News & Analysis as of

Co-payments

Pullman & Comley - Connecticut Health Law

Health Care Providers Should Take Note of Recent Repeals and Extensions of COVID-Related Executive Orders

Governor Lamont’s recent renewal of his declaration of the public health and civil preparedness emergencies through July 20, 2021 was followed by  Executive Order 12B that repeals portions of previously-issued Executive...more

Morrison & Foerster LLP - Class Dismissed

One ESTOPP Shop: The Ninth Circuit Weighs In On The Use Of Equitable Estoppel To Compel Arbitration In Two Recent Decisions

When can you compel arbitration of a putative class action? The law is developing quickly and still doesn’t provide a crystal clear answer. The Ninth Circuit recently weighed in on two cases examining what happens when the...more

Troutman Pepper

New State Law Eliminates All Copays, Coinsurance, and Deductibles for Mental Health and Substance Use Disorder Services

Troutman Pepper on

Patient access to behavioral health and substance use disorder services has increasingly become the subject of legislation. Although the federal Mental Health Parity and Addiction Equity Act (MHPAEA), introduced in 2008,...more

Foster Swift Collins & Smith

2021 Arrives with Additional Flexibility for Flexible Spending Accounts

During 2020, a number of newly enacted laws created flexibility for various employee benefit plans. The Consolidated Appropriations Act of 2021 (the “Act”), which was signed into law on December 27, 2020, provides additional...more

Adler Pollock & Sheehan P.C.

Massachusetts Enacts Telehealth Bill That Signals Further Expansion Of Telehealth Services In The Commonwealth

Massachusetts began this year by enacting comprehensive health care legislation that will have a lasting impact on the provision of telehealth within the Commonwealth. Massachusetts had previously expanded the use of...more

Faegre Drinker Biddle & Reath LLP

HHS-OIG: Pharma Manufacturer’s Proposed Copayment Assistance Program ‘Highly Suspect’ Under Federal Anti-Kickback Statute

On September 23, 2020, the Office of Inspector General of the United States Department of Health and Human Services (OIG) publicly released Advisory Opinion 20-05 (AO 20-05), a significant, adverse opinion rejecting a...more

Hogan Lovells

OIG denies proposed manufacturer-sponsored copay support program for Medicare beneficiaries

Hogan Lovells on

On September 23, the HHS OIG published Advisory Opinion No. 20-05, advising that OIG found “highly suspect” a manufacturer’s proposal to create a copay subsidy program to help certain financially eligible Medicare...more

Rivkin Radler LLP

Gilead Reaches $97 Million FCA/AKS Settlement

Rivkin Radler LLP on

On September 23, the U.S. Department of Justice announced that pharmaceutical company Gilead Sciences, Inc. agreed to pay $97 million to resolve claims that it illegally used a foundation as a conduit to pay the copays of...more

Rivkin Radler LLP

Teva under Fire from DOJ

Rivkin Radler LLP on

Teva Pharmaceuticals USA Inc. is in the crosshairs of the U.S. Department of Justice (DOJ) on two separate matters. On August 18, the DOJ announced that it filed a lawsuit against Teva and an affiliate, Teva Neuroscience...more

Robins Kaplan LLP

Financial Daily Dose 8.19.2020 | Top Story: S&P 500 Erases Pandemic Losses Despite U.S. Failure to Control Virus

Robins Kaplan LLP on

Unlike much of the world, the U.S. has not turned the corner on the coronavirus outbreak. But you wouldn’t know it by looking at the markets. On Tuesday, the S&P 500 topped out at its highest level ever, “capping a remarkable...more

Stinson - Benefits Notes Blog

Multiemployer Pension Recapitalization and Reform Plan

Multiemployer Pension Recapitalization and Reform Plan - Senate Republicans introduced their own multiemployer pension reform plan, the Multiemployer Pensions Recapitalization and Reform Plan (MPRRP), on November 20, 2019....more

McDermott Will & Emery

OIG Clarifies Scope of Telehealth Copayment Waiver

McDermott Will & Emery on

On March 24, 2020, the US Department of Health and Humans Services Office of Inspector General (OIG) issued guidance regarding OIG’s March 17, 2020, policy statement on reductions or waivers of cost-sharing obligations owed...more

Pierce Atwood LLP

Summary of Maine COVID-19 Proclamations, Laws and Orders

Pierce Atwood LLP on

Earlier this month, Maine Governor Janet Mills announced that she had taken the following initial steps to respond to the growing threat from COVID-19...more

