⚖ Oral Arguments, with Context

The Second Circuit hears a dispute over payment for pandemic testing. Murphy Medical and its co-plaintiffs sued EmblemHealth and other insurers, saying testing claims were unpaid or underpaid. Central to the dispute is a machine that screened a sample for twenty-two respiratory pathogens, including the virus that causes COVID-19. The providers say pandemic coverage rules require reimbursement regardless of plan terms; the insurers dispute coverage of the full testing panel. The district court dismissed the amended complaint for insufficient detail about insurance plans and internal claim appeals. The providers want the case reinstated, or another chance to amend. The Families First Coronavirus Response Act required coverage of qualifying COVID tests without patient cost sharing. The CARES Act set reimbursement rules, including for providers without a negotiated rate. The suit uses ERISA, the federal employee-benefits law, to pursue plan benefits, alongside state contract claims. Assignment means a patient's transfer of payment rights to a provider; exhaustion means using the plan's required internal review process before suing. The question here is whether the allegations state a plausible claim, not which bills must ultimately be paid. Roy Breitenbach will argue for the medical providers.

Murphy Medical Associates, LLC v. Emblem Health, Inc. (No. 25-3225) — U.S. Court of Appeals for the Second Circuit, argued October 14, 2026.