10th Circuit Affirms Ruling Denying Preauthorization For Nurse’s Knee Surgery

Mealey's (February 24, 2021, 7:37 PM EST) -- DENVER — In a nurse’s Employee Retirement Income Security Act action challenging a health care system’s denial of coverage for knee surgery, the 10th Circuit U.S. Court of Appeals on Feb. 9 affirmed a trial court ruling upholding the system’s refusal to pre-authorize the procedure.  It concluded that the system could reasonably rely on certain research about the most effective course of treatment and that the lower court correctly denied the system’s motion to dismiss the action as time-barred....