News & Analysis as of

Scope of Coverage Health Insurance

Bass, Berry & Sims PLC

Tolling No More: Preparing for the End of COVID-19 Emergency Declarations

On January 30, President Biden announced his intention to end the COVID-19 National Emergency (NE) and Public Health Emergency (PHE) effective May 11, 2023. Both emergency declarations resulted in various forms of relief for...more

Goodwin

Federal District Court Ruling May Jeopardize Insurance Coverage of More Than 50 Recommended Procedures, Screenings, and Treatments

Goodwin on

Under the Affordable Care Act, group health plans and health insurance issuers are required to provide health insurance coverage based on recommendations made by healthcare coverage professionals. The covered categories...more

Polsinelli

Ninth Circuit Reverses Landmark Wit Case Addressing Behavioral Health Coverage

Polsinelli on

The President and his administration continue to tout their efforts to strengthen coverage for behavioral health care, including significantly increasing behavioral health spending and strengthening parity between physical...more

K&L Gates LLP

Recent District Court Decision Highlights the Importance of Adequate Behavioral Health Claims Processing Guidelines for ERISA...

K&L Gates LLP on

On this week’s episode, Carla DewBerry and Sarah Carlins discuss a recent California Federal District Court decision in David Wit v. United Behavioral Health, in which the court found that the defendant insurer violated ERISA...more

Hogan Lovells

CMS proposes “reasonable and necessary” definition, expedited breakthrough device coverage process

Hogan Lovells on

On Tuesday, September 1, 2020, the Centers for Medicare & Medicaid Services (CMS) published a proposed rule addressing the Medicare coverage standard and expedited coverage for certain medical devices. If finalized, the...more

Manatt, Phelps & Phillips, LLP

[Webinar] COVID-19: The Road Ahead for Commercial Health Insurance - April 23rd, 2:00 pm - 3:00 pm ET

Examine the Evolving Challenges That Lie Ahead for Healthcare Stakeholders and State Regulators—and What You Can Do Now to Prepare and Protect Your Organization—at a New Manatt Webinar. Effective health insurance...more

Manatt, Phelps & Phillips, LLP

Manatt on 1332: Hawaii Posts Nation's First State Innovation Waiver Proposal

Overview - On September 9 Hawaii became the first state to post a draft 1332 waiver proposal for public comment. While Hawaii's waiver proposal is focused on the state's unique 40-year-old employer mandate, the 40-page...more

FordHarrison

Affordable Care Act Update: Hospitalization Services Required for Plan to Meet Minimum Value

FordHarrison on

On November 4, 2014, the Internal Revenue Service (IRS) released guidance (Notice 2014-69) clarifying that certain group health plans that do not provide for hospitalization services or physician services or both will fail to...more

Womble Bond Dickinson

Health Insurance Coverage for the Treatment of Autism Spectrum Disorder

Womble Bond Dickinson on

Womble Carlyle Government Relations lobbied successfully to gain coverage for the treatment of Autism Spectrum Disorder under the NC State Health Plan...more

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