News & Analysis as of

Tennessee Supreme Court Holds That Healthcare Providers Can Only collect What Insurance Companies are willing to Pay

A woman is seriously injured in a car accident. It is not her fault. She is taken to the emergency room where she is treated. When she is released, the hospital bills total $100,000. The woman has health insurance. The...more

Health Care Update - February 2015 #2

In This Issue: - Open Enrollment Update - Implementation of the Affordable Care Act - Other Federal Regulatory Initiatives - Congressional Initiatives - Other Health Care News -...more

Healthcare Legal News: Volume 5, Number 1

CMS ANNOUNCES NEW RULES THAT MAKE OWNER DOCTORS LIABLE FOR ALL PRACTICE MEDICARE DEBTS - Even after they leave the Practice. CMS announced its final rules on "Medicare Provider Oversight" on December 3, 2014....more

Health Law Wire: New Telehealth Legislation Proposed in New York for 2016 (2/15)

On December 29, 2014, New York State Governor Andrew Cuomo signed into law the provisions of chapter 550 that requires commercial insurers and the medical assistance program (Medicaid) to reimburse for the delivery of health...more

Washington Healthcare Update

This Week: Energy and Commerce Hearing Examines ICD-10 Preparedness... HHS Announces Oncology Care Model Initiative... Pennsylvania Governor Abandons Alternative Medicaid Expansion Approach for Traditional Plan....more

Medicare Will Cover Lung Cancer Screening

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

Manatt on Health Reform: Weekly Highlights - February 2015 #2

HHS ramps up for the final week of open enrollment. Families buying into CHIP in Pennsylvania are granted tax relief, and though Medicaid expansion efforts seem to have hit a wall in Tennessee and Wyoming, Arkansas assures...more

Obama Administration Releases FY 2016 Budget Proposal with Medicare/Medicaid Provisions

On February 2, 2015, the Obama Administration released its proposed federal budget for fiscal year (FY) 2016. The budget would impact all types of health care providers, health plans, and drug manufacturers if adopted as...more

Manatt on Health Reform: Weekly Highlights - February 2015

The President’s budget reveals the healthcare agenda for his Administration’s penultimate year. Medicaid expansion proposals advance in Arkansas and Wyoming; California’s Marketplace reports 9 out of every 10 enrollees remain...more

Indiana Wins Federal Approval to Expand Medicaid Coverage Under Obamacare

Republican Indiana Gov. Mike Pence announced on Tuesday that an agreement had been reached on the state’s Medicaid expansion proposal submitted in July. As many as 350,000 people could gain coverage under the federal health...more

QNHII Regs Due Thursday—After Only Five Years

When the Affordable Care Act (ACA) was signed into law back in 2010, it directed the Centers for Medicare & Medicaid Services (CMS) to establish the Consumer Operated & Oriented Program (CO-OP). The point of the CO-OP is to...more

Health Alert (Australia) - January 27, 2015

In This Issue: Judgments; Legislation; and Reports. Excerpt from Reports: Ensuring National Capacity in Genomics-Guided Public Health Laboratory Surveillance. Australia. Department of Social...more

Three Factors Affecting the Mid-Level Practitioner Workforce, Part One

As more Kentuckians gain access to health care as a result of the Affordable Care Act, healthcare workforce shortages for primary care providers becomes problematic particularly in rural Kentucky. Never before have mid-level...more

Decision Alert: US Supreme Court Potentially Shifts the Balance in Healthcare Employee Benefits Litigation

Justice Clarence Thomas and a unanimous US Supreme Court decided to vacate a Sixth Circuit decision and hold that the federal courts cannot assume from silence in a union’s collective bargain agreement that retiree group...more

Manatt on Health Reform: Weekly Highlights: January 2015 #3

This week, leadership changes at CMS continue, Montana’s Governor introduces Medicaid expansion legislation, and the California Marketplace allows new health plan entrants into the individual and SHOP Marketplaces for the...more

BCBSNC Release of Data

After objecting to the release of hospital reimbursement rates mandated under North Carolina’s Health Care Cost Reduction and Transparency Act of 2013 (NCGS Section 131E-214.5), Blue Cross Blue Shield of North Carolina...more

New York Passes Telemedicine Reimbursement Legislation

New York became the 22nd state to sign into law legislation that will require commercial and Medicaid plans to provide coverage of telehealth and telemedicine services. The law, originally intended to take effect on January...more

News from the Health Law Gurus™:

News from the Health Law Gurus™ is a weekly summary of notable health law news from around the country with helpful links to related content. Check back every week for the latest health law news stories....more

Benesch Health Care Market Intelligence - Physician/Hospital Summary Report 2014

In this Report: - Key Findings - Industry Trends – Hospitals - Industry Trends – Physician Practices - Government/Regulatory – Ohio - Government/Regulatory – U.S. -...more

Health Care Update - January 2015

In This Issue: - SGR Already Strong Focus of 114th Congress: - Implementation of the Affordable Care Act - Other Federal Regulatory Initiatives - Congressional Initiatives - Other Health...more

New York Passes Telehealth Bill

New York Governor Andrew Cuomo signed a Bill late last week, which will take effect as of January 1, expanding telehealth coverage in New York. This law does three things which are on the leading edge of telehealth coverage....more

Texas Adopts Standard Prior Authorization Form

In an effort to reduce the number of different prior authorization forms with which providers must contend, the Texas Department of Insurance (TDI) has adopted a single, standard form for requesting prior authorization of...more

California Insurance Commissioner Issues Emergency Regulations Affecting Narrow Provider Networks

On January 5, 2015, Commissioner Dave Jones issued emergency regulations affecting health insurers with respect to access to provider networks in response to consumer complaints that appointments with physicians are hard to...more

Challenges Physicians Can Expect in 2015

Reimbursement for medical services continues to decline. Continuing uncertainty about the Affordable Care Act persists. Government regulations create burdensome paperwork, busywork, and compliance headaches. Technology costs...more

Warning: Don’t Lose your Right to Contest Medical Treatment

Newly implemented rule (04 NCAC 10A.1001 [Rule 1001]) requires, among other things, that you immediately respond to requests for authorization for surgery and hospitalization. Under this rule, you have only seven days to...more

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