General Business Insurance Health

Read need-to-know updates, commentary, and analysis on General Business issues written by leading professionals.
News & Analysis as of

FTC Commissioner Criticizes Proposed Legislation That Would Permit Health Providers to Negotiate Jointly with Health Insurers

In a February 26 speech before the Connecticut Bar Association, Federal Trade Commissioner Maureen Olhausen expressed strong opposition to proposed legislation that would create an antitrust exemption for collective...more

Court of Appeals Issues Decision Regarding Vesting of School District Retiree Health Insurance Benefits

On December 12, 2013, the New York Court of Appeals issued a decision in Kolbe v. Tibbetts, in which the Court addressed whether the Newfane Central School District could unilaterally alter the health insurance benefits of...more

Insurance Antitrust Legal News - March 2014 • Volume 3, Number 2

In This Issue: - FTC COMMISSIONER CRITICIZES PROPOSED LEGISLATION THAT WOULD PERMIT HEALTH PROVIDERS TO NEGOTIATE JOINTLY WITH HEALTH INSURERS: In a February 26 speech before the Connecticut Bar Association,...more

Appeals Court Sides With Hospitals, Rejects Health Plan’s Demand for Refund

The United States Court of Appeals for the Seventh Circuit recently affirmed a Wisconsin district court’s grant of summary judgment in favor of two Wisconsin hospitals, ruling the hospitals were not obligated to repay $1.7...more

Connecticut High Court Clarifies Aggregate Limit and Number of SIRs Under Professional Liability Policy

On January 28, 2014, the Supreme Court of Connecticut, in Lexington Ins. Co. v. Lexington Healthcare Group, Inc., 311 Conn. 29, addressed three issues that define the extent of coverage available under a medical professional...more

Mississippi Governor Rescinds Executive Order Requiring Blue Cross of Mississippi to Grant “In Network” Status to Excluded...

In early November, Mississippi Governor Phil Bryant rescinded an Executive Order (Executive Order 1327), issued only weeks earlier, that would have compelled Blue Cross of Mississippi to continue to offer “in-network” status...more

Judge Finds Illinois Insurance Department's Policy Prohibiting Offshoring To Be Improper Rulemaking

On November 27, 2013, the Circuit Court of Cook County, Illinois issued an Order in a lawsuit filed by the American Council of Life Insurers, Inc. ("ACLI") v Andrew Boron, Director of the Illinois Department of Insurance and...more

Insurance Antitrust Legal News - January 2014 • Volume 3, Number 1

In This Issue: - MISSISSIPPI GOVERNOR RESCINDS EXECUTIVE ORDER REQUIRING BLUE CROSS OF MISSISSIPPI TO GRANT “IN NETWORK” STATUS TO EXCLUDED HOSPITALS: In early November, Mississippi Governor Phil Bryant...more

Here's One Good Way to Anticipate Top Business & Legal Trends in 2014

If the past is prologue, what better way to consider the interests, needs, and concerns of business leaders and consumers in the new year than to look at what captured their attention in 2013? And so...more

Legal Alert: NAIC Report: Fall 2013 National Meeting

The National Association of Insurance Commissioners (NAIC) returned to Washington, D.C. for its Fall meeting – the final national meeting for 2013. Two notable events overshadowed technical work on various NAIC initiatives: ...more

Private Health Insurance Fraud – Rooting Out Bogus Providers

The United States spends over $2.81 trillion dollars on health care annually and generates billions of claims from millions of health care service and product providers. The vast majority of these providers of services and...more

Valid Assignment Confers Beneficiary Status on Chiropractor

A federal district court in Illinois recently issued a pair of rulings in cases where insurers sought to recoup payments from practitioners. Pennsylvania Chiropractic Association v. Blue Cross Blue Shield Association, 2013...more

Health Plan Class Action Lawsuit Filed in Northern California

Approximately 300 employers and other organizations, many of which are in Northern California, were named as co-defendants in an ERISA class action lawsuit filed on November 22, 2013, in the U.S. District Court for the...more

Health Insurance Exchanges: Litigation to Follow and How to Avoid It Next Time

First you have the problem and then you have the litigation. This more-or-less iron rule of American life will be honored once again in the aftermath of the “roll out” of Obamacare. The design and operational failures...more

Recent California Decision Upholds Data Breach Coverage

The U.S. District Court for the Central District of California recently upheld coverage under a commercial general liability policy for a hospital data breach that compromised the confidential medical records of nearly 20,000...more

OIG Advisory Opinion 13-15 - Anesthesiologists: Chickens or Eggs?

It is often said that advisory opinions are requested from the U.S. Office of Inspector General (OIG) when one wants a very safe deal blessed or when one wants to dissuade a competitor or counter-party from entering into or...more

December 1 Deadline for New Reporting Requirements for Physician-Owned Hospitals Approaching Fast

Physician-owned hospitals that seek to avail themselves of the “whole hospital” exception or “rural provider” exception to the federal physician self-referral law, commonly known as the Stark Law, should carefully review...more

OIG Issues Negative Advisory Opinion Regarding Anesthesiology Provider Contract

On November 12, 2013, the Office of Inspector General (“OIG”) released Advisory Opinion 13-15 concluding that a proposed arrangement between an anesthesiology group and a hospital-based psychiatry group could potentially...more

Proposed Massachusetts Regulations Governing Risk-Bearing Provider Organizations

On November 7, 2013, the Massachusetts Division of Insurance (“DOI”) published a Notice of Hearing and proposed regulations regarding the certification of Risk-Bearing Provider Organizations (“RBPOs”). These regulations are...more

Are Exchange Health Plans Federal Health Care Programs, and Therefore Subject to Anti-Kickback Statutes?

Background - As we reported earlier this week, Rep. Jim McDermott, the ranking Democrat on the Ways and Means Health Subcommittee in the House of Representatives, received a response to his August 6 letter to Secretary...more

OIG Report Concludes that Physician-owned Distributors Increase Utilization

In response to the U.S. Senate Committee on Finance’s continued questioning of physician-owned distributorships (PODs), the U.S. Department Health and Human Services Office of the Inspector General issued its long-awaited...more

Ninth Circuit Upholds Rescission of Life Insurance Policy and Rejects Novel Theories

This week the Ninth Circuit affirmed a grant of summary judgment in favor of USAA Life Insurance Company, holding that the insurer was entitled to rescind the policy under California law when it discovered that its insured...more

Insurance Antitrust Legal News - November 2013 • Volume 2, Number 6

In This Issue: - BILL SEEKING TO REPEAL THE MCCARRAN FERGUSON ACT’S ANTITRUST EXEMPTION INTRODUCED IN CONGRESS: On September 18, Congressman Phil Roe (R-Tennessee) introduced legislation (H.R.3121) that would,...more

Physician Quality Reporting For 2013 and Beyond

The 2010 Patient Protection and Affordable Care Act (the “ACA”) impacts a number of industries and professions, including healthcare practitioners, insurance companies, employers, and individuals. Recently, for example,...more

OIG Comes Down Hard on Physician-Owned Distributorship Arrangements

Hospitals and physician-owned entities should consider new report’s cost and utilization concerns. On October 24, the Office of Inspector General (OIG) of the U.S. Department of Health and Human Services (HHS) released...more

218 Results
|
View per page
Page: of 9

Follow General Business Updates on: