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IV Solutions, Inc. v. PacifiCare Life & Health Insurance Co.

Paid petition · United States Court of Appeals for the Ninth Circuit, No. 17-56609 · judgment February 21, 2020


Certiorari denied · October 5, 2020
Pre-decision estimate: 1% cert probability

Before the decision, well below the 4.1% base rate, with no standout signals pointing toward a grant.

Question presented

When a health care insurance company issues an Explanation of Benefits (“EOB”) expressly inviting a health care provider to “notify it of additional information clarifying the services and/or charges,” and thereafter engages in an extended dialogue with the health care provider regarding the reprocessing of the provider’s claims in light of such additional information, does the statute of limitations begin running as a matter of law immediately upon the issuance of that Explanation of Benefits, even though the insurance company, through its representatives, thereafter communicated to the provider on numerous occasions that the provider’s claims were still being reviewed and reprocessed?

Counsel of record

For petitioner
Marc E. Rohatiner
Wolf, Rifkin, Shapiro, Schulman & Rabkin, LLP

For respondent
Emily Tomoko Barner Kuwahara
Crowell & Moring LLP

Case

Conference history
Distributed for 1 conference

Proceedings

  1. Oct 05 2020
    Petition DENIED.
  2. Aug 19 2020
    DISTRIBUTED for Conference of 9/29/2020.
  3. Aug 11 2020
    Waiver of right of respondent Pacificare Life & Health Insurance Company to respond filed.
  4. Jul 17 2020
    Petition for a writ of certiorari filed. (Response due August 26, 2020)