The move by some employer plans to a “reference-based” pricing model has created a need for healthcare providers to develop a strategy to confront payment challenges that these plans create. A prevalent model of...more
12/13/2019
/ Affordable Care Act ,
Department of Labor (DOL) ,
Employer Group Health Plans ,
Health Care Providers ,
Health Insurance ,
Out-of-Pocket Expenses ,
Pricing ,
Public Health Service Act ,
Regulatory Standards ,
TPAs ,
Uniform Commercial Code (UCC)
On January 15, 2019, the United States Court of Appeals for the Eighth Circuit considered whether certain plan documents allowed UnitedHealth Group Inc. and affiliates (“United”) to engage in a practice known as “cross-plan...more