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Limitations on Arbitrator Authority to Issue Pre-Hearing, Non-Party Discovery in the Wake of Aixtron

Third party discovery may be helpful to providers in arbitrations. For example, if a provider is in a dispute with a health plan, if there are questions as to whether the health plan or the medical group has financial...more

Key Criteria to Assign New ICD-10-CM Diagnosis Code For COVID-19 and associated MS-DRGs

Effective April 1, 2020 through September 30, 2020, a new diagnosis code U07.1 was added to the ICD-10-CM code set for the novel coronavirus COVID-19: U07.1. The ICD-10-CM Official Coding and Reporting Guidelines– Chapter 1...more

New Risk of Arbitration Award Vacatur Following Ninth Circuit’s Decision in Monster Energy Co. v. City Beverages, LLC

Health plan contracts typically include binding arbitration clauses, and the health plan typically specifies which arbitration association it prefers to use. If the arbitration association makes millions of dollars resolving...more

Health Plan Responsibility to Pay for Hospital Inpatient Care When Members Await Placement at Post-Acute Facilities

Hospitals that attempt to discharge a patient to a post-acute level of care but are not able to because they cannot find an appropriate accepting facility must continue providing care if the patient cannot be safely...more

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