California Governor Newsom signed Senate Bill 1120 into law, which is known as the Physicians Make Decisions Act. At a high level, the Act aims to safeguard patient access to treatments by mandating a certain level of health...more
California is among a handful of states that seeks to regulate the use of artificial intelligence (“AI”) in connection with utilization review in the managed care space. SB 1120, sponsored by the California Medical...more
5/9/2024
/ Affordable Care Act ,
Algorithms ,
Analytics ,
Artificial Intelligence ,
Bias ,
California ,
Centers for Medicare & Medicaid Services (CMS) ,
Discrimination ,
Health Care Providers ,
Healthcare ,
Insurance Industry ,
Machine Learning ,
Managed Care Contracts ,
Popular ,
Section 1557
On Monday, August 8th, the Deputy Director of Legislative Affairs of the Department of Managed Health Care (the “Department”) released a letter of opposition (the “Letter”) to Assembly Bill 1249 (“AB 1249”). The Letter was...more
After a protracted comment period, the California Department of Managed Health Care (the “Department”) formally adopted its much anticipated “global risk” regulation (the “Regulation”), which will go into effect on July 1,...more
On September 7, 2018, Governor Jerry Brown signed into law Assembly Bill No. 595, A.B. 595, which amends the California Health and Safety Code to increase oversight by the California Department of Managed Health Care (“DMHC”)...more
The Office of the National Coordinator for Health Information Technology (ONC) has released a final rule (Final Rule) introducing a new regulatory framework for certified health information technology (Health IT). The use of...more
This past May, the Department of Health and Human Services (HHS) issued a final rule implementing Section 1557 of the Affordable Care Act (ACA), which prohibits discrimination on the basis of race, color, national origin,...more
8/5/2016
/ Affordable Care Act ,
Children's Health Insurance Program (CHIP) ,
Contraceptive Coverage Mandate ,
Covered Entities ,
Department of Health and Human Services (HHS) ,
Federal Funding ,
Final Rules ,
Gender Identity ,
Health Care Providers ,
Health Insurance ,
Healthcare ,
LGBTQ ,
Medicaid ,
Medicare ,
Non-Discrimination Rules ,
Section 1557 ,
Sex Discrimination ,
Sexual Orientation Discrimination ,
Transgender
Are medical devices, subject to pre- and post-market regulatory controls, under increasing cybersecurity scrutiny? The FDA recently published recommendations for consideration of cybersecurity management in a product’s design...more
The Center for Medicare and Medicaid Services (CMS) recently announced that it will add roughly 4,100 providers to the 2,400 existing providers testing the possible use of Medicare bundled payment contracts. Providers must...more
Perhaps putting added pressure on insurers as they prepare to set rates for 2015, new evidence suggests that people enrolled in health plans under the Affordable Care Act have higher rates of serious health conditions than...more
Is the Office of the National Coordinator for Health Information Technology (ONC) overstepping its statutory authority in pursuing enhanced regulatory activity? A June 3, 2014 letter from the House Committee on Energy and...more
Last week President Obama signed into law a measure to extend Medicare physician pay rates for one year and to extend the enforcement delay of the “Two-Midnight” rule through March 2015. Medicare Recovery Audit Contractors...more
One of the largest hurdles to the growth of telemedicine – streamlined physician licensure in multiple states – soon may be addressed. The Federation of State Medical Boards (FSMB) will vote on adopting the federation’s...more