News & Analysis as of

Hospitals Medical Expenses

Brownstein Hyatt Farber Schreck

Colorado Raises Stakes for Hospitals That Don’t Comply With Price Transparency Law

In an effort to push hospitals toward compliance with federal hospital price transparency laws, Gov. Jared Polis signed HB 22-1285, “Prohibit Collection Hospital Not Disclosing Prices,” into law on June 8, 2022. Specifically,...more

Schwabe, Williamson & Wyatt PC

Surprise Medical Bills in the Crosshairs:‎ Supreme Court Decision Places Additional Obligations on Health Care ‎Providers

On May 16, 2022, the Colorado Supreme Court issued an opinion that serves as a cautionary tale for health care providers hoping to bill patients at chargemaster rates. The court’s decision in French v. Centura Health turned...more

Robinson+Cole Health Law Diagnosis

Connecticut Governor Signs Bill Limiting Hospital Billing and Collection Efforts and Revising Connecticut’s Facility Fee Laws

On July 7, 2021, Connecticut Governor Ned Lamont signed into law Public Act 21-129 entitled “An Act Concerning Hospital Billing and Collection Efforts By Hospitals And Collection Agencies” (“the Act”)....more

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

UVA health system will curb decades of hounding patients over medical bills

The University of Virginia health system has decided to end decades of draconian bill collection, giving a reprieve to tens of thousands of patients and their families who faced harsh legal actions to recover crushing medical...more

Cranfill Sumner LLP

Cap On Recovery of Medical Bills in Wrongful Death Claims in North Carolina

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Defense lawyers and insurance adjusters are frequently faced with evaluating medical damages presented by plaintiffs counsels and claimants.  We often examine alleged damages arising out of personal injuries.  Less fortunate...more

Burr & Forman

Hospital Price Transparency Rule – January 1, 2021 Effective Date

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As if hospitals don’t have enough challenges to deal with in caring for patients with COVID-19 and diverting resources to manage the COVID-19 public health emergency, they also need to make sure they comply with the new...more

Bricker Graydon LLP

The uncertain future of the price transparency rule in 2021

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The Trump administration’s hospital price transparency rule went into effect on January 1, 2021, after it was upheld by the U.S. Court of Appeals for the District of Columbia Circuit in a December 2020 decision....more

King & Spalding

OIG Issues Advisory Opinion Permitting Drug Manufacturer to Provide Travel, Lodging, and Expenses to Patients in Limited...

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On January 15, 2020, OIG issued Advisory Opinion No. 20-02 analyzing an arrangement between a pharmaceutical manufacturer and certain drug recipients whereby the manufacturer provides certain drug recipients with financial...more

Ballard Spahr LLP

Health Care and Price Transparency: The Latest Summary

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Federal executive agencies recently published two rules, one final and one proposed, aimed at publicizing the various costs associated with health care. A final rule, promulgated by the Department of Health and Human Services...more

Polsinelli

CMS Issues New Final Rule on Pricing Transparency

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On November 15, CMS issued the Price Transparency Requirements for Hospitals to Make Standards Charges Public Final Rule (“Final Rule”), as directed by President Donald Trump’s Executive Order on Improving Price and Quality...more

King & Spalding

What Recent Class Action Rate Litigation Means for Hospitals

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Legal challenges to hospital charges are increasing in both number and intensity with plaintiffs’ counsel continuing to file suits against hospitals around the country challenging the very existence and use of chargemasters...more

Flaster Greenberg PC

Have Medical Bills, Game Plan Needed

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It’s important to have a game plan for medical bills, and the game plan should probably not involve suing the hospital as a preemptive strike. That is precisely what occurred in Pitell v. King County Public Hospital, No....more

Michigan Auto Law

Detroit Medical Center CEO calls insurers’ No-Fault bluff

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Auto insurers balk at Detroit Medical Center CEO Conrad Mallett’s offer for a dollar-for-dollar price cut with hospital charges and No-Fault insurance premiums - Did Detroit Medical Center CEO Conrad Mallett just call-out...more

Butler Snow LLP

Dedmon: The Destiny of “Reasonable” Medical Expenses in Tennessee

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Currently pending before the Tennessee Supreme Court is a case that could change the face of personal-injury litigation in the state. Accepted for review on October 24, 2016, Dedmon v. Steelman asks whether the amount billed...more

Shumaker, Loop & Kendrick, LLP

Client Alert: Florida: What the New Balance Billing Law Means for Physicians

This year two bills became law in Florida that are intended to equip Floridians with tools to make health care decisions based on cost and to protect them from significant unanticipated medical bills. The first (HB1175)...more

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

Taking poor people to court over unpaid medical bills

Pro Publica- the online, Pulitzer-winning investigative web site-has reported on a disturbing trend in Nebraska, where hospitals and collection agencies have exploited low fees and accommodating courts to sue patients and...more

Chambliss, Bahner & Stophel, P.C.

New York – Emergency Medical Services and Surprise

The Emergency Medical Services and Surprise Bills Law (the "New Law"), which goes into effect March 31, 2015, increases protection of New York consumers from "surprise bills" received for medical services performed by certain...more

Baker Donelson

IPPS Final Rule: CMS Addresses Allina Decision and Addresses New Medicare DSH Payment Calculations

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In the fiscal year 2014 Inpatient Prospective Payment System (IPPS) rule published in the Federal Register on August 19, 2013, CMS took two steps of note regarding the Medicare disproportionate share hospital (DSH)...more

Davis Wright Tremaine LLP

Trouble Ahead for One-Day Inpatient Stays: New Pre-Billing Challenges Loom

On Aug. 19, CMS published a final rulemaking that may effectively eliminate DRG Part A payments for most acute care inpatient stays of one day....more

Cozen O'Connor

Ruminations on Observation

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On July 29, 2013, the Office of Inspector General of the U.S. Department of Health and Human Services (OIG) released a memorandum report finding that Medicare paid more on average for short inpatient stays than for...more

King & Spalding

OIG Finds That Medicare Could Save Millions by Strengthening Billing Requirements for Canceled Surgeries

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On August 6, 2013, OIG released a report with its findings that in a sampling of 100 hospital inpatient claims involving short-stay, canceled elective surgery admissions, 80 did not meet Medicare’s requirement that the...more

King & Spalding

CMS Releases FY 2011 SSI Ratios

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CMS has released the FY 2011 SSI data for IPPS hospitals, LTCHs, and IRFs. This data will be used to determine the disproportionate share adjustment for hospitals and the low-income payment adjustment for IRFs for cost...more

Hinshaw & Culbertson LLP

A prerequisite to the recovery of fees: How "reasonable and necessary" are your charges?

In State Farm Mutual Automobile Insurance Co. v. Huff, 2013 DJDAR 7379 (2013), the California Court of Appeal for the Fourth Appellate District decided a novel fee case in the medical context, referencing standards used to...more

King & Spalding

Senate Finance Committee Hearing Discusses Transparency in Healthcare Pricing

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On June 18, 2013, the Senate Finance Committee held a hearing entitled, “High Prices, Low Transparency: The Bitter Pill of Health Care Costs.” Senators Max Baucus (D-MT) and Orrin Hatch (R-UT) gave statements on ways to...more

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