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Patrick Malone & Associates P.C. | DC Injury...

Better Health Care Newsletter - March 2024

Patrick Malone & Associates P.C. | DC Injury... on

Is Medicare Advantage really a Disadvantage for seniors and taxpayers? Our nation is graying rapidly. Every day, 10,000 baby boomers, members of one of the largest generations in U.S. history, hit the traditional...more

Foley & Lardner LLP

Massachusetts Governor Proposes Facility Fee Ban

Foley & Lardner LLP on

Massachusetts Governor Charlie Baker has restarted the discussion on health care cost containment in the Commonwealth with a proposed bill that contains a raft of initiatives. This is the first in a series of blog posts to...more

Chambliss, Bahner & Stophel, P.C.

Medicare Coverage While Traveling Within the U.S.

Chambliss, Bahner & Stophel, P.C. on

When people retire they often have more time to travel. Although Medicare coverage is generally not available when beneficiaries are overseas, what about coverage for those exploring our own varied and scenic land?...more

Sheppard Mullin Richter & Hampton LLP

New Study Finds Medicare Advantage Plans Pay Lower Prices Than Traditional Medicare

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A new study by Stanford University researchers finds that Medicare Advantage plans pay lower prices than traditional fee-for-service (FFS) Medicare for most types of hospital admissions. According to the study—published...more

Carlton Fields

No More Surprises: Florida Ends Certain Medical Balance Billing

Carlton Fields on

"Surprise medical billing" occurs when a patient receives care at a facility and receives treatment from a provider, such as an anesthesiologist or radiologist, who is not contracted with the patient’s health insurance plan....more

Akerman LLP - Health Law Rx

Surprise Medical Bills? The Florida Legislature Offers Some Relief!

Akerman LLP - Health Law Rx on

With House Bill 221, the last bill to pass during the 2016 legislative session, the Florida legislature took a significant step towards reducing uncertainty for medical costs for persons with Preferred Provider Organization...more

Jackson Walker

Insurers May Not Terminate Physicians for Recommending Out-of-Network Providers

Jackson Walker on

Under a new Texas law, effective September 1, 2015, health maintenance organizations (HMOs) and Preferred Provider Benefit Plans (PPO) (collectively referred to as "Insurers") can no longer terminate a physician from their...more

Foley & Lardner LLP

Medicare Advantage Value-Based Insurance Design Model

Foley & Lardner LLP on

CMS, through the Center for Medicare and Medicaid Innovation, announced on September 1, 2015, the introduction of the Medicare Advantage Value-Based Insurance Design (VBID) Model as part of the Health Plan Innovations...more

Baker Donelson

Medigap Insurer's Contract with Preferred Hospital Network Approved (Yet Again)

Baker Donelson on

On April 22, 2015, the Department of Health and Human Services, Office of Inspector General (OIG) issued Advisory Opinion 15-05 [PDF], approving a Medigap insurer’s proposed contract with a preferred hospital network. The...more

Epstein Becker & Green

PPOs and Other Non-HMO Products Now Require Approval and Periodic Reviews of Network Adequacy in New York

Epstein Becker & Green on

The New York Legislature recently enacted legislation that will require all health insurance plans that issue policies that provide for the use of a provider network to obtain network adequacy certification. The new...more

McDermott Will & Emery

View From McDermott: A New Type of ERISA-Based Hold-Up—The Rise of Out-of-Network Provider Suits Against Self-Funded Health Care...

McDermott Will & Emery on

Over the past decade, there has been a significant increase in the number of physicians who have dropped out of Preferred Provider Organization (‘‘PPO’’) and Health Maintenance Organization (‘‘HMO’’) networks and attempted to...more

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