News & Analysis as of

Health Insurance Discrimination Medicare

Whiteford

New CMS Guidance on Use of Algorithms and AI in Prior Authorizations and Utilization Management

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Use of algorithms and artificial intelligence (AI) in prior authorization and utilization management is facing growing criticism and litigation. Notable lawsuits include alleged automatic authorization denials for tests that...more

Manatt, Phelps & Phillips, LLP

CMS Weighs in on the Use of Algorithms and Artificial Intelligence in Coverage Determinations

Apparently in light of recent litigation against Medicare Advantage (MA) plans, on February 6, 2024, CMS published responses to frequently asked questions (FAQs) regarding the use of algorithms and artificial intelligence in...more

Sheppard Mullin Richter & Hampton LLP

2023 Payment Rule’s Nondiscrimination Provisions and Anticipation of New Section 1557 Rules

On January 5, 2022, we discussed the Notice of Benefit and Payment Parameters for 2023 proposed rule released by the Centers for Medicare & Medicaid Services (CMS). On April 28, 2022, CMS issued the NBPP 2023 Final Rule. CMS...more

Manatt, Phelps & Phillips, LLP

How Will the Trump Administration Impact Healthcare Litigation?

Editor's Note: In a dramatic conclusion to the heated debate surrounding the American Health Care Act (AHCA), the bill was withdrawn after it became clear that House leadership did not have enough votes to pass it. There is...more

FordHarrison

Texas Court Enjoins Enforcement of Regulation that Would Forbid Discrimination in Healthcare on the Basis of Gender Identity and...

FordHarrison on

As LGBTQ rights have taken center stage in political and social issues, FordHarrison has been following ground-breaking litigation related to LGBTQ rights and providing updates. In the latest decision, a federal judge in...more

Winstead PC

U.S. Supreme Court Ruling: Defense of Marriage Act ("DOMA")

Winstead PC on

While the U.S. Supreme Court(the “Court”) ruled section 3 of the Defense of Marriage Act (“DOMA”) unconstitutional, that does not mean that the changes for human resources departments and employee benefits plans can be...more

Sherman & Howard L.L.C.

2013 and 2014 under the Affordable Care Act - Updated as of May 14, 2013

This is an update on an earlier Client Advisory on this subject, with updates to reflect recently issued guidance. Employers should consider the following checklist of new requirements as the nation moves ahead with...more

Ervin Cohen & Jessup LLP

In Case You Were Confused, Medicare is for the Benefit of Employees, not Employers

Most employers these days know that they cannot set a mandatory retirement age for employees. This arcane practice runs directly afoul of the Age Discrimination in Employment Act (ADEA)....more

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