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McDermott Will & Emery

Landmark Mental Health Parity Final Rule: What Plan Sponsors and Insurers Need to Know

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The US Departments of the Treasury, Labor, and Health and Human Services (the Departments) recently issued much-anticipated final regulations under the Mental Health Parity and Addiction Equity Act (MHPAEA). The newly issued...more

Pullman & Comley - Labor, Employment and...

Reminder: July 31 Is the PCORI Fee Remittance Deadline for Self-Insured Health Plans

Employers that sponsor a self-insured health plans must submit their Patient-Centered Outcomes Research Institute (PCORI) fees to the Internal Revenue Service by July 31, 2024. Plan sponsors need to calculate their PCORI fee...more

McDermott+

Regs, Regs and More Regs: The Biden Administration Releases Spring 2024 Unified Agenda

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We are in the midst of a storm of regulations that are being released by the Centers for Medicare & Medicaid Services (CMS) and the US Department of Health and Human Services (HHS), including the Calendar Year (CY) 2025...more

Manatt, Phelps & Phillips, LLP

Building a Collaborative Care Model: Lessons from Integrating Behavioral Health into Primary Care

As the national crisis in behavioral and mental health care continues to worsen, providers have tested innovative ways to bring services to children and adults in need. One approach to enhance service delivery is the...more

Holland & Knight LLP

Change Healthcare Cybersecurity Incident: Financial Impact and Resulting Litigation

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On Feb. 21, 2024, the ransomware hacker group ALPHV, otherwise known as "BlackCat," disabled Change Healthcare's nationwide healthcare billing and information systems and demanded a ransom to unlock them....more

Mintz - Antitrust Viewpoints

Judge Denies FTC’s Request to Enjoin Sale of Two Hospitals in North Carolina

Last week, a federal judge in North Carolina declined to preliminarily enjoin Novant Health, Inc.’s (“Novant”) acquisition of two hospitals from Community Health Systems, Inc. (“CHS”). The FTC filed suit in federal court and...more

Akerman LLP - HR Defense

Employers Must Keep Reproductive Health Information About Their Plan Participants Private Under New HIPAA Privacy Rule

Imagine you are a corporate Human Resources/Total Rewards leader who receives a request from a state’s law enforcement agency for health plan records about a plan participant’s abortions or other reproductive health care. How...more

Akerman LLP - Health Law Rx

Attention, Group Health Plans: New HIPAA Privacy Rule Governing Reproductive Health Care Information Imposes Obligations,...

It is critical for employers and plan fiduciaries/administrators to stay informed of HIPAA privacy and security-related legal developments because most employer sponsored group health plans — regardless of the employer’s...more

Woodruff Sawyer

Navigating Mid-Year Benefit Election Changes

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One of the most common questions that we receive is whether an employee can change their benefits elections after the plan year has already started (also referred to as a mid-year change).  The answer is very fact-specific...more

Arnall Golden Gregory LLP

Appeals Court Revives AGG Class Action Against UnitedHealth Group for Federal Mental Health Parity Law Violations

The United States Court of Appeals for the Ninth Circuit ruled on April 11, 2024, that AGG’s class action lawsuit against UnitedHealth Group and its subsidiaries for the wrongful and systematic denial of mental health and...more

Alston & Bird

Health Care Week in Review: CMS Issues Rules on FY 2025 Payment Rates; Medicaid Enrollment; and Short-Term, Limited Duration...

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Below is Alston & Bird’s Health Care Week in Review, which provides a synopsis of the latest news in health care regulations, notices, and guidance; federal legislation and congressional committee action; reports, studies,...more

Bressler, Amery & Ross, P.C.

New York Department of Financial Services Provides Guidance in the Face of the Change Healthcare Cyber Incident

On February 21, 2024, Change Healthcare, a platform that provides certain technology solutions for the health care industry, experienced a nationwide network interruption related to a cybersecurity issue (cyber incident) and...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

Alston & Bird

Health Care Week in Review: Congress Passes Continuing Resolution to Avert Government Shutdown; CMS Issues Final Rule on...

