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Price Transparency Health Insurance

McDermott+

CMS Finalizes Major Reforms to Medicaid, Part 2: Medicaid Managed Care Reg

McDermott+ on

Medicaid Regs Part 2! Last week, Regs & Eggs took a deep dive into the Ensuring Access to Medicaid Services final reg, one of two regs that the Centers for Medicare & Medicaid Services (CMS) released to add new requirements...more

Nelson Mullins Riley & Scarborough LLP

Expanded Behavioral Health Access, Enhanced Price Transparency, and the 340B Remedy in the CY 2024 Hospital Outpatient and...

The Centers for Medicare & Medicaid Services (CMS) has announced new measures to enhance access to behavioral health services for Medicare beneficiaries and improve hospital price transparency as part of the final rule for...more

McDermott+

McDermottPlus Check-Up: May 19, 2023

McDermott+ on

The House and Senate were both in session this week, with significant healthcare activity at the committee level. The House Ways & Means Committee met to discuss healthcare price transparency, and the Ways & Means Health...more

McDermott+

McDermottPlus Check-Up: April 28, 2023

McDermott+ on

Congress was in session, and it was a busy healthcare week at the committee level, with six hearings focused specifically on health issues. On the House floor, Republicans passed the Limit, Save, Grow Act—a bill that raises...more

Manatt, Phelps & Phillips, LLP

The Manatt State Cost Containment Update - March 20, 2023 - Additional Resources

Other Cost Containment Resources - The recommendations in Health Affairs’ new report, “A Road Map for Action: Recommendations of the Health Affairs Council on Health Care Spending and Value” (February 2023), span four...more

Manatt, Phelps & Phillips, LLP

The Manatt State Cost Containment Update - March 20, 2023 - Health Data Corner

The Health Data Corner compiles the latest state health care data capacity innovations and policy developments and showcases select novel data use cases emerging from states. ...more

Maynard Nexsen

Taking the Pulse, A Health Care and Life Sciences Video Podcast | Episode 117: Chris Severn, Co-Founder & CEO, Turquoise Health

Maynard Nexsen on

This week, Chris Severn of Turquoise Health joins Matthew and Tina for the 2nd time on Taking the Pulse to give us an update on all things price transparency. Chris provides insight on the market’s reaction to the price...more

Maynard Nexsen

Taking the Pulse, A Health Care and Life Sciences Video Podcast | Episode 115: Dr. Michael Havig, CEO, HealthMe

Maynard Nexsen on

Matthew and Amanda welcome Dr. Michael Havig, HealthMe founder and CEO, to episode 115. Michael is an orthopedic surgeon and sports medicine specialist who created HealthMe to help patients find the best health care and save...more

McDermott Will & Emery

Agencies Provide Guidance on Transparency in Coverage Rule Implementation

McDermott Will & Emery on

On April 19, 2022, the US Departments of Labor, Health and Human Services, and the Treasury (collectively, the Departments) released Frequently Asked Questions (FAQs) regarding the implementation of certain reporting...more

Woodruff Sawyer

Two New Healthcare Pricing Transparency Rules Employers Should Know

Woodruff Sawyer on

On our last visit to The Hill, we reported on the buzz surrounding the government’s efforts to end health care surprise billing and create more transparency in billing practices. Not long after that visit in 2020, the Biden...more

Manatt, Phelps & Phillips, LLP

CMS Publishes Letters on No Surprises Act Enforcement in States

The federal Centers for Medicare & Medicaid Services (CMS) has begun publishing on its website letters that it sent to states beginning in December 2021 that provide important information regarding the manner in which the...more

Proskauer - Health Care Law Brief

New York Enacts Landmark Legislation Regulating PBM

On December 31, 2021, New York Governor Kathy Hochul signed landmark legislation to increase the transparency of prescription drug pricing and to establish requirements on pharmacy middlemen. This new law is amongst 100 ...more

Pullman & Comley - Connecticut Health Law

The Federal No Surprises Act: 10 Things Connecticut Providers Should Know Now

The Federal No Surprises Act (42 USC §300gg-111 et seq.), effective for plan years beginning January 1, 2022, restricts surprise bills for patients with job-based or individual health care coverage who receive...more

Manatt, Phelps & Phillips, LLP

States Begin to Issue Guidance on Implementing the No Surprises Act: Are You Ready?

