News & Analysis as of

Diagnostic Tests Health Insurance

Manatt, Phelps & Phillips, LLP

Leveraging Medicaid to Support Children and Youth Living With Complex Behavioral Health Needs

Editor’s Note: In a new report prepared for The Commonwealth Fund, Manatt Health and its co-authors provide an actionable framework and strategies for how state-level policymakers can use Medicaid and the Children’s Health...more

Stinson LLP

Considerations for Group Health Plans as COVID-19 Emergency Declarations End

Stinson LLP on

Part I: COVID-19 Diagnostic Testing Coverage - On January 30, 2023, the Biden Administration announced that it intends for the National Emergency (NE) relating to the COVID-19 pandemic to end on May 11, 2023....more

Stinson - Benefits Notes Blog

Preparing for the End of the COVID-19 Emergency Declarations: Part I. Considerations for COVID-19 Diagnostic Testing Coverage

On January 30, 2023, the Biden Administration announced that it intends for the National Emergency (“NE”) relating to the COVID-19 pandemic to end on May 11, 2023. Shortly after, the Secretary of the Department of Health and...more

Proskauer - Minding Your Business

A Test Costs What? Pricing and Reimbursing COVID-19 Tests

Out-of-network providers appear to be inflating the price of COVID-19 diagnostic and antibody tests, according to a recent America’s Health Insurance Plans (AHIP) survey. The October 2020 survey reports that out-of-network...more

Holland & Hart - Health Law Blog

COVID-19 Testing: Who Pays?

As COVID-19 testing continues to increase throughout the nation, providers and patients alike are faced with the issue of who is responsible for covering the cost of testing. Whether a payor will reimburse for a COVID-19 test...more

Bricker Graydon LLP

Surprise COVID-19 medical bills: What providers can and cannot do

Bricker Graydon LLP on

Providers have faced many challenges since the start of the COVID-19 pandemic and have needed to quickly react to changing laws and regulatory requirements impacting their operations. One such change is the restrictions on...more

Ballard Spahr LLP

FAQs on Families First and CARES Acts Implementation for Health Plans

Ballard Spahr LLP on

The Departments of Labor (DOL), Health and Human Services (HHS), and the Treasury (collectively, the “Departments”) have released frequently asked questions (FAQs) for health plans implementing coverage changes under the...more

McNees Wallace & Nurick LLC

Employer-Provided Health Coverage During the Reign of COVID-19

Over the past several weeks, human resources and employee benefits professionals (and their attorneys) have been scrambling to assemble staffing plans, telework arrangements and strategies for complying with the paid leave...more

FordHarrison

Health Plan Provisions and FAQs in COVID-19 Related Guidance

FordHarrison on

On March 27, the President signed the Coronavirus Aid, Relief and Economic Security Act (“CARES Act” or “Act”), which contains a number of tax- and employee benefit-related provisions that are intended to provide economic...more

Foley & Lardner LLP

Personalized Medicine Coalition Releases Spring 2020 Newsletter Amid the Coronavirus

Foley & Lardner LLP on

...The Personalized Medicine Coalition (“PMC”) recently published its 2020 Spring Newsletter that examines the landscape and outlook for personalized medicine as COVID-19 prompts new discussions about the effect of COVID-19...more

McGuireWoods LLP

FDA’s Emergency Use Authorization Process for COVID-19 Tests May Alleviate Shortage

McGuireWoods LLP on

As the nation battles shortages of novel coronavirus (COVID-19) testing kits, the U.S. Food and Drug Administration (FDA) has engaged its emergency use authorizations (EUA) process for unapproved products and uses to...more

BCLP

CARES Act Expands U.S. Retirement Plan Access and Provides Additional Relief and Changes to Employer-Provided Benefits

BCLP on

The Coronavirus, Aid, Relief and Economic Security Act (“CARES Act”) provides legislative relief to participants impacted by the Coronavirus pandemic. A summary of key provisions of the CARES Act, based on the current draft,...more

BCLP

Families First Coronavirus Response Act Part 2 of 2: Impact on Employer Health Plans

BCLP on

The Families First Coronavirus Response Act (“FFCRA”) enacted March 18 provides a combination of benefits to help employees during the COVID-19 pandemic...more

Bricker Graydon LLP

COVID-19 Update: ODI issues bulletin on out-of-network coverage for coronavirus testing and treatment

Bricker Graydon LLP on

On March 20, 2020, the Ohio Department of Insurance (ODI) issued Bulletin 2020-05, which contains the order of the Superintendent of Insurance regarding preauthorization and cost-sharing requirements for testing and...more

Holland & Knight LLP

Sequence of Events: Genetic Testing Offers Significant Promise, But Coverage and Access Limited

Holland & Knight LLP on

In the world of rare diseases, patient testimonies about the extreme difficulties of receiving an accurate diagnosis for an illness are numerous. For instance, one woman, sick for most of her young life, was not properly...more

Foley & Lardner LLP

Three Pressing Challenges for Personalized Medicine

Foley & Lardner LLP on

Personalized medicine can be described as the science of targeted therapies. Advances in diagnostic and molecular medicine have made it possible to more precisely identify alternative treatment options for patients based on...more

King & Spalding

CMS Proposes Sweeping Changes to Medicare Reimbursement for Clinical Diagnostic Laboratory Tests

King & Spalding on

First Data Collection Period for Clinical Laboratories Is July 1, 2015 to December 31, 2015 - In the October 1, 2015 Federal Register, the Centers for Medicare & Medicaid Services (CMS) published a proposed rule...more

Foley & Lardner LLP

Navigating the Diagnostic Commercialization Process

Foley & Lardner LLP on

Guest Post By: Perry Dimas, Senior Vice President and General Manager for Premier Source, part of AmerisourceBergen The 2015 Business of Personalized Medicine Summit was an inspiring day with talented professionals. One...more

Foley & Lardner LLP

Clinical Laboratories: Proposed Rule Implements Requirements for Reporting and Payment Based on Private Payer Rates

Foley & Lardner LLP on

As required by a 2014 statute, CMS has issued proposed regulations (Proposed Rule) implementing new requirements for laboratory reporting of, and eventually basing Medicare payment on, rates for clinical laboratory services...more

McDonnell Boehnen Hulbert & Berghoff LLP

PTO Releases Report on Confirmatory Genetic Diagnostic Testing

More than three years after the June 15, 2012 deadline for providing it, the U.S. Patent and Trademark Office has issued its report on so-called "second opinion" genetic diagnostic testing, mandated by Section 27 of the...more

Foley & Lardner LLP

Precision Medicine - Even Medicare Will Pay for It!

Foley & Lardner LLP on

President Barack Obama announced in his 2015 State of the Union address that he was introducing a new Precision Medicine Initiative, supported with over $200 million in the proposed 2016 federal budget. "Precision Medicine"...more

Foley & Lardner LLP

AmerisourceBergen Guest Post: Solutions to Overcome Reimbursement Challenges in Personalized Medicine

Foley & Lardner LLP on

The continued development and refinement of personalized medicine (PM) has offered an opportunity to revolutionize medical practice and improve outcomes by providing treatments for patients with the notion that “this drug is...more

King & Spalding

Medicare Will Cover Lung Cancer Screening

King & Spalding on

On February 5, 2015, CMS announced that it will cover lung cancer screening with low dose computed tomography (LDCT). “This is the first time that Medicare has covered lung cancer screening. ...more

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