Understanding Pharmacy Benefit Managers: The PBM Landscape Explained
DOJ’s New Self-Disclosure Policy and Corporate Whistleblower Awards Pilot Program
AGG Talks: Healthcare Insights Podcast - Episode 4: What to Do When Insurance Companies Deny Behavioral Health Claims
Video: Braidwood v. Becerra – Challenging the Affordable Care Act’s Preventive Services Coverage Provision – Thought Leaders in Health Law
Updates to Statute 1557 that Healthcare Providers Need to Know
The No Surprises Act: A Cost Saving Opportunity for Employer Plan Sponsors
Podcast: Health Equity – Behind the Buzzwords – Diagnosing Health Care
Opting Out of Medicare: When and How to Do It
The Burr Broadcast April 2023 - The Official End of COVID-19 Emergencies
Video: Health Care's Past, Present, and Future - Diagnosing Health Care Podcast
Taking the Pulse, A Health Care and Life Sciences Video Podcast | Episode 117: Chris Severn, Co-Founder & CEO, Turquoise Health
Taking the Pulse, A Health Care and Life Sciences Video Podcast | Episode 115: Dr. Michael Havig, CEO, HealthMe
Taking the Pulse, A Health Care and Life Sciences Video Podcast | Episode 106: Dr. James McElligott, MUSC & Dr. Shawn Stinson, BlueCross BlueShield of SC
PODCAST: Williams Mullen's Benefits Companion - Health Plan Transparency Requirements
Thinking About a Concierge Medical Practice? Assure Compliance with Payor Requirements and the Law
PODCAST: Williams Mullen's Benefits Companion - New Prescription Drug and Health Coverage Reporting Requirements
Video: Getting Ready for the No Surprises Act - Thought Leaders in Health Law
Podcast: What Is the Future of the Acute Care Hospital Industry? - Diagnosing Health Care
PODCAST: Williams Mullen's Benefits Companion - Can Employers Impose a Health Insurance Surcharge on Plan Participants Not Vaccinated for COVID-19?
Compliance Into The Weeds - Delta Airlines Responds to the Delta Variant
The emergence of joint ventures between health systems and payors is quickly reshaping the healthcare sector as we know it—presenting both new complexities and fresh opportunities for the changemakers involved....more
A Florida communications firm and its owner agreed to pay $293,771 to resolve False Claims Act (FCA) allegations that they failed to secure personal information on a federally funded Florida children’s health insurance...more
Across the country, states are investing in organizations and cross-departmental offices responsible for collecting, managing, integrating and analyzing health system data to provide policymakers, regulators, researchers and...more
The first ever VIRTUAL Managed Care Compliance Conference will have the great speakers and content you have come to expect from the in-person event. Each year, we look forward to hosting compliance professionals at our...more
Premera Blue Cross (Premera) has agreed to settle with the Office for Civil Rights (OCR) for $6.85 million over allegations of violations of HIPAA after an investigation of a data breach that occurred in 2014 affecting 10.4...more
Report on Patient Privacy 20, no. 9 (September 2020) - The fact that people are the weakest link in compliance is a truism in the privacy and security world. But just how weak is this link, and how likely is it that...more
Report on Patient Privacy 20, no. 1 (January 2020) - ? A cybersecurity breach temporarily halted cancer radiation treatment services at the Cancer Center of Hawaii on Oahu,[1] the center said. The center, which provides...more
Effective October 1, 2019, organizations providing health insurance and related services must notify the Maryland Insurance Administration as part of its breach notification requirements. In August 2019, the Maryland...more
Ohio Attorney General Dave Yost recently announced a multistate settlement that will require health insurance company Premera Blue Cross to pay $10 million following a breach of protected health information (PHI). According...more
Following an investigation led by the Washington Attorney General, Premera Blue Cross has agreed to pay $10 million to 30 states after experiencing a data breach in 2014 that compromised the Protected Health Information of...more
Every year, there are numerous state laws and local ordinances that take effect after the first of the year — and 2019 is no exception. Indeed, if anything, this year has seen a dramatic surge in the number of measures...more
Maine Bill Requires ISPs to Obtain Opt-In Consent from Customers - The Maine legislature has passed a bill that requires internet service providers (ISPs) operating in Maine to obtain express, affirmative consent from...more
Last week the firm moderated a discussion of banking and lending in the cannabis industry. The event was well attended and most importantly provided practical insights concerning the financing of cannabis businesses...more
On October 15, 2018, the U.S. Department of Health and Human Services, Office for Civil Rights (OCR) announced that Anthem, Inc. will pay $16 million to settle OCR’s investigation of its potential violations of the Health...more
A single, multidisciplinary entity, like a university, may include certain departments that use PHI, and other departments that do not. Such institutions are eligible to (and should) self-identify as “hybrid entities” to...more
The recent $575,000 settlement with EmblemHealth signals a push from AG Schneiderman “for stronger security laws and hold[ing] businesses accountable for protecting their customers’ personal data.” Noting New York’s “weak and...more
On January 20, 2017, businessman Donald J. Trump was sworn in as the 45th President of the United States following a contentious and unconventional 2016 presidential election. Republicans also successfully maintained control...more
As we head into the new week, here’s a quick summary of major data security developments from around the country. Aetna Hit With Second “Envelope” Lawsuit - Aetna Inc. is now facing a second lawsuit over the disclosure...more
You may not realize how much personal information your insurance company has about you. Scarier still is that much of this data is sensitive and valuable to hackers – such as your Social Security number, financial...more
The last couple of years have brought a steady rain of bad news for the healthcare industry when it comes to data security: Insurers faced with massive data breaches affecting thousands of health plans and millions of...more
The Pennsylvania Superior Court has affirmed a trial court's decision denying class certification in a data breach case against two health plans, reversing its own earlier ruling in the same case that the plaintiff did not...more
McCarter & English, LLP’s Health Care Group presents Issue 8 of the Health Law Insights, which discusses the latest legal issues in the health care industry. NATIONAL - New Payment Model for Part B Drugs Proposed -...more
We previously reported that several states, including Connecticut and Rhode Island, have adopted data security requirements, similar to the Commonwealth of Massachusetts’ data security regulations that have been in effect...more
There are several reasons an employer might have employee health information, ranging from the results of a pre-employment physical to the contents of a request for FMLA leave to what’s written in a health provider’s note...more
In late June, the New York Court of Appeals affirmed a trial court ruling that there was no coverage for a health insurance company policyholder, under a “Computer Systems Fraud” rider issued by its insurer, for an underlying...more