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Health Maintenance Organizations Healthcare

Akerman LLP - Health Law Rx

The Florida Office of Insurance Regulation Amends the Application for Certificate of Authority for Health Maintenance...

Applicants for a health maintenance organization (HMO) certificate of authority (COA) in Florida must use a new application form effective January 28, 2024. After rule development by the Florida Office of Insurance...more

Nilan Johnson Lewis PA

Heath Care in the Minnesota Legislature: Update

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Things are heating up in the Minnesota legislature for nonprofit health care entities. Here are breakdowns of local bills that may affect these types of businesses should they become law....more

Sheppard Mullin Richter & Hampton LLP

New California Law re HMO M&A

On September 7, 2018, Governor Jerry Brown signed into law Assembly Bill No. 595, A.B. 595, which amends the California Health and Safety Code to increase oversight by the California Department of Managed Health Care (“DMHC”)...more

Chambliss, Bahner & Stophel, P.C.

Medicare Coverage While Traveling Within the U.S.

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

Akerman LLP - Health Law Rx

Anti-Discrimination, Language Access Rules Compliance Deadline Fast Approaching for Health Insurers

Health insurers and HMOs have a limited time to review the new federal meaningful access rules and amend plan documents accordingly. However, many payors still have not revised their plans to include the required language,...more

BakerHostetler

Send Lawyers, Guns and Money:* Providers Lining Up Against Anthem/Cigna and Aetna/Humana Mergers

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In the wake of Anthem’s proposed acquisition of Cigna and Aetna’s proposed acquisition of Humana, providers are lining up to be heard. Take the American Medical Association (AMA), for example, which is urging federal and...more

Burr & Forman

Antitrust Issues Facing Physicians in Medicaid and Professional Licensing

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Physicians who were practicing in the 1990s were involved in numerous attempts to organize themselves in order to be able to participate in and even financially survive the onslaught of managed care delivery systems. The new...more

McDermott Will & Emery

FTC Comment: Minnesota Law Requiring Public Disclosure of Health Care Contract Data Increases Risk of Anticompetitive Behavior

McDermott Will & Emery on

On June 29, 2015, the Federal Trade Commission (FTC) responded to a request for comment from two Minnesota state legislators concerning recently enacted amendments to the Minnesota Government Data Practices Act (MGDPA). Under...more

Troutman Pepper

Recent Developments in PA and NJ Regarding Scope of Privilege for Health Care Facilities Engaged in Peer Reviews and Self-Critical...

Troutman Pepper on

Three recent cases offer guidance to health care entities in Pennsylvania and New Jersey regarding the discovery of documents created in connection with peer reviews, quality of care reviews and adverse event investigations...more

Epstein Becker & Green

New York’s “Emergency Medical Services and Surprise Bills” Law

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Earlier this year, the New York Legislature enacted, and Governor Cuomo signed, legislation that will impact billing and reimbursement for some out-of-network health care services, require new disclosures from providers...more

Ogletree, Deakins, Nash, Smoak & Stewart,...

Resistance WAS Futile—California Conforms to ACA Waiting Period Requirement

After wandering in the wilderness for a year, California has now come in from the cold and conformed its requirements for eligibility waiting periods to the federal standard adopted in the Affordable Care Act (ACA). Effective...more

Akerman LLP - Health Law Rx

New ACA Rules Could Require Broader Provider Networks

"If you like your doctor, you can keep your doctor." President Obama repeated this assurance to the American public numerous times, and the statement was prominently featured on the White House web site prior to and after...more

McDermott Will & Emery

Favorable Ruling: Taxability of HMOs Under New York City General Corporation Tax

McDermott Will & Emery on

A New York City Tax Appeals Tribunal Administrative Law Judge (ALJ) recently ruled in favor of Aetna, Inc. (Aetna) on whether a health maintenance organization (HMO) was “doing an insurance business” in New York State,...more

Burr & Forman

Medicaid Regional Care Organizations – Turning The Clock Back Twenty Years

Burr & Forman on

Physicians who were practicing in the 1990s were involved in numerous attempts to organize themselves in order to be able to participate in and even financially survive the onslaught of managed care delivery systems. The new...more

Carlton Fields

Capitol Report: Bill To Implement And Enforce The Patient Protection And Affordable Care Act’s Requirements Applicable To Health...

Carlton Fields on

Committee Substitute for Senate Bill 1842 (CS/SB 1842), passed by the 2013 Florida Legislature, enacts changes to the Florida Insurance Code (the “Code”). These changes are necessary to implement and enforce requirements of...more

Sheppard Mullin Richter & Hampton LLP

Playing Cards With a Government That Stacks the Deck - D.C. District Court Radically Expands The "Christian Doctrine" To...

On March 30, 2013, the U.S. District Court for the District of Columbia issued a decision imposing certain socio-economic contract requirements on subcontractors operating hospitals associated with the University of...more

K&L Gates LLP

OFCCP Enforcement Powers Expanded Over Healthcare Industry

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In a case closely monitored by the healthcare industry, a recent decision from the United States District Court for the District of Columbia expanded the jurisdiction of the Office of Federal Contract Compliance Programs...more

Pillsbury Winthrop Shaw Pittman LLP

Hospitals Face Mandatory Affirmative Action Obligations Incorporated by Operation of Law Into Their Federal Subcontracts

In UPMC Braddock v. Harris, the U.S. District Court for the District of Columbia upheld the U.S. Department of Labor’s Arbitration Review Board decision treating hospitals as government subcontractors subject to the equal...more

Davis Wright Tremaine LLP

Court Ruling May Subject Hospitals and Health Care Providers to OFCCP Regulation

Hospitals, health care providers, and managers of other businesses across the country may be surprised to learn that under a new federal court ruling, their organizations may now qualify as government contractors or...more

Foley & Lardner LLP

Health Care Providers Beware — You May Be a Governmental Contractor

Foley & Lardner LLP on

Executive Order 11246 (Order) was first issued in September 1965 by President Johnson. Its purpose was to prohibit race, religion, color, and national origin discrimination by federal contractors and subcontractors and...more

King & Spalding

Hospitals that Provide Services to Government Employees Through an HMO are Government Contractors, Court Rules

King & Spalding on

Healthcare providers who treat government employees through a health maintenance organization are government subcontractors subject to the jurisdiction of the Office of Federal Contract Compliance Programs (OFCCP), according...more

Littler

Federal District Court Affirms U.S. Department of Labor's Position that Healthcare Providers Participating in HMOs for Federal...

Littler on

In a long-awaited decision, the U.S. District Court for the District of Columbia ruled that three hospitals that provide medical services through a Health Maintenance Organization (HMO) to individuals covered by the Federal...more

FordHarrison

Healthcare Industry Legal Alert: Federal Judge Finds That OFCCP Has Jurisdiction Over Three Hospitals

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The Office of Federal Contract Compliance Programs ("OFCCP") has jurisdiction over three hospitals that provided medical services to federal employees who were members of an HMO, according to Judge Paul L. Friedman of the...more

Nossaman LLP

Getting Healthy Together

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Originally Published in The Recorder, September 4, 2012. A whole lotta conjunctions goin' on with California health care system players, an exceptional surge of large acquisitions and consolidations, some with surprising...more

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