Several health plans have announced that for certain services related to COVID-19 they are waiving patient financial responsibility – e.g., copays, coinsurance, deductibles, etc. The federal government has encouraged these...more
The California Court of Appeal in Los Angeles recently took up the issue of whether federal and/or state law sets any rate for Medicaid MCOs to pay to hospitals for out-of-network post-stabilization services. The case was...more
Payers are increasingly establishing purported “site of service” policies and guidelines that restrict the circumstances under which members may obtain certain services at hospital outpatient departments (HOPDs). In the...more