For the past decade, CGL has been involved in prosecuting actions on behalf of subscribers and providers against insurance companies for inadequate reimbursements for "out of plan" charges for medical care.
United Health Care
In 2008, CGL was counsel in a case in which United Healthcare paid $350 million to a settlement class of subscribers and providers for inadequate healthcare reimbursements and agreed to change its calculation techniques. In 2011, after extensive hearings, the United States District Court for the Southern District of New York approved that settlement, which CGL and its clients had supported from the outset.
Morris v. Directors Guild of America – Producer Health Plan
Jonathan Cuneo and Matthew Miller recently represented documentary filmmaker Len Morris (director of Stolen Childhoods, an award winning documentary about child labor) in an ERISA action concerning eligibility for pension and health benefits with the pension and health plans associated with the Directors’ Guild of America. Morris v. Directors Guild of America – Producer Health Plan (D. Mass. 2014). The case raised questions of plan interpretation particularly relevant to directors engaged in nonprofit and public interest film making. The matter was resolved with a confidential settlement.
Blue Cross & Blue Shield
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.
New York Life Insurance
Mr. Cynkar, while at another firm, was lead counsel representing New York Life in New York Life Insurance Co. v. United States, a case against the federal government to recover medical expenses of New York Life’s older agents that should have been paid by Medicare.
The firm was co-lead counsel in this class involving all 21,000 salaried retirees of McDonnell Douglas Corporation in seeking to reinstate their rights to health and welfare benefits after termination by the corporation. The firm succeeded in obtaining a settlement in the approximate amount of $450 million on behalf of the retirees.