ACA ‘Prudent Layperson,’ ERISA Suit Revived By 11th Circuit

Mealey's (October 23, 2020, 2:08 PM EDT) -- ATLANTA — Medical provider advocates adequately plead standing in an Employee Retirement Income Security Act case challenging whether an insurer’s diagnostic-code based coverage system meets the Patient Protection and Affordable Care Act (ACA)’s prudent layperson standard, an 11th Circuit U.S. Court of Appeals panel held Oct. 22 in reversing and remanding (American College of Emergency Physicians, et al. v. Blue Cross and Blue Shield of Georgia, et al., No. 20-11511, 11th Cir., 2020 U.S. App. LEXIS 33293)....