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Health Insurance › Quality of Care Standards

Fennemore

Regulatory Landscape of Insurance Claims Denial Practices and Suggestions for a Path Forward to a Sustainable Healthcare Future

Fennemore on

In the wake of the December 4, 2024 fatal shooting of UnitedHealthcare’s CEO Brian Thompson, questions were raised about insurance claim denial practices. Several news outlets noted that UnitedHealth Group’s profits have been...more

Genova Burns LLC

Heads Up To Group Health Plans: December 31 Gag Clause Attestation Deadline Approaches

Genova Burns LLC on

The Consolidated Appropriations Act of 2021 prohibits group health plans from agreeing to avoid making certain disclosures of provider-specific cost or quality-of-care information. This is referred to as the gag clause...more

Oberheiden P.C.

Why Are We Putting Patients at Greater Risk by Holding Telemedicine Doctors to an Outdated Ordinary Standard of Care?

Oberheiden P.C. on

Everything else in the world has changed, why not how we treat our doctors? If a doctor can only bill for a two-minute telemedicine consultation, why should that doctor be held to the ordinary standard of care? If insurance...more

Stinson LLP

CMS Issues Final Rule on New Medicare and Medicaid Conditions of Participation for Home Health Agencies

Stinson LLP on

The Centers for Medicare & Medicaid Services (CMS) recently issued a final rule, 42 C.F.R. pt. 484, implementing significant changes to the conditions of participation (CoPs) that home health agencies (HHAs) must satisfy to...more

King & Spalding

CMS Announces Collaborative Core Quality Measures

King & Spalding on

CMS, in a collaboration with American’s Health Insurance Plans (AHIP), announced on February 16, 2016, seven sets of “core measures” to align quality measures required for physician reporting. These core measures align the...more

King & Spalding

CMS Announces New Value-Based Insurance Design Model for Medicare Advantage

King & