News & Analysis as of

Arbitrary and Capricious Health Care Providers

Fisher Phillips

Court Blocks Healthcare Vaccine Mandate Across the Nation: A Game Plan for Healthcare Employers

Fisher Phillips on

Not 24 hours after a Missouri federal court temporarily blocked the Centers for Medicaid and Medicare Services (CMS) from enforcing its COVID-19 vaccine mandate in 10 states, a Louisiana federal court took one giant step...more

King & Spalding

New Kidney Transplant Allocation Policy Survives Eighth Circuit Legal Challenge

King & Spalding on

On November 8, 2021, the Eighth Circuit affirmed a district court order that denied an attempt to preliminarily block the Organ Procurement and Transplant Network’s (OPTN) policy changing the manner in which donor kidneys are...more

K&L Gates LLP

K&L Gates Triage: Michael P. V. BCBS Of Texas

K&L Gates LLP on

In this week’s episode, Gary Qualls discusses a recent case decided in the Western District of Louisiana, which highlights how the application of the arbitrary and capricious standard as applied to payor coverage...more

Troutman Pepper

D.C. District Court Upholds Rule Requiring Hospitals To Disclose Privately Negotiated Insurances Prices

Troutman Pepper on

On June 23, the U.S. District Court for the District of Columbia dismissed a challenge to a federal rule requiring hospitals to disclose prices they privately negotiated with insurers....more

Hinshaw & Culbertson - The LHD/ERISA Advisor

The LHD/ERISA Advisor: Eighth Circuit Upholds Payment for Out-of-Network Air Ambulance Flight at 150 Percent of Medicare Rates

In Mitchell v. Blue Cross Blue Shield of N.D., 2020 U.S. App. LEXIS 8818 (8th Cir. Mar. 20, 2020), the Eighth Circuit upheld the payment of 150% of Medicare rates for an out-of-network air ambulance flight, although the...more

UB Greensfelder LLP

Judge Says Canadian Physicians Are Eligible for H-1B Admission Regardless of the J-1 Two-Year Foreign Residency Requirement

UB Greensfelder LLP on

A federal judge in New York has ruled that Canadian physicians who are subject to the J-1 two-year foreign residency requirement may enter the United States in H-1B status, even though they have not spent two years in Canada...more

Dechert LLP

DC Circuit shuts down effort to limit TCPA liability for communicating health information

Dechert LLP on

The U.S. Court of Appeals for the D.C. Circuit, on March 16, 2018, struck a blow to healthcare industry efforts to exclude certain communications subject to the Health Insurance Portability and Accountability Act (HIPAA) from...more

Baker Donelson

The Battle over Medicare's Treatment of Provider Taxes May be Coming to an End

Baker Donelson on

For much of the past decade, hospitals and CMS have battled over whether providers may claim, as Medicare reasonable costs, the full amount of provider tax assessments levied upon them by the states in which they operate. In...more

Foley & Lardner LLP

Ninth Circuit Victory Opens the Door to Medicaid Reimbursement Challenges Based on Equal Access Requirement

Foley & Lardner LLP on

The Ninth Circuit held August 7 that the Department of Health and Human Services Secretary erred in approving a Medicaid State Plan Amendment (SPA) that cut reimbursement for outpatient hospital services in California by 10%...more

Perkins Coie

Ninth Circuit Raises Bar for Approving Changes in State Medicaid Reimbursement

Perkins Coie on

The U.S. Court of Appeals for the Ninth Circuit Court raised the bar last week for what states must prove to establish that their Medicaid provider reimbursement rates are sufficient to ensure a robust network of providers...more

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