Podcast — Drug Pricing: How Are Payers Responding to the IRA?
Hospice Insights Podcast - A Rise in Medicare Deactivations: Tips for Avoiding This Financial Pain
Taking the Pulse, A Health Care and Life Sciences Video Podcast | Episode 187: South Carolina Hospitals and Healthcare Industry Trends with Thornton Kirby, SCHA President
A Fond Farewell: Musings on the End of the Medicare Advantage Hospice Carve-In Demonstration
Video: Braidwood v. Becerra – Challenging the Affordable Care Act’s Preventive Services Coverage Provision – Thought Leaders in Health Law
Taking the Pulse, A Health Care and Life Sciences Video Podcast | Episode 173: Improving rural health care with Dr. Kevin Bennett, the Director of the Research Center for Transforming Health and the
Medical Device Legal News with Sam Bernstein: Episode 19
Counsel That Cares - The Private Payer's Perspective on Value-Based Care
Opting Out of Medicare: When and How to Do It
Medical Device Legal News with Sam Bernstein: Episode 11
Show Me the Money: New Study Confirms Hospice Saves Money for Medicare
An Unwanted Spotlight: DOJ Announces Hospice Fraud Is Top Priority
The Chartwell Chronicles: Medicare & Medicaid
Navigating EMTALA Rules
Heed Caution: Takeaways From the OIG's Advance Care Planning Report
Podcast: The End of the Public Health Emergency – What's to Come? – Diagnosing Health Care
Patient Steering and Charting
Telehealth Risk Report: What the Government Found
Do You Have a Backup? Building Redundancies Into Your Written Certification Process
COVID-19 Hospice How-To Series | The Results Are In: More Wins for Hospices in HIS Appeals
The Centers for Medicare & Medicaid Services (CMS) issued the final procedural notice on Transitional Coverage for Emerging Technologies (TCET), effective as of August 12, 2024. TCET is a new pathway that uses existing...more
Find this week’s updates on 340B litigation to help you stay in the know on how 340B cases are developing across the country. Each week we comb through the dockets of more than 50 340B cases to provide you with a quick...more
“The American people deserve to know that the insurance companies receiving more than $700B annually in taxpayer funds are working to ensure you receive effective, high-quality care. Remember, you have rights and options to...more
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
Each week while Congress is in session, our Policy team delivers a key update to highlight a topical benefits, health, or retirement news item from the Hill, such as a newly introduced bill, a summary of a committee hearing,...more
Some Medicare Advantage beneficiaries receive Medicare flex cards, pre-paid debit cards for qualifying expenses, as part of their benefits. The U.S. government does not issue Medicare flex cards. This benefit is only...more
This August, a working group sponsored by the National Association of Insurance Commissioners (the "NAIC") unanimously approved revisions to the NAIC's Unfair Trade Practices Act Model #880 (the "Model Law") to restrain...more
Most states have statutes or common law that allow an insurance policyholder to bring a civil action and seek more than just compensatory damages (e.g., punitive damages) when her insurance company denies coverage in bad...more
The United States Court of Appeals for the Seventh Circuit, applying Illinois law, has held that a $100 million settlement between the United States government and a pharmaceutical company for claims arising under the False...more
In this session, McDermott Will & Emery Partner Patrick Healy moderated a panel that examined the expansion of value-based care in the employer market. We summarize the panel’s insights on how stakeholders can successfully...more
Additional insured disputes can sometimes get complicated. How much coverage the additional insured gets is often a hotly contested issue, especially when the named insured has coverage above the minimum limits it promised...more
On January 1, 2022, the new Medicaid clinical research coverage law became effective requiring states to add clinical research coverage as a mandatory benefit for Medicaid enrollees. In response, research teams, revenue cycle...more
What amount of past medical expenses can a plaintiff present to the jury when he or she is a Medicare recipient? The short answer: only the amount of past medical expenses the plaintiff is obligated to pay, not the gross...more
Whether it's reporting to CMS, getting CMS approval, or wondering how to handle LMSAs, this webinar will help answer those questions....more
On February 24, 2023, CMS issued a proposed rule that would modify the Medicare Disproportionate Share Hospital (DSH) payment regulation to limit the universe of Section 1115 demonstration beneficiaries who can be “regarded...more
This past week, the United States Court of Appeals for the Eleventh Circuit held that private causes of action brought under the Medicare Secondary Payer Act (MSP Act) are not preempted by contractual and state procedural...more
2022 was an eventful year on the 340B front, packed with updates to consequential litigation, proposed new rules, ongoing uncertainty into the Health Resources and Services Administration's (HRSA) underlying enforcement...more
Key Points - A new legal challenge to OIG on Medicare Beneficiaries’ ability to receive co-pay assistance has emerged. The Supreme Court has been asked to review HHS’s prohibition of co-pay assistance programs under the...more
On November 18, 2022, the U.S. Department of Justice (DOJ) announced charges against 10 defendants in its first coordinated action against individuals using business email compromise (BEC), money laundering, and wire fraud...more
The nation’s biggest health insurers are gaming a giant program to provide health coverage to seniors, exploiting the privatization of Medicare Advantage plans to rake in profits with schemes that have drawn fire from...more
On September 27, 2022, the Centers for Medicare & Medicaid Services (CMS) released 2023 premiums, deductibles and coinsurance amounts for Medicare Parts A and B, and the Medicare Part D income-related monthly adjustment...more
Under the Affordable Care Act, group health plans and health insurance issuers are required to provide health insurance coverage based on recommendations made by healthcare coverage professionals. The covered categories...more
The Mitchell Williams Insurance Regulatory team of lawyers recently attended the National Association of Insurance Commissioners (NAIC) 2022 Summer National Meeting which was held in Portland, Oregon on August 9-13th. We have...more
Healthcare fraud related to durable medical equipment (DME) is extremely costly to insurers yet often continues without criminal or civil consequences. Fraudulent schemes by DME supply companies vary in complexity but...more