2016 , ... On Friday, June 10, Van ... Wellness at Work award to iHire in recognition of their exemplary accomplishments in worksite ... 7th annual Maryland Workplace Health & Wellness Symposium at the BWI Marriott in Linthicum ...
(Date:6/24/2016)... ... 2016 , ... Marcy was in a crisis. Her son James, eight, was out of control. ... and physically. , “When something upset him, he couldn’t control his emotions,” remembers Marcy. ... rocks at my other children and say he was going to kill them. If ...
(Date:6/24/2016)... NY (PRWEB) , ... June 24, 2016 , ... Topical BioMedics, Inc, makers of Topricin ... companies that call for a minimum wage raise to $12 an hour by 2020 and ... This will restore the lost value of the minimum wage, assure the wage floor does ...
(Date:6/24/2016)... (PRWEB) , ... June 24, 2016 , ... ... is actively feeding the Frederick area economy by obtaining investment capital for emerging ... the past 2½ years that have already resulted in more than a million ...
Breaking Medicine News(10 mins):
(Date:6/24/2016)... The Academy of Managed Care Pharmacy (AMCP) ... would allow biopharmaceutical companies to more easily share health ... and coverage decisions, a move that addresses the growing ... The recommendations address restrictions in the sharing of ... label, a prohibition that hinders decision makers from accessing ...
(Date:6/24/2016)... , June 24, 2016 According ... by Type (Standard Pen Needles, Safety Pen Needles), Needle ... GLP-1, Growth Hormone), Mode of Purchase (Retail, Non-Retail) - ... This report studies the market for the forecast period ... reach USD 2.81 Billion by 2021 from USD 1.65 ...
(Date:6/23/2016)... , June 23, 2016  MedSource announced ... as its e-clinical software solution of choice.  This ... best possible value to their clients by offering ... The preferred relationship establishes nowEDC as the EDC ... for MedSource,s full-service clients.  "nowEDC has long been ...
Breaking Medicine Technology: