News & Analysis as of

Out of Network Provider Medicaid

Sheppard Mullin Richter & Hampton LLP

Payor-Led Initiatives to Strengthen Mental Health Resources

In light of the increasing demand for mental health treatment and simultaneous provider shortages, the private insurance industry is rolling out targeted initiatives to increase mental health support for members by mitigating...more

Hendershot Cowart P.C.

Texas ER Physicians Sue Insurer for Underpayment – Thousands of Claims at Stake

Hendershot Cowart P.C. on

An appeal brought before the Texas Supreme Court could unleash a wave of legal action by out-of-network ER physicians pursuing insurers for underpayment of claims. Unlike in-network providers who negotiate reimbursement...more

Foley & Lardner LLP

Behavioral Health Trends for 2022

Foley & Lardner LLP on

Over the last two years, behavioral health (BH) has been one of the biggest growth areas in the health care ecosystem, fueled by the Public Health Emergency (PHE) but in many ways an ignored, overlooked, understaffed, and...more

Moritt Hock & Hamroff LLP

The No Surprises Act: Congress Takes Aim at Surprise Medical Bills

In the closing days of 2020, Congress passed federal legislation aimed at protecting patients against surprise medical bills and facilitating payment dispute resolutions among providers and insurers. Slated to take effect on...more

Holland & Hart - Health Law Blog

COVID-19 Testing: Who Pays?

As COVID-19 testing continues to increase throughout the nation, providers and patients alike are faced with the issue of who is responsible for covering the cost of testing. Whether a payor will reimburse for a COVID-19 test...more

Troutman Pepper

State Medicaid Waivers Provide Flexibility To Out-Of-State Providers Treating COVID-19

Troutman Pepper on

Upon a presidential declaration of an emergency or disaster, or a declaration of a public health emergency by the Secretary of the Department of Health and Human Services (HHS), section 1135 of the Social Security Act (42...more

Bricker Graydon LLP

Behavioral Health Redesign provisional measures extended

Bricker Graydon LLP on

As Ohio’s payment and care coordination system for behavioral health continues to be reworked and overhauled through the Behavioral Health Redesign, providers, patients, families and other stakeholders are facing uncertainty,...more

Manatt, Phelps & Phillips, LLP

Manatt on Health Reform: Weekly Highlights - September 2016

The national uninsurance rate hits a record low; Georgia’s Chamber of Commerce outlines three Medicaid expansion proposals; and California legislation targets surprise medical bills. FEDERAL AND STATE MARKETPLACE NEWS: ...more

Manatt, Phelps & Phillips, LLP

Health Update - January 2016

The Megatrends Reshaping Healthcare: Managing Change and Maximizing Opportunity - Editor's Note: In 2013, Manatt Health identified 10 megatrends that would reinvent the healthcare marketplace across the next decade. In a...more

BakerHostetler

Providers Get Rare Win in New Texas Law Protecting Out-of-Network Referrals

BakerHostetler on

On June 1, 2015, Texas Governor Greg Abbott signed House Bill 574 into law protecting physicians and other providers from having their participating provider agreements terminated by an insurer solely because the provider’s...more

Jackson Walker

Recent Federal Court Ruling on Application of Texas Prompt Pay Laws to Self-Funded, Medicaid and Out-of-State Plans and Their...

Jackson Walker on

What's new? A Dallas federal district court recently ruled that the Texas Prompt Pay Law does not apply to employer-funded health plans, Medicaid plans, or out of state patients that use Texas providers, or to a Third Party...more

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