Community Insurance Company v. HaloMD, LLC et al.

Docket No.
1:25-cv-00388
District Court
Ohio Southern

Goal

  • Award damages
  • Award restitution
  • Declaration that awards are unenforceable
  • Vacate arbitration awards

Issues

Why this Matters:

A private insurer alleges that providers and their third-party biller are abusing the No Surprises Act arbitration process to receive higher out-of-network payments in violation of the federal Racketeer Influenced and Corrupt Organizations Act, the Ohio Corrupt Activity Act, the Ohio Deceptive Trade Practices Act, and the Employee Retirement Income Security Act. The higher than expected volume of arbitration cases (including the prevalence of ineligible cases) to date and high provider win rate could raise health costs and plan premiums.

Potential Impact:

Actions that flout the intent of the No Surprises Act arbitration process through the submission of ineligible disputes could lead to higher costs and lower-quality care for patients.

News And Analysis (1)

10 Major Filings

Related Litigation

Current Status

Briefing is ongoing

Important Date

Plaintiff's Response to Motion to Dismiss Due

Legal Issues

Racketeer Influenced and Corrupt Organizations (“RICO”) Act, Ohio Corrupt Activity Act, Theft By Deception (Ohio Law), Civil Conspiracy, Ohio Deceptive Trade Practices Act, Fraudulent Misrepresentation, Employee Retirement Income Security Act

Topic(s)

Arbitration Awards/Conduct

Date Filed
June 10, 2025
Case Type
Civil
Court Type
District Court
Court
Ohio Southern
Court Division
Western
Judge
McFarland, Matthew W. Appointed By: Donald Trump
Plaintiff(s)
Community Insurance Company
Lead Counsel For Plaintiff(s)
Frost Brown Todd LLP et al.
Defendant(s)
HaloMD, LLC; Alla LaRoque; Scott LaRoque; MPOWERHealth Practice Management; Evokes, LLC; Midwest Neurology, LLC; One Care Monitoring, LLC; Value Monitoring LLC
Lead Counsel for Defendant(s)
Jones Day et al.