News & Analysis as of

Hospitals Insurance Industry

Spilman Thomas & Battle, PLLC

The Health Record - Healthcare Law Insights, Issue 3, July 2024

Welcome to our third issue of The Health Record - our healthcare law insights e-newsletter! We are winding down the summer with our talented group of law students and they have continued to research and write, shadow...more

McDermott+

Regs, Regs and More Regs: The Biden Administration Releases Spring 2024 Unified Agenda

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We are in the midst of a storm of regulations that are being released by the Centers for Medicare & Medicaid Services (CMS) and the US Department of Health and Human Services (HHS), including the Calendar Year (CY) 2025...more

Perkins Coie

Expansion of Hospital Tort Liability in Washington

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The Washington State Supreme Court significantly expanded the scope of potential hospital tort liability for the allegedly negligent actions of nonemployee, independently contracted emergency room service physicians, and...more

Arnall Golden Gregory LLP

OIG Approves Arrangement Incentivizing Medigap Policyholders to Seek Treatment From PHO Network Hospitals

The Department of Health and Human Services, Office of Inspector General (“OIG”) recently released a favorable advisory opinion, OIG Advisory Opinion No. 24-01 (the “Opinion”), to a Medicare Supplemental Health Insurance...more

Mitratech Holdings, Inc

What is Recruitment Marketing Software?

Are you struggling to attract, engage, and hire top talent for your organization? As the war for talent rages, traditional recruitment methods may no longer be enough. That’s where recruitment marketing software comes in....more

Kennedys

New trends in fragment billing: Non-facility companies billing for facility-bundled services

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When one receives surgery, it is common to receive a separate invoice from the physician and the facility. The physician bills for performing the surgery, and the facility bills for providing the products and services...more

Bass, Berry & Sims PLC

Sutter Health Prevails in Antitrust Trial Arising from Its Contracting Practices

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On March 11, a California federal jury delivered a verdict in favor of Sutter Health, one of the nation’s largest hospital systems, in a $411 million class-action lawsuit alleging Sutter’s contracts with insurers unlawfully...more

Manatt, Phelps & Phillips, LLP

[Webinar] Ten Health Care Imperatives for the Decade Ahead: Ensuring Access to Coverage and Care - March 31st, 4:00 pm - 5:00 pm...

Join Manatt and Innovators From Callen-Lorde and NY State of Health for a Dynamic Roundtable Exploring New Policy Opportunities and Strategies for Advancing Coverage and Care. Access to coverage and care is the linchpin of...more

King & Spalding

Court of Appeals Upholds CMS Rule Requiring Public Disclosure of Prices Negotiated Between Hospitals and Insurance Companies

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On December 29, 2020, the U.S. Court of Appeals for the District of Columbia Circuit upheld a CMS final rule promulgated in November 2019 that requires hospitals to disclose various forms of pricing information related to the...more

Saul Ewing LLP

Lost the Battle, Still Looking to Fight the War — the FTC Presses Forward on All Fronts to Stop Jefferson-Einstein Merger

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Faced with a December 8, 2020, Memorandum and Order by Eastern District Judge Pappert (link) denying the Federal Trade Commission’s (FTC’s) request to enjoin the proposed Jefferson-Einstein merger, and the resulting right of...more

Manatt, Phelps & Phillips, LLP

[Webinar] What Will Super Tuesday Mean for Healthcare? - March 2nd, 1:00 pm ET

With healthcare playing such a central role in the election, what could the Super Tuesday results mean for healthcare stakeholders? On March 2—the day before Super Tuesday—Manatt Health will explore these questions in a new...more

Foley & Lardner LLP

Behavioral Health & Substance Abuse Services: Massachusetts Proposal Reflects Focus on Expanding Access and Coverage

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... Massachusetts House Bill 4134 includes several provisions aimed at expanding access to treatment for mental health and substance use conditions in the Massachusetts Commonwealth. Most notably, the Bill would require...more

