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Enforcement Health Insurance

Foley & Lardner LLP

Health Care Enforcement: “Tea Leaves” in the 2024 National Health Care Fraud Summer Takedown

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Each summer in recent years, the U.S. Department of Justice (DOJ) and associated fraud enforcement partners have indicted many health care defendants, in multiple cases across the country. This summer continued the tradition....more

ArentFox Schiff

Investigations Newsletter: FCA Enforcement & Compliance Digest — Summer 2024 False Claims Act Newsletter

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Welcome to the Summer 2024 issue of “FCA Enforcement & Compliance Digest,” our quarterly newsletter in which we compile essential updates on False Claims Act (FCA) enforcement trends, litigation, agency guidance, and...more

Foley & Lardner LLP

Medicaid: CMS Final Rules Aim to Expand Access, Provide Parity with Commercial Markets

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The Centers for Medicare & Medicaid Services (CMS) published two significant updates to its Medicaid regulations on May 10, 2024. The two Final Rules, a Medicaid Access Rule and a Medicaid Managed Care Rule, impose new...more

Sheppard Mullin Richter & Hampton LLP

OIG Sparks Public Excitement about Managed Care and Alludes to Incoming Enforcement Guidance

“The American people deserve to know that the insurance companies receiving more than $700B annually in taxpayer funds are working to ensure you receive effective, high-quality care. Remember, you have rights and options to...more

Foley & Lardner LLP

Don’t You Forget About Me: Terminating Employees and Benefits to Think About

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No matter the size of your organization, at some point in time employees leave. As we noted previously, it behooves human resources and other departments to provide departing employees with an exit letter that includes...more

Miles & Stockbridge P.C.

Highlights from the Inaugural Hot Topics in Health Care Law

The Miles & Stockbridge Health Care Practice Group hosted its inaugural Hot Topics in Health Care Law seminar last month for clients from Maryland and beyond. Miles & Stockbridge health care lawyers kicked off the seminar...more

McDermott Will & Emery

New MHPAEA Guidance Regarding NQTLs: Network Access and Composition

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Recently proposed regulations attempt to ensure that health plans allow access to mental health or substance use disorder (MH/SUD) benefits as easily as medical or surgical (M/S) benefits. The proposed regulations, issued by...more

Faegre Drinker Biddle & Reath LLP

DOL Issues Long Awaited Mental Health Parity Guidance

Plan sponsors, insurers, and third-party administrators should pay close attention to the new guidance to facilitate health plan compliance with complex nonquantitative treatment limitation comparative analyses requirements....more

Zuckerman Spaeder LLP

Whither Insurance Coverage for Preventive Health Services? District Court Decision Striking Down Affordable Care Act’s Preventive...

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On May 15, 2023, the Fifth Circuit temporarily stayed a district-court ruling that struck down a key part of the Affordable Care Act (ACA). As a result of the stay, the ACA’s health insurance coverage requirements for...more

Manatt, Phelps & Phillips, LLP

[Webinar] Navigating the Rapidly Changing Medicare Advantage Regulatory Landscape - April 11th, 1:00 pm - 2:00 pm ET

Medicare Advantage (MA) plans now cover about half of Medicare beneficiaries, and with that enrollment growth has come increased scrutiny from federal and state regulators. As federal regulators complete a busy season of...more

Williams Mullen

Change Can Be Hard: Will the DOJ Antitrust Division’s Loss of Its UnitedHealth/Change Merger Challenge Cause It To Reassess Its...

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​​​​​​​Earlier this year, Assistant Attorney General Jonathan Kanter, who leads the Department of Justice’s (DOJ) Antitrust Division, announced that the Antitrust Division would eschew settlements in merger challenges in...more

Foley & Lardner LLP

Postponement in the Massachusetts Patients First Act Penalties

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On July 5, 2022, the Commonwealth of Massachusetts re-extended the implementation and enforcement date for the “Patients First Act”, sometimes referred to as the Massachusetts No Surprises Act, to January 1, 2025. As...more

Goodwin

HHS, Labor, and Treasury Departments Defer Enforcement of Transparency in Coverage and No Surprises Act Requirements

Goodwin on

The No Surprises Act and Transparency in Coverage final rules go into effect January 1, 2022. Implemented as Titles I and II of Division BB of the Consolidated Appropriations Act, these rules are intended to protect patients...more

McDermott Will & Emery

[Webinar] Healthcare Anti-Discrimination Litigation: What Payors Need to Know - May 13th, 1:00 pm - 2:00 pm ET

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As we continue our three-part webinar series, McDermott’s litigation and healthcare lawyers will focus on how payors can actively prepare for possible enforcement and litigation stemming from recent and potential changes to...more

Robins Kaplan LLP

[Remote Event] Health Care Antitrust Under President Biden - What Health Care Companies May Expect By Way Of Antitrust Policy And...

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After a turbulent year that roiled the economy, and the health care sector more than most, the Democrats emerged with control of both the White House and Congress for the first time since 2014. Business leaders and in-house...more

Manatt, Phelps & Phillips, LLP

[Webinar] National Roadmap on State-Level Efforts to End the Drug Overdose Epidemic - February 9th, 2:00 pm - 3:00 pm ET

How Can Mental Health and Substance Use Disorder (SUD) Parity Laws Help Battle the Overdose Epidemic? Learn the Answers—and Catch Up on the Most Recent State and Federal Developments—at a New Webinar from the AMA and Manatt. ...more

Proskauer - Employee Benefits & Executive...

Third Circuit Upholds Health Plan’s Anti-Assignment Clause

The Third Circuit recently held that anti-assignment clauses in ERISA-governed healthcare plans are enforceable as long as they are unambiguous. The Court concluded that the anti-assignment clause clearly stated that...more

Foster Garvey PC

Seattle Delays I-124 Medical Requirements

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Pending the results of a lawsuit challenging the medical requirements under the Hotel Employees Health and Safety Initiative (“I-124”), the City of Seattle has agreed to delay enforcement of Part 3 of that law. Part 3...more

Verrill

Near Unity Among the Circuits: Anti-Assignment Provisions are Enforceable

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U.S. Courts of Appeals in all but four Circuits have now held that anti-assignment provisions in health insurance plans governed by ERISA are enforceable. In American Orthopaedic & Sports Medicine v. Independence Blue Cross...more

Katten Muchin Rosenman LLP

Health Care Perspectives

With deep experience in the health care industry and a comprehensive understanding of its diverse participants, Katten attorneys serve as conference moderators and panelists, host accredited events, and produce webinars to...more

King & Spalding

Insurance Coverage for Healthcare False Claims Act, Stark, and HIPAA/HITECH Government Investigations

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Federal enforcement of False Claims Act (FCA), Stark anti-kickback, and HIPAA/HITECH claims against healthcare companies continues to rise rapidly. FCA recoveries by the U.S. Department of Justice (DOJ) exceeded $9.5 billion...more

The Volkov Law Group

Privatizing Health Insurance Companies For Anti-Fraud Enforcement

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The federal government faces overwhelming challenges in trying to stem the tide of fraud in the health care system. The problem is massive, and even with the increase in resources, and adoption of new tools to fight fraud,...more

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