Health Insurance, Medicare | JD Supra Law News

Court of Appeals Rules for Government in DSH Exhausted Benefit Day Appeal

by Thomas W. Coons | Ober|Kaler on 4/5/2013

For the last several years, hospitals and the government have fought hard over where days associated with certain “dual eligible” patients should be placed in the Medicare disproportionate share hospital (DSH) calculation. At...more

New HIPAA Rules Regarding Genetic Information Affect Employers, Group Health Plans, Health Insurers and Healthcare Providers

by Lisa Clark, Harry Silver | Duane Morris LLP on 2/26/2013

Genetic Information Under HIPAA - While the final rule supplementing and modifying the Health Insurance Portability and Accountability Act (HIPAA) Privacy, Security, Breach Reporting and Enforcement Rules—78 Fed. Reg....more

CMS Announces Proposed Rule Implementing the ACA's MLR Requirements for MA and Prescription Drug Plans

by Darryl Landahl, Ishra Solieman | Brownstein Hyatt Farber Schreck on 2/22/2013

On February 15, the Centers for Medicare & Medicaid Services (CMS) released its Proposed Rule, effective calendar year (CY) 2014, implementing the Medical Loss Ratio (MLR) requirements for Medicare Advantage (MA)...more

To Waive or Not to Waive, That is the Question

by Darren Gelber | Wilentz, Goldman & Spitzer P.A. on 2/12/2013

A burgeoning problem is developing for out of-network healthcare providers that systemically fail to collect deductibles and coinsurance from patients. Insurance companies often seek to deny insurance coverage to subscribers...more

The SMART Act: A Bipartisan Attempt to Make the MSP Act Workable

by Gregory Fliszar, Judy Mayer | Cozen O'Connor on 1/17/2013

On January 10, 2013, President Obama signed into law H.R. 1845, which includes the Strengthening Medicare and Repaying Taxpayers Act of 2011 (SMART Act). The SMART Act amends several portions of the Medicare Secondary Payer...more

Privatizing Health Insurance Companies For Anti-Fraud Enforcement

by Michael Volkov on 1/8/2013

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

Health Reform + Related Health Policy News Update - December 19, 2012

by Polsinelli on 12/20/2012

In This Issue: - President Opposes Medical Device Tax Repeal or Replace - Senators Call for Extension of Comment Period on ACA Proposed Rules - AHA Urges U.S. District Court to Expedite Case Involving CMS' Payment...more

Private Health Insurance Efforts To Fight Fraud

by Michael Volkov on 12/13/2012

Healthcare fraudsters do not discriminate between private and public health insurance. Fraudsters use similar schemes to defraud Medicare and Medicaid and private insurance companies. ...more

In Case You Were Confused, Medicare is for the Benefit of Employees, not Employers

by Karina Sterman | Ervin Cohen & Jessup LLP on 11/8/2012

Most employers these days know that they cannot set a mandatory retirement age for employees. This arcane practice runs directly afoul of the Age Discrimination in Employment Act (ADEA)....more

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