The No Surprises Act (NSA), which was enacted in December 2020 as part of the Consolidated Appropriations Act, 2021, protects patients from surprise medical bills for emergency services and when they are treated by...more

Akerman LLP - Health Law Rx

Providers Get Unpleasant Surprise from Latest Provisions to the No Surprises Act

Efforts to stop surprise medical costs are continuing to evolve. The Departments of Health and Human Services (“HHS”), Labor, and Treasury (collectively, the “Departments”), and the Office of Personnel Management issued an...more

Polsinelli

Health Care Reimbursement and Payor Dispute Update - September 2021

Polsinelli on

On July 1, 2021, the Departments of Health and Human Services (“HHS”), Treasury, and Labor, along with the Office of Personnel Management (collectively the “Departments”), issued the first tranche of regulations implementing...more

Sheppard Mullin Richter & Hampton LLP

Elijah E. Cummings Lower Drug Costs Now Act: The Long and Winding Road to Drug Pricing Reform

As reintroduced in the U.S. House of Representatives by Rep. Frank Pallone, Jr. (D-NJ-6) on April 22, 2021 after originally being introduced on September 19, 2019, H.R. 3, also known as known as the Elijah E. Cummings Lower...more

Proskauer - Health Care Law Brief

The Surprises Continue: The Biden Administration Delays Implementation of Certain Provisions of the No Surprises Act and...

In a FAQ published on August 20, 2021, the Departments of Labor, Health and Human Services, and the Treasury (collectively, the “Departments”) significantly delayed implementation of statutory requirements on surprise billing...more

Manatt, Phelps & Phillips, LLP

Federal Government Delays and Modifies Price Transparency and Surprise Billing Rules

The Biden Administration this month significantly relaxed several compliance obligations related to price transparency and surprise billing that have been of intense concern to the health care industry—and had already...more

Manatt, Phelps & Phillips, LLP

[Webinar] Navigating the No Surprises Act: Your Guide to Requirements, Challenges & Compliance - August 2nd, 1:00 pm - 2:00 pm ET

What New Obligations Does the No Surprises Act Impose on Health Systems and Health Plans—and How Can You Prepare for the Impact? Learn the Answer at a New Manatt Webinar. The No Surprises Act (NSA)—set to take effect...more

Manatt, Phelps & Phillips, LLP

Interoperability and Transparency Rules Usher in a New Era of Health Plan Data Obligations

After a six-month delay due to the COVID-19 pandemic, the first provisions of the interoperability rule issued by the Centers for Medicare & Medicaid Services (CMS) took effect on July 1. The new requirements are the first of...more

Goodwin

Biden Executive Order Targets Competition in Healthcare, Life Sciences to Spur Economic Activity

Goodwin on

On July 9, 2021, President Joe Biden issued an Executive Order (the “Order”) designed to promote competition in the American economy. The Order describes the administration’s concerns with competition in several markets,...more

Akerman LLP - Health Law Rx

Group Health Plan Sponsors are Getting Serious About Pricing Transparency – Are You Keeping Up?

In early July, the Department of Health and Human Services (HHS), the Department of Labor (Labor), and the Department of the Treasury (Treasury) (collectively, the Departments), along with the Office of Personnel Management...more

Proskauer - Health Care Law Brief

New Federal Transparency Requirements Impacting Health Providers and Plans

As promised, this is a follow-up to our first blog post on the new federal transparency requirements. In our prior post, we summarized the Hospital Price Transparency rule which went into effect on January 1, 2021, and here...more

Baker Donelson

Lawmakers Raise Compliance Concerns Over Hospital Price Transparency Rules, Request Increased Enforcement

Baker Donelson on

On April 13, 2021, four key lawmakers in the U.S. House of Representatives wrote to the U.S. Department of Health and Human Services (HHS) expressing concern over reports of non-compliance with hospital price transparency...more

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