On September 9, the U.S. Departments of Labor, Health and Human Services, and the Treasury (collectively, the Departments) released a final rule to strengthen implementation of the Mental Health Parity and Addiction Equity...more
9/18/2024
/ Biden Administration ,
Department of Health and Human Services (HHS) ,
Department of Labor (DOL) ,
Employee Benefits ,
Employer Group Health Plans ,
Final Rules ,
Health Insurance ,
Healthcare ,
Mental Health ,
Mental Health Parity Rule ,
MHPAEA ,
NQTLs ,
Rulemaking Process ,
U.S. Treasury
As artificial intelligence (AI) continues to permeate the health care industry (and every other part of American life), the industry should be attentive to the risk of anticompetitive conduct arising from reliance on AI and...more
5/15/2024
/ Anti-Competitive ,
Artificial Intelligence ,
Competition ,
Department of Justice (DOJ) ,
Federal Trade Commission (FTC) ,
Health Care Providers ,
Healthcare ,
Innovative Technology ,
Life Sciences ,
Machine Learning ,
Medical Bills ,
No Surprises Act (NSA) ,
Price-Fixing
Artificial intelligence (AI) continues to proliferate throughout the health care industry. With each advance comes complex legal and policy questions. Join us for a live webinar to explore these questions—specifically...more
5/14/2024
/ Affordable Care Act ,
Antitrust Provisions ,
Artificial Intelligence ,
Bias ,
Enforcement Actions ,
Ethics ,
FTC Act ,
Health Care Providers ,
Health Technology ,
Non-Discrimination Rules ,
Section 1557 ,
Webinars
Last week, the Department of Health and Human Services (HHS) finalized antidiscrimination regulations implementing Section 1557 of the Affordable Care Act (ACA Section 1557). The final rule expands upon the proposed rule’s...more
The Mental Health Parity and Addiction Equity Act (MHPAEA) requires health plans and insurers to offer mental health coverage in “parity” with a plan’s medical or surgical coverage. In 2024, as the post-COVID era brings a...more
3/6/2024
/ Class Action ,
Continuing Legal Education ,
Department of Health and Human Services (HHS) ,
Department of Labor (DOL) ,
Employee Retirement Income Security Act (ERISA) ,
Health Care Providers ,
Health Insurance ,
Health Plan Sponsors ,
Insurance Litigation ,
Mental Health ,
Mental Health Parity Rule ,
MHPAEA ,
Proposed Regulation ,
Regulatory Agenda ,
Statutory Interpretation ,
Statutory Violations ,
Substance Abuse ,
U.S. Treasury ,
Webinars
Apparently in light of recent litigation against Medicare Advantage (MA) plans, on February 6, 2024, CMS published responses to frequently asked questions (FAQs) regarding the use of algorithms and artificial intelligence in...more
2/22/2024
/ Algorithms ,
Artificial Intelligence ,
Centers for Medicare & Medicaid Services (CMS) ,
Discrimination ,
Disparate Impact ,
Eligibility Determination ,
Health Insurance ,
Healthcare ,
Medicare ,
Medicare Advantage ,
Popular
Three years after the No Surprises Act (NSA) was enacted, industry stakeholders and government regulators alike are still navigating the intricate twists and turns of the wide-ranging legislation’s key provisions. In a new...more
Last week the Centers for Medicare & Medicaid Services (CMS) reminded health plans and health insurance issuers that the deadline for electronically filing attestations of compliance with the prohibition against so-called gag...more
Editor’s Note: In the article below, Manatt discusses the Ninth Circuit’s new opinion in the ongoing Wit v. United Behavioral Health litigation and the changes from the now-vacated January 2023 Wit decision. ...more
8/31/2023
/ Abuse of Discretion ,
Article III ,
Class Action ,
Class Certification ,
Department of Health and Human Services (HHS) ,
Department of Labor (DOL) ,
Employee Benefits ,
Employee Retirement Income Security Act (ERISA) ,
Exhaustion Doctrine ,
Health Insurance ,
Medical Necessity ,
Mental Health ,
Mental Health Parity Rule ,
MHPAEA ,
Standard of Care ,
Standing ,
U.S. Treasury
The Mental Health Parity and Addiction Equity Act (MHPAEA) requires health plans to provide mental health benefits, including coverage for substance use disorders (SUDs), that are in “parity” with medical and surgical...more
8/29/2023
/ Continuing Legal Education ,
Department of Health and Human Services (HHS) ,
Department of Labor (DOL) ,
Health Care Providers ,
Health Insurance ,
Health Plan Sponsors ,
Insurance Litigation ,
Mental Health ,
Mental Health Parity Rule ,
MHPAEA ,
New Guidance ,
Proposed Regulation ,
Substance Abuse ,
U.S. Treasury ,
Webinars
Last week, after several slow news months for the No Surprises Act (NSA), a Texas district court issued its most recent decision in a series of cases brought by the Texas Medical Association and other health care providers...more
Last week, the departments of the Treasury, Labor and Health and Human Services (collectively, the Departments) published long-awaited proposed regulations intended to clarify and improve compliance with the federal mental...more
