OVERVIEW - This report proposes a vision and plan for action—collectively a statewide Health Equity Action Plan—for achieving a racially and ethnically equitable health care delivery system in Massachusetts. The report is...more
Attorneys Matthew M. Lavin and Aaron R. Modiano recently secured a complete denial of Blue Cross & Blue Shield of Michigan’s Motion to Dismiss a $40+ million dollar lawsuit brought on behalf of behavioral health providers for...more
Antitrust litigation has been ongoing for several years in the U.S. District Court for the Northern District of Alabama against one of the biggest business associations in America, the Blue Cross Blue Shield Association...more
As the coronavirus spreads throughout the country, hospitals and other health care providers are finding themselves inundated with patients. Those providers who are in-network with payors have and will likely continue to...more
Massachusetts Governor Charlie Baker has restarted the discussion on health care cost containment in the Commonwealth with a proposed bill that contains a raft of initiatives. This is the first in a series of blog posts to...more
The Federal Trade Commission has issued orders to five health insurers and two health systems requiring them to provide information that will assist the FTC in studying the competitive effects of certificates of public...more
Serving over 1.8 million Massachusetts residents, MassHealth provides access to healthcare services for people of varying ages and life circumstances across the Commonwealth. These services improve enrollees’ health and...more
In a somewhat unexpected but highly significant move, United States District Judge David Procter (Northern District of Alabama), who is presiding over the In re Blue Cross Blue Shield Antitrust Litigation (Case No....more
On April 23, a federal court in Rhode Island fired a warning shot over the bow of dominant health insurers across the country, holding that a refusal to negotiate in good faith with a healthcare provider that focuses...more
“Orangeworm” Targeting Health Care Industry - In what is being called a systematic targeting of large health care organizations, pharmaceutical companies, and IT companies and equipment manufacturers that service the...more
Transportation is often cited as one of the top barriers to health care for individuals in the United States. To reduce this burden and increase access to care, many health care providers are now partnering with ride-sharing...more
Act 188 Plans On Hold as New Chemical Bill is Introduced - Nearly three years after the legislature passed a law to regulate children’s products containing chemicals of high concern, a web site intended to inform the...more
Covered entities have a long list of laws and regulations governing their conduct, including their communications with patients, customers, and members. Specifically, the Health Insurance Portability and Accountability Act...more
Plaintiffs across the country have continued to file class actions against companies of all stripe for violation of the Telephone Consumer Protection Act (“TCPA”), often for communications far afield from the classic...more
After fending off a motion for judgment on the pleadings in March 2015, a small hospital in Peoria, Illinois lost on summary judgment in its $300 million antitrust suit alleging illegal exclusive dealing and attempted...more
On June 8, District Judge Claire Eagan (N.D. Okla.) dismissed the Blue Cross Blue Shield Association (BCBSA) and Blue Cross Blue Shield of Oklahoma (BCBSO) from an antitrust suit brought by a disgruntled health care provider,...more
Bicameral Bill Introduced to Provide HHS Authority to Reject Proposed Insurance Rates - Before Congress left for its Columbus Day recess, Rep. Jan Schakowsky (D-IL) and Sen. Diane Feinstein (D-CA) introduced the Health...more
Iowa's largest insurer joins the State's Marketplace for coverage year 2017; carrier changes are announced for Marketplaces in Kentucky, Oklahoma and Wyoming; and South Dakota's Governor convenes the Health Care Solutions...more
Excellus, a BlueCross BlueShield (BCBS) provider servicing upstate New York, announced last week that it was the latest in a string of BCBS providers that experienced a data breach as a result of a cyberattack. CareFirst...more
It was recently reported that Blue Cross and Blue Shield (BCBS), along with the Blue Cross Blue Shield Association, was sued across all states in a class action brought by two types of plaintiffs. One plaintiff class reflects...more
When Oklahoma Blue Cross-Blue Shield terminated Dr. Gude’s provider agreement, he decided to fight back. He sued the Blues in federal court, alleging they had violated—and this is the imaginative part—Oklahoma’s Consumer...more