Linda Tiano

Linda Tiano

Epstein Becker Green

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Latest Publications


CMS Issues Broad-Reaching Proposals to Better Align Medicaid Managed Care with the Commercial and Medicare Markets

On May 26, 2015, the Centers for Medicare & Medicaid Services (“CMS”) released a proposed rule (“Proposed Rule”) containing the first proposed revisions to the Medicaid managed care (“MMC”) program’s regulations in more than...more

6/3/2015 - Affordable Care Act CHIP CMS Comment Period Health Care Providers Health Insurance Healthcare Managed Care Contracts Medicaid

CMS Releases Key Proposals for the 2016 Qualified Health Plan Application Process

Stakeholders received insight on the Obama administration’s expected approach to the certification and oversight of qualified health plans (“QHPs”) on December 19, 2014, with the release by the Centers for Medicare & Medicaid...more

1/6/2015 - Certifications CMS Health Care Providers Healthcare Medicaid Medicare Public Health Insurance Marketplace Qualified Health Plans

PPOs and Other Non-HMO Products Now Require Approval and Periodic Reviews of Network Adequacy in New York

The New York Legislature recently enacted legislation that will require all health insurance plans that issue policies that provide for the use of a provider network to obtain network adequacy certification. The new...more

12/9/2014 - Certifications Department of Insurance EPO Health Insurance HMOs PPOs

National Association of Insurance Commissioners Releases Draft Model Law Updating Managed Care Adequacy Model Act

On November 12, 2014, the National Association of Insurance Commissioners (“NAIC”) released a draft model law updating the NAIC’s Managed Care Network Adequacy Model Act. The NAIC regularly creates model laws to serve as...more

11/26/2014 - Affordable Care Act CMS Health Insurance NAIC Policy Drafting

CMS Cost Sharing Reduction Reconciliation Reporting for QHPs

Qualified Health Plans (“QHPs”) and other stakeholders have until October 27, 2014, to comment on CMS’s proposed cost sharing reduction payment reconciliation reporting process. On Friday, September 26, 2014, CMS released...more

10/13/2014 - Affordable Care Act CMS Employee Benefits Healthcare Healthcare Reform Qualified Health Plans

HEAL Advisory: How Big Is Halbig? The Potential Effects of This Major Ruling Are Numerous and Significant

On July 22, 2014, the U.S. Court of Appeals for the D.C. Circuit and the U.S. Court of Appeals for the Fourth Circuit issued conflicting opinions on a key aspect of the Affordable Care Act ("ACA"). The cases are Halbig v....more

7/30/2014 - Affordable Care Act Appeals Barack Obama Employer Mandates En Banc Review Halbig v Burwell Health Insurance Health Insurance Exchanges Healthcare Reform King v Burwell SCOTUS Subsidiaries Tax Credits

CMS Identifies Key Priorities for 2014 Compliance Reviews of Qualified Health Plans in the Federally Facilitated Marketplace

At a Centers for Medicare & Medicaid Services ("CMS") teleconference titled "Compliance Reviews in the Federally-Facilitated Marketplace" ("FFM"), which was held on April 10, 2014, CMS representatives discussed the agency's...more

4/14/2014 - Audits CMS Compliance Healthcare Medicaid Medicare Qualified Health Plans

Key Highlights of the New York State Public Health and Health Planning Council's Recommendations for Oversight of Ambulatory Care...

In the setting of a more sophisticated, cost-conscious patient population coupled with a potential crisis with respect to primary care access, more and more ambulatory and stand-alone clinic services are becoming available to...more

3/13/2014 - Healthcare Healthcare Reform

Governor Cuomo Revisits Pilot Program for Private Business Corporations to Own and Operate Hospitals in New York

New York is set to revisit the debate regarding the private ownership of hospitals. On January 21, 2014, Governor Andrew Cuomo released his Executive Budget, which again calls for the implementation of a pilot program ("Pilot...more

2/14/2014 - Andrew Cuomo Business Ownership Healthcare Facilities Hospitals

HEALTH REFORM: Federally Facilitated Exchanges Are Almost Ready

On March 1, 2013, the Center for Consumer Information and Insurance Oversight (“CCIIO”) and the Centers for Medicare & Medicaid Services (“CMS”) released lengthy and detailed draft guidance regarding the federally facilitated...more

4/1/2013 - Affordable Care Act CCIIO CMS Health Insurance Exchanges Healthcare

HEALTH REFORM: New York Issues "Invitation to Participate in the New York Health Benefit Exchange," Clarifying Application Process...

The New York Department of Health's Office of the New York Health Benefit Exchange issued the long-awaited "Invitation to Participate in the New York Health Benefit Exchange" (the "Invitation") on January 31, 2013. The...more

2/13/2013 - Affordable Care Act Health Insurance Exchanges Healthcare Qualified Health Plans

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