Rivkin Radler LLP

NYS Takes Emergency Steps to Encourage Telehealth

Rivkin Radler LLP on

On March 17, the New York State Department of Financial Services (DFS) announced the issuance of a new emergency regulation requiring insurance companies in the state to waive cost-sharing, including deductibles, copayments,...more

Neal, Gerber & Eisenberg LLP

Families First Legislation Requires First Dollar Coverage for COVID-19 Testing

Effective March 18, 2020, group health plans and health insurance policies are required to pay for COVID-19 testing and related health provider visits, without imposing any cost sharing requirements, such as a deductible,...more

Hodgson Russ LLP

IRS Issues HDHP Coronavirus Relief

Hodgson Russ LLP on

The IRS issued Notice 2020-15 providing that a high deductible health plan (HDHP) will not fail to be a HDHP for allowing first dollar coverage for benefits associated with the testing and treatment of COVID-19. Also, a...more

Bricker & Eckler LLP

COVID-19 developments in employee medical insurance

Bricker & Eckler LLP on

HDHP and HSA participants - The IRS has expanded prior guidance to allow health plans to pay first-dollar costs for testing and treatment of COVID-19 without jeopardizing the participant’s HSA eligibility. ...more

Ballard Spahr LLP

Coronavirus Reverberates Throughout Health Care Industry

Ballard Spahr LLP on

With the spread of COVID-19, barriers to testing, treating, and getting paid for coronavirus-related care and containment efforts are being identified and addressed by federal and state regulators on a daily basis. ...more

Downs Rachlin Martin PLLC

Vermont Legislative Update 02-07-2020 - An analysis from DRM's Government & Public Affairs Team

Underfunded pension liabilities get needed attention The topic of Vermont’s overwhelming state employee and teachers’ pension burdens rears its head on occasion, but legislators quickly move on to challenges more easily...more

Robinson+Cole Health Law Diagnosis

DOJ Reaches Settlement with Patient Assistance Foundation Resolving Allegations of FCA Violations

On January 21, 2020, the Department of Justice (DOJ) announced a $3 million settlement with Patient Services, Inc. (PSI) to resolve allegations of False Claims Act (FCA) violations. The DOJ alleged that PSI enabled three...more

Skadden, Arps, Slate, Meagher & Flom LLP

A Dialogue With Corporate Counsel: Skadden’s Ninth Annual Pharmaceutical and Medical Device Seminar

On October 22, 2019, Skadden hosted our Ninth Annual Pharmaceutical and Medical Device Enforcement and Litigation Seminar in New York, which focused on U.S. enforcement issues companies face throughout the industry. The key...more

Michael Volkov

Two Charitable Foundations Pay $6 Million for Anti-Kickback Violations

Michael Volkov on

Two charitable foundations that helped patients pay for drug co-payments settled anti-kickback charges for $6 million.  The Patient Access Network Foundation (PANF) agreed to pay $4 million and Good Days agreed to pay $2...more

Foley & Lardner LLP

Medicare Remote Patient Monitoring: CMS Finalizes New Code and General Supervision

Foley & Lardner LLP on

CMS just released the 2020 final rule with changes to remote patient monitoring (RPM), officially titled “Chronic Care Remote Physiologic Monitoring,” reimbursed under the Medicare program, as part of the Physician Fee...more

Foley Hoag LLP - White Collar Law &...

No Good Deed Goes Unpunished: DJ's Pursuit of Alleged Drug Co-Pay Kickbacks Extends to the Charities Themselves

Back in May, we wrote about substantial settlements totaling $125 million to resolve Department of Justice (DOJ) allegations that money donated by Astellas Pharma US, Inc. and Amgen Inc. to drug co-pay charities constituted...more

Robinson+Cole Health Law Diagnosis

Government Continues to Closely Scrutinize Pharmaceutical Marketing Practices

On September 4, 2019 the Department of Justice (DOJ) announced a $15.4 million settlement with pharmaceutical company Mallinckrodt ARD LLC (Mallinckrodt) to resolve alleged violations of the Anti-Kickback Statute (AKS) in two...more

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Updated: Apr 27, 2021:

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Privacy Officer
JD Supra, LLC
10 Liberty Ship Way, Suite 300
Sausalito, California 94965

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Privacy Officer
JD Supra, LLC
10 Liberty Ship Way, Suite 300
Sausalito, California 94965

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Updates to This Policy

We may update this cookie policy and our Privacy Policy from time-to-time, particularly as technology changes. You can always check this page for the latest version. We may also notify you of changes to our privacy policy by email.

Contacting JD Supra

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