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Below is Alston & Bird’s Health Care Week in Review, which provides a synopsis of the latest news in health care regulations, notices, and guidance; federal legislation and congressional committee action; reports, studies,...more

Hall Benefits Law

The No Surprises Act: A Cost Saving Opportunity for Employer Plan Sponsors

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Benefits costs continue to increase globally, and in the midst of high inflation and potentially a recession, executives are exploring cost effective methods to manage their self-insured health plans without compromising the...more

Manatt, Phelps & Phillips, LLP

[Webinar] State Telehealth Policy Trends: 2023 Year in Review - December 5th, 12:00 pm - 1:00 pm ET

Three years following the onset of the COVID-19 public health emergency (PHE), states across the United States continue to enact permanent changes to telehealth laws that impact how physicians and other providers can deliver...more

Butler Snow LLP

Prior Authorization Reform in Healthcare: Winds of Change?

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Bob Dylan, winner of the Nobel Prize in Literature and one of the greatest American songwriters of all time, has effectively used wind as a metaphor in a number of songs he has written, each with its own distinct message....more

Holland & Hart LLP

How A Union Fight Played A Key Role In Yellow's Bankruptcy

Holland & Hart LLP on

Trucking giant Yellow Corp. skuttled operations and filed for bankruptcy protection in the U.S. Bankruptcy Court for the District of Delaware on Aug. 6, a mere three years after receiving $700 million in pandemic-era relief...more

K&L Gates LLP

Health Care Triage: The End of Continuous Medicaid Enrollment—What Health Systems Should Know

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In this episode, Alexander Chu and Ashley Davis review the end of the continuous Medicaid enrollment condition as a result of the Consolidated Appropriations Act, 2023. They discuss potential impacts of the disenrollment...more

Locke Lord LLP

Artificial Intelligence: The Expansion of ‎Growth Opportunities for Health Insurers and ‎Related ‎Regulatory Hurdles

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The stories of artificial intelligence applications and ChatGPT are all over the news with daily reports of new uses and challenges. With the mind-boggling speed at which generative artificial intelligence is developing, it...more

Alston & Bird

Health Care Week in Review: Leqembi Approval, Administration Issues Proposed Rules

Alston & Bird on

Below is Alston & Bird’s Health Care Week in Review, which provides a synopsis of the latest news in health care regulations, notices, and guidance; federal legislation and congressional committee action; reports, studies,...more

Carlton Fields

7th Cir. Holds Insurance Coverage Applies to Settlement Payments for Alleged Anti-Kickback and False Claims Act Violations

Carlton Fields on

On May 3, 2023, the Seventh Circuit Court of Appeals, in Astellas US Holding Inc. v. Federal Insurance Co., held that a liability insurer was required to contribute its limits toward its insured’s payment to settle potential...more

Manatt, Phelps & Phillips, LLP

Executive Summary: Tracking Telehealth Changes State-by-State in Response to COVID-19 - April 2023 #2

As the COVID-19 pandemic continues across the United States, states, payers, and providers are looking for ways to expand access to telehealth services. Telehealth is an essential tool in ensuring patients are able to access...more

Akerman LLP

False Claims Act 2022 in Review

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The U.S. government continued to earn its longstanding reputation for its vigorous enforcement of the False Claims Act (FCA) in 2022, either directly or through relator proxies. The Department of Justice (DOJ) recorded the...more

Manatt, Phelps & Phillips, LLP

Wit Redux: Ninth Circuit Issues New Superseding Opinion in Landmark Mental Health Case

The Ninth Circuit has issued a new opinion in the long-running Wit v. United Behavioral Health litigation that changes the legal landscape for ERISA class actions. The Ninth Circuit’s opinion includes significant holdings on...more

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