Health Insurance Healthcare

News & Analysis as of

Hold the Phone! Washington Adopts Telemedicine Parity Law

On April 17, Washington Governor Jay Inslee signed Substitute Senate Bill 5175 (the “Parity Law”), which expands coverage for telemedicine services paid by health plans in the state of Washington. With the new law, Washington...more

MHPA Class Action Settlement

A federal district court in Washington recently granted preliminary approval to a $6 million settlement of a mental health parity class action suit against Regence Blueshield. Plaintiffs claimed that defendants routinely...more

Manatt on Health Reform: Weekly Highlights - April 2015 #4

CMS releases new redetermination regulations and links uncompensated care funds to expanding Medicaid, and New York becomes the second state to launch the Basic Health Program. ...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

Health Care Update - April 2015 #2

In This Issue: - With SGR Behind Us, Delivery Reform Up Next - Implementation of the Affordable Care Act - Other Federal Regulatory Initiatives - Congressional Initiatives - Other Health...more

How New York’s Emergency Medical Services and Surprise Bills Law Impacts Providers and Plans

Last year New York passed legislation known as the “Emergency Medical Services and Surprise Bills” law, a much-heralded consumer protection law primarily intended to guard against surprise bills for out of network (OON)...more

EEOC Issues Guidance on Employer Provided Wellness Programs

The Equal Employment Opportunity Commission (EEOC) has released long-awaited proposed guidance (the proposed rule) relating to employer wellness programs. The proposed rule amends regulations implementing Title I of the...more

Pharmacists: Aren’t you really providers already? – Part One

While the passage of the Patient Protection and Affordable Care Act (“ACA”) ushered in a new era of access to health care, it only served to exacerbate a growing crisis in the provision of health care – lack of providers....more

Wellness Programs: Agencies Issue Helpful Guidance but Look Before You Leap

Recent studies indicate that wellness programs significantly improve the health of workers. If only it were so easy to implement a wellness program . . . As explained in our July 17, 2013 Benefits Update – Final...more

EEOC Proposes Wellness Program Regulations

The Equal Employment Opportunity Commission (EEOC) has proposed much-anticipated regulations regarding the use of employee health program under the Americans with Disabilities Act (ADA). The regulations are an attempt to...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

Health Alert (Australia) - April 20, 2015

In This Issue: Judgments; Legislation; and Reports. Excerpt from Judgments: New South Wales (NSW) - 13 April 2015 - Sarah White v The Local Health Authority & Anor - [2015] NSWC 417 - The New South...more

Locke Lord QuickStudy: Doc Fix Statute Contains a Lot More than SGR Repeal

On April 16, 2015, the President signed the Medicare Access and CHIP Reauthorization Act of 2015, commonly known as the “Doc Fix.” As has been extensively reported, the Act repeals the Sustainable Growth Rate or (SGR)...more

SGR Law Brings Changes to CMP Prohibition on Gainsharing

On April 16, President Barack Obama signed into law the “Medicare Access and CHIP Reauthorization Act of 2015,” ending a perennial struggle over the Medicare reimbursement formula for physicians. Although the law is most...more

CMS’s Proposes Rule On Mental Health Parity to Strengthen Access to Medicaid and CHIP Plans

On April 6, 2015, CMS announced a proposed rule intended to align mental health and substance use disorder benefits for low-income Americans with benefits required of private health plans and insurance. The proposed rule...more

Federal Trade Commission and Department of Justice Hold Joint Workshop on Payment Models and Competition Within the Health Care...

On February 24-25, 2015, the Federal Trade Commission (“FTC”) and Antitrust Division of the Department of Justice (“DOJ”) co-hosted a second public workshop as part of the “Examining Health Care Competition” series to study...more

Medicaid Expansion Leads to Economic Benefits While Improving Access to Coverage

The Affordable Care Act provides states with a powerful incentive to expand Medicaid to adults with incomes up to 133% of the Federal Poverty Level, paying for 100% of Medicaid coverage through 2016, and eventually phasing to...more

Healthcare Legal News Volume 5 Number 2

According to a recent study by Accenture, by 2017 approximately 18 percent of the American public will purchase insurance through exchanges versus relying on traditional employer healthcare coverage or foregoing insurance...more

New York’s Surprise Medical Bill Law Goes into Effect

New York’s Emergency Medical Services and Surprise Bills law went into effect yesterday, which means consumers who receive out of network (OON) emergency services will no longer have to pay more than their usual in-network...more

Health Care: Out-of-Network Provider Coverage, Notice, Disclosure, and Dispute Resolution (3/15)

New York State has adopted legislation to address consumer complaints related to health insurance coverage and "surprise bills" for health care services performed by out-of-network physicians and providers....more

OIG Warns Lab “Pull-Through” Arrangements May Be Illegal

In an important advisory opinion, the U.S. Department of Health and Human Services Office of Inspector General (OIG) gave a thumbs-down to a proposed clinical laboratory “pull-through” arrangement even though the patients in...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

Hospital Wins First Round Against Largest Rival in Antitrust Suit Alleging Illegal Exclusive Dealing Agreements with Insurers

The waves of change affecting health care providers include reimbursement and funding developments, the impact of the Affordable Care Act, technological and medical advances, provider network design transformations imposed by...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

"Surprise Medical Bills" Law

Consider the following scenario. You are a patient who had a colonoscopy performed by a physician who participates in your health insurance plan. A week later, you receive two “surprise” medical bills from an anesthesiologist...more

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