Anthem Blue Cross Life and Health Insurance Company et al. v. HaloMD LLC et al.

Docket No.
26-2355
Appellate Court
Ninth Circuit

Goal

  • Award damages
  • Block defendant action
  • Vacate arbitration awards

Issues

Case History

Why This Matters:

Why this Matters:

Private insurers allege 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 (“RICO”) Act, the Employee Retirement Income Security Act, and California’s Unfair Competition Law, among other legal requirements. 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. The private insurers appeal a judgment dismissing the case.

Potential Impact:

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)

9 Major Filings

Related Litigation

Current Status

Briefing is ongoing

Important Date

Defendants' Response Brief Due

Legal Issues

Racketeer Influenced and Corrupt Organizations (“RICO”) Act, Fraudulent Misrepresentation, Negligent Misrepresentation, California State Law, Employee Retirement Income Security Act

Topic(s)

Arbitration Awards/Conduct

Date Filed
April 13, 2026
Case Type
Civil
Court Type
Appellate Court
Court
Ninth Circuit
Plaintiff(s)
Anthem Blue Cross Life Insurance Company; Blue Cross of California
Lead Counsel For Plaintiff(s)
Reed Smith LLP
Amicus Briefs for Plaintiff(s)

American Benefits Council et al.; America’s Health Insurance Plans; California Association of Health Plans et al.

Defendant(s)
Halo MD LLC; Alla LaRoque; Scott LaRoque; MPOWERHealth Practice Management LLC; Bruin Neurophysiology P.C.; iNeurology PC; N Express PC; North American Neurological Associates PC; Sound Physicians Emergency Medicine of Southern California PC; Sound Physicians Anesthesiology of California PC; Los Angeles Neurological Associates PC (Dismissed)
Lead Counsel for Defendant(s)
Nixon Peabody LLP