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The Soon-to-be Reality of Medicare Part B Reimbursements for Biosimilars

As the country’s largest health insurer, Medicare has immense influence on the health care market. In the wake of the recent approval of Sandoz’s Zarxio (filgrastim-sndz), the first FDA-approved biosimilar, last month the...more

HIPAA Rules and Procedures in the Event of a Data Breach, Part One

As discussed in my prior post, recent massive data breaches at major retailers and health insurance providers paint a bleak picture of modern data and emphasize the importance of strong security safeguards and plans for...more

Regulators Examining Cybersecurity Policies and Practices for the Insurance Industry

Shortly after the discovery of a cybersecurity breach at the health insurance company Anthem, Inc., the National Association of Insurance Commissioners (NAIC) called for a multi-state examination of Anthem’s cybersecurity...more

Washington Healthcare Update

This Week: Energy and Commerce Health Subcommittee Explores Post-Acute Bundling…CMS Releases First-ever Hospital Compare Star Ratings…Fiscal Year 2016 Proposed Inpatient and Long-term Care Hospital Policy and Payment Changes....more

CMS Fines Insurer for Misleading Medicare Part D Beneficiaries

The federal agency that oversees Medicare’s prescription drug program has alleged that a major U.S. insurance company misled beneficiaries about the pharmacies included in the company’s drug plan, and imposed a $1 million...more

Illinois joins growing list of states to adopt anti-markup legislation; statute impacts all payors

After three years of negotiations between several constituencies, including pathologists, dermatologists and other specialist associations, Illinois has joined 25 states that have enacted laws addressing the practice of some...more

Another Health Plan Hit By Massive CyberAttack and Class Actions Follow

Coming fresh off the heels of the Anthem data breach Premera Blue Cross announced on March 17th that it was the victim of a “sophisticated” cyberattack that may have exposed the personal information of approximately 11...more

CMS Discusses Medicare Implications of FDA Approval of First Biosimilar Product

CMS has issued an educational article on “Food and Drug Administration Approval of First Biosimilar Product,” and the implications for Medicare coverage. CMS states that its policies “will ensure Medicare beneficiaries will...more

Colorado Passes “Full Parity” Telemedicine Law, Although Some Gaps Remain

On March 20, 2015, Colorado Governor John Hickenlooper signed into law HB 15-1029, which requires that insurers operating in Colorado reimburse health care providers for telehealth services in all of Colorado’s counties,...more

Blog: Class Action Following Health Information Data Breach

As we discussed in our previous post, Premera Blue Cross (Premera) recently revealed that it suffered a massive data breach potentially exposing the personal data of 11 million customers. ...more

Washington Healthcare Update

This Week: Bipartisan, Bicameral Permanent SGR Fix Introduced... House Budget Committee Advances FY2016 Budget Proposal... National Coverage Determinations Proposed for Removal... HHS Releases Proposed Rules on EHR Incentive...more

Health Alert (Australia) - March 23, 2015

In This Issue: Judgments; Legislation; and Reports. Excerpt from Reports: New South Wales (NSW). Ministry of Health - Media Releases - 18 March 2015 - NSW says protect against mosquitoes after huge...more

Premera Blue Cross Targeted by Hackers – 11 Million Individuals Compromised

Premera Blue Cross (“Premera”) announced this week that it has been the target of a sophisticated cybersecurity attack in which the information of approximately 11 million individuals has been compromised. This announcement...more

A Look Back: NetDiligence 2014 Cyber Claims Study

The NetDiligence 2014 Cyber Claims Study relies on data voluntarily provided by insurers about amounts paid out on cyber claims occurring from 2011 through 2013. Since the Study only accounts cyber claims reported to larger...more

Lessons Learned from Recent Data Security Breaches, Part Two

Because controlling access is essential to protecting privacy of PHI under HIPAA, the HITECH Security Rule essentially requires that a covered entity control physical and electronic access to the data system by implementing...more

State Legislatures React To Latest Health Data Breaches By Updating State Data Breach Notification Laws And Encryption...

Recent, large-scale breaches of health information have served to highlight the fact that federal agencies have only rarely assessed penalties against companies as a result of these breaches, while many states do not have...more

Blog: Another Large Scale Data Breach Announced by Premera Blue Cross

Premera Blue Cross revealed Tuesday it was hit by a sophisticated cyber attack potentially exposing personal data for approximately 11 million of its members including members, employees and others with whom it does business,...more

State Data Breach Notification Law Updates

State legislatures are not waiting for Congressional action on a national data breach notification standard. Montana — Montana has amended its 10-year old breach notification law (see Mintz Matrix) to expand the...more

Health Care Update - March 2015 #2

In This Issue: - Senate HELP Begins Innovation for Healthier Americans Hearings - 340B Hearing Postponed; Written Testimonies Shed Light on Agenda - Implementation of the Affordable Care Act -...more

Washington Healthcare Update

1. Congress - House - House Republican Working Group Outlines King v. Burwell “Off-Ramp” Plan The House Republican Health Care Working Group has released an outline of policies they would support if the...more

Anthem’s Data Breach Affects Many Non-Anthem Plans: What Employers Need to Know Now

On February 4, 2015, Anthem Inc. (“Anthem”) disclosed that it had been a victim of a sophisticated cyber-attack that compromised the personal health plan data of up to 80 million customers of not only Anthem but also a much...more

MNsure Audit Released

The Office of the Legislative Auditor (OLA) released its much-anticipated review of MNsure’s first year of operations. MNsure is Minnesota’s online health insurance marketplace that was established in accordance with the...more

Locke Lord QuickStudy: Attention, Health Insurers: Unique Encryption Requirements in NJ

Setting a new standard for encryption, New Jersey has enacted a new law (P.L. 2014, c. 88, codified at N.J. Stat. Ann. §§ 56:8-196 - 56:8-198) effective August 1, 2015, requiring health insurance carriers authorized to issue...more

Cyber Attackers Reach Anthem, Health Care Providers Seen As Vulnerable

Anthem, one of the nation’s largest health insurers, announced last Wednesday that it had been attacked by cyber hackers and that personal information for as many as 80 million individuals had been compromised....more

The Anthem Data Breach: The Fallout and What’s Next

By now (unless you have been under a snow drift), you have likely heard about the apparent intrusion into a database at the nation’s largest health insurer, Anthem, Inc. Rather than reiterate the facts as currently known...more

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