Zuckerman Spaeder Named Insurance Litigation Department of the Year by New York Law Journal
Zuckerman Spaeder LLP is pleased to announce that it has been named the “Insurance Litigation Department of the Year” as part of the New York Law Journal’s 2022 Professional Excellence Awards. The award recognizes the success of the firm’s practice in protecting the rights of health care patients and providers.
Zuckerman Spaeder is leading one of the only national legal efforts that systematically challenges health insurers for abusive coverage and reimbursement practices, particularly those that discriminate against those with behavioral health conditions. With a team of highly experienced attorneys who have spent years developing innovative interpretations of the Employee Retirement Income Security Act (ERISA), the firm has delivered dramatic wins that have empowered health care providers and patients, provided relief to tens of thousands of individuals, and fundamentally changed health law.
In the New York Law Journal’s article about the award, partners D. Brian Hufford and Jason S. Cowart spoke about Zuckerman Spaeder’s success, explaining that despite routinely going against large, highly resourced adversaries, “we have been building demonstrable momentum in the fight for provider and patient rights, particularly in the context of behavioral health care. We have, on multiple occasions, forced the nation’s largest insurers to fundamentally reform their processes, end discriminatory practices, and pay injured insureds millions of dollars.”
Zuckerman Spaeder’s recent wins include a 2021 ruling that struck down UnitedHealth’s categorical exclusion of coverage for a primary Autism treatment, which violates the Mental Health Parity and Addiction Equity Act (MHPAEA) and United’s fiduciary responsibilities under ERISA. This was a particularly impactful case that not only restored coverage in the plaintiff’s health plan but sparked a government investigation that led United, the largest health insurer, to eliminate the exclusion in over 1,000 plans covering 500,000 insureds. It also took a significant step toward eroding a legal shield used by insurers. The court categorically rejected United’s defense that it can’t be held responsible for enforcing illegal plan terms.
The same year, the firm broke new ground with a $10 million settlement that forced United to end a policy that unfairly reduced benefit payments based on a provider’s professional qualifications. The extraordinary settlement is providing compensation to over 110,000 class members.
These behavioral health wins reinforce and build upon the firm’s success in other health insurance cases. In 2017, for example, Zuckerman Spaeder obtained the first major ruling ever against United’s use of cross-plan offsets, a highly lucrative billing scheme used against out-of-network providers.