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PLASTIC SURGERY CENTER, P.A. v. AETNA LIFE INS.

No. 18-3381, No. 18-3556.

967 F.3d 218 (2020)

The PLASTIC SURGERY CENTER, P.A., Appellant v. AETNA LIFE INSURANCE COMPANY. The Plastic Surgery Center, P.A., Appellant v. Aetna Health Inc.

United States Court of Appeals, Third Circuit.

Filed: July 17, 2020.

Attorney(s) appearing for the Case

Michael M. DiCicco [ARGUED], James A. Maggs , Maggs & McDermott, 3349 Highway 138, Building C, Suite D, Wall, NJ 07719, Counsel for Appellant, The Plastic Surgery Center, P.A.

Colin J. O'Boyle [ARGUED], Gregory S. Voshell , Elliott Greenleaf, 925 Harvest Drive, Suite 300, Blue Bell, PA 19422, Counsel for Appellees Aetna Life Insurance Co, Aetna Health Inc.

Before: KRAUSE, MATEY, Circuit Judges, and QUIÑONES ALEJANDRO, District Judge.

OPINION OF THE COURT

This case presents an issue of first impression for this Circuit and of great importance to the healthcare industry: What remedies are available to an out-of-network healthcare provider when an insurer agrees to pay for the provision of services that are not otherwise available in-network and...

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