8/2/2023
/ Consolidated Appropriations Act (CAA) ,
Department of Health and Human Services (HHS) ,
Department of Labor (DOL) ,
Employee Benefits ,
Employee Retirement Income Security Act (ERISA) ,
Employer Group Health Plans ,
Health Insurance ,
Mental Health ,
Mental Health Parity Rule ,
MHPAEA ,
NQTLs ,
Substance Abuse ,
U.S. Treasury
On July 20, 2023, the Office for Civil Rights (OCR) at the U.S. Department of Health and Human Services (HHS) and the Federal Trade Commission (FTC) sent a joint letter to approximately 130 hospital systems and telehealth...more
7/24/2023
/ CIPA ,
CMIA ,
Cybersecurity ,
Data Privacy ,
Data Security ,
Department of Health and Human Services (HHS) ,
Federal Trade Commission (FTC) ,
FTC Act ,
Health Insurance Portability and Accountability Act (HIPAA) ,
Healthcare Facilities ,
Mobile Apps ,
OCR ,
PHI ,
Technology ,
Tracking Systems ,
Web Tracking
As of March 17, certified independent dispute resolution (IDR) entities may resume IDR payment determinations under the No Surprises Act (NSA) that were temporarily halted last month due to a Texas court’s decision vacating...more
President Biden’s proposed 2024 budget includes substantial additional amounts for continued funding of the implementation and enforcement of the No Surprises Act (NSA) and the transparency laws passed along with the NSA,...more
3/14/2023
/ Biden Administration ,
Centers for Medicare & Medicaid Services (CMS) ,
Employee Benefits ,
Employer Group Health Plans ,
Federal Budget ,
Federal Funding ,
Health Insurance ,
Healthcare ,
Mental Health ,
Mental Health Parity Rule ,
No Surprises Act (NSA) ,
Surprise Medical Bills
The Department of Health and Human Services, the Department of Labor and the Department of the Treasury (the Departments) are continuing to respond to decisions by a federal district court in Texas regarding the Independent...more
On February 6, a Texas federal district court sided with the Texas Medical Association (TMA) and health care providers vacating regulations issued by the Office of Personnel Management and the Departments of Health and Human...more
The No Surprises Act (NSA), which went into effect January 1, 2022, was designed to protect patients from surprise medical bills when they are treated in out-of-network emergency departments or by out-of-network providers at...more
2/2/2023
/ Arbitration ,
Arbitrators ,
Continuing Legal Education ,
Dispute Resolution ,
Enforcement Actions ,
Explanation of Benefits (EOBs) ,
Health Care Providers ,
Health Insurance ,
Insurance Litigation ,
No Surprises Act (NSA) ,
Out of Network Provider ,
Surprise Medical Bills ,
Webinars
Controversy continues to surround the independent dispute resolution (IDR) provisions of the No Surprises Act (NSA). On November 18, bipartisan leadership of the House Ways and Means Committee sent a letter to the Secretaries...more
12/1/2022
/ Arbitration ,
Centers for Medicare & Medicaid Services (CMS) ,
Dispute Resolution ,
Final Rules ,
Health Care Providers ,
Health Insurance ,
Healthcare ,
Healthcare Reform ,
Interim Final Rules (IFR) ,
No Surprises Act (NSA) ,
Out of Network Provider ,
Rebuttable Presumptions ,
Surprise Medical Bills
Creditors and medical services providers should reevaluate their consumer credit agreements and collection practices in light of a recent amendment to Washington, D.C.’s debt collection law, which goes into effect on January...more
The Mental Health Parity and Addiction Equity Act (MHPAEA) requires health plans to provide equal levels of coverage for mental health conditions and substance use disorders (SUD) as for physical illnesses. Understanding and...more
10/14/2022
/ Addiction Equity Act ,
Continuing Legal Education ,
Enforcement Actions ,
Health Care Providers ,
Health Insurance ,
Health Plan Sponsors ,
Mental Health ,
Mental Health Parity Rule ,
MHPAEA ,
Proposed Legislation ,
Substance Abuse ,
Webinars
The Big -
Picture On August 19, the Biden Administration released a final rule on the No Surprises Act (NSA) that primarily addresses regulatory provisions invalidated by the United States District Court for the Eastern...more
The federal No Surprises Act (NSA), which went into effect January 1, 2022, protects patients from surprise medical bills for emergency services and for when they are treated by out-of-network providers in an in-network...more
On February 23, the federal District Court in the Eastern District of Texas struck down key provisions of regulations issued by the federal Departments of Health and Human Services, Labor, and the Treasury (Departments) and...more
The federal Centers for Medicare & Medicaid Services (CMS) has begun publishing on its website letters that it sent to states beginning in December 2021 that provide important information regarding the manner in which the...more