On August 19, 2022, three federal agencies tasked with adopting regulations for the No Surprises Act (“NSA”) issued a highly anticipated Final Rule implementing key aspects of the NSA’s independent dispute resolution (“IDR”)...more
8/25/2022
/ Biden Administration ,
Billing ,
Dispute Resolution ,
Final Rules ,
Health Care Providers ,
Health Insurance ,
Healthcare ,
Healthcare Reform ,
Out of Network Provider ,
Out-of-Pocket Expenses ,
Surprise Medical Bills
Five months ago, in TMA v. HHS, et al. (“TMA”), a federal court in Texas struck down portions of a controversial interim final rule (“Rule”) jointly issued by three federal executive agencies (“Departments”) intended to...more
The President and his administration continue to tout their efforts to strengthen coverage for behavioral health care, including significantly increasing behavioral health spending and strengthening parity between physical...more
4/4/2022
/ Biden Administration ,
Denial of Insurance Coverage ,
Employee Retirement Income Security Act (ERISA) ,
Health Insurance ,
Health Plan Sponsors ,
Healthcare ,
Healthcare Reform ,
Insurance Claims ,
Insurance Litigation ,
Mental Health ,
Plan Administrators ,
Scope of Coverage ,
Standard of Care
On Wednesday, February 23, 2022, a federal court in Texas struck down five controversial portions of the interim final rule (“Rule”) jointly issued by three federal executive agencies (“Departments”) that implement the...more
Strategies for Complying with Price Transparency and Surprise Billing Laws -
State legislatures and the federal government have been busy the past 12 months churning out laws that impose new disclosure and billing obligations...more
2/23/2021
/ Coronavirus/COVID-19 ,
Health Care Providers ,
Health Insurance ,
Healthcare Reform ,
Infectious Diseases ,
Payor Contracts ,
Regulatory Agenda ,
Reimbursements ,
Surprise Medical Bills ,
Telehealth ,
Vaccinations ,
Value-Based Care
The Centers For Medicare & Medicaid Services Issues New Inpatient Prospective Payment System Final Rule -
On September 3, 2020, the Centers for Medicare & Medicaid Services (CMS) issued the fiscal year (FY) 2021 Medicare...more
12/31/2020
/ Centers for Medicare & Medicaid Services (CMS) ,
Cramdown ,
Drug Pricing ,
Health Care Providers ,
Healthcare Reform ,
Inpatient Prospective Payment System (IPPS) ,
Medicaid ,
Medicare ,
Physician Fee Schedule ,
Physician Medicare Reimbursements ,
Section 340B ,
Telehealth ,
Value-Based Care
Introduction -
CMS has taken extensive measures to assist providers and promote access to care in light of the Public Health Emergency (PHE) related to the COVID-19 pandemic. The efforts taken have and continue to benefit...more
8/4/2020
/ Audits ,
CARES Act ,
Centers for Medicare & Medicaid Services (CMS) ,
COBRA ,
Coronavirus/COVID-19 ,
Health Care Providers ,
Health Insurance ,
Medicaid ,
Medical Reimbursement ,
Medicare ,
Skilled Nursing Facility ,
Telehealth ,
Telemedicine
Polsinelli is pleased to share the Health Care Reimbursement and Payor Dispute Update. This newsletter is a designated source of news, information and guidance on the constantly evolving reimbursement industry.
...more
11/1/2019
/ Administrative Appeals ,
Centers for Medicare & Medicaid Services (CMS) ,
Contract Disputes ,
Enrollment ,
Health Care Providers ,
Injunctive Relief ,
Managed Care Contracts ,
Medical Reimbursement ,
Medicare ,
Payor Contracts ,
Revocation ,
Site-Neutral Exception ,
Universal Health Services Inc v United States ex rel Escobar