Sheppard Mullin Richter & Hampton LLP

Surprise Billing Initiatives Face Not-So-Surprising Resistance

“Surprise billing,” also known as “balance billing,” is one of few areas that garners bipartisan support. Surprise billing occurs when a patient inadvertently goes out of his or her insurer’s network, resulting in a “surprise...more

Foley & Lardner LLP

Massachusetts Governor Proposes Facility Fee Ban

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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

Bass, Berry & Sims PLC

Trump Administration Proposes Transparency Rule for Group Health Plans and Insurers

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On November 15, 2019, the Department of Health and Human Services, the Department of Labor, and the Department of the Treasury (collectively, the Departments), unveiled a proposed rule (scheduled to be published on November...more

Jones Day

A Dramatic Shift in Health Care Pricing Transparency

Jones Day on

The Issue: On June 24, 2019, President Trump signed an executive order, which instructed the Department of Health and Human Services to publish rules requiring hospitals to publicly disclose their negotiated rates for...more

Sheppard Mullin Richter & Hampton LLP

Balanced Billing in California: Update Regarding 2016’s A.B. 72 and an Overview of Newly Introduced Bill A.B. 1611

Balanced billing or “surprise billing” has been getting increased attention at both the federal and state level. Balance bills arise when a payor covers out-of-network care, but the provider bills the patient for amounts...more

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

Will Rx drug costs fall if U.S. puts squeeze on middlemen and curbs rebates?

The Trump Administration has put out its latest prescription to try to slash out-of-control prescription drug prices: Officials want to call medication “rebates” what they say they’ve really become — “kickbacks” — and crack...more

King & Spalding

Senate Judiciary Chairman Urges FTC to Launch Probe Into Allegedly Anti-Competitive Contracts Between Hospitals and Insurers

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On October 10, 2018, Senate Judiciary Chairman Chuck Grassley, R-Iowa, urged the Chairman of the Federal Trade Commission (FTC) to conduct an assessment of potentially anti-competitive provisions in contracts between...more

Holland & Knight LLP

Ruling: Medical Providers Not Subject to Double Damages Under Medicare Secondary Payer Act

Holland & Knight LLP on

• In a matter of first impression, the U.S. District Court for the Middle District of Florida has ruled that a private right of action under the Medicare Secondary Payer Act (MSP Act), which provides for double damages in the...more

Carlton Fields

Virginia Supreme Court Considers Terms Of Assumption Reinsurance Transaction In Determining Obligations Of Insolvent Insurer

Carlton Fields on

A group of Kentucky hospitals sought reimbursement for legal fees incurred in two lawsuits related to the insolvency of their insurer, Reciprocal of America (“ROA”). In the 1970s and 1980s, the hospitals created two trusts to...more

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

Wisconsin appeals court rejects legal changes that GOP seeks nationally

Even as congressional Republicans advance their counter-factual campaign to strip patients who have been harmed while seeking medical services of their rights to seek legal redress, another state appeals court has rejected...more

BakerHostetler

Darwinian Insurance

BakerHostetler on

This case demonstrates the need for providers to know and follow the notification provisions set forth in their insurance policies in order to avoid an inadvertent loss of coverage. Once again, the terms of a hospital’s...more

Searcy Denney Scarola Barnhart & Shipley

Congressional Hypocrisy — Taking away your rights

As a part of the recent speed racing bills through Congress, they have put up HR 1215. Quite erroneously, they have titled it: “Protecting Access to Care Act of 2017”. A read of the act’s text quickly tells any objective...more

Downs Rachlin Martin PLLC

News from the Vermont State House - An analysis from DRM's Government & Public Affairs Team - February 2017 #3

Act 188 Plans On Hold as New Chemical Bill is Introduced - Nearly three years after the legislature passed a law to regulate children’s products containing chemicals of high concern, a web site intended to inform the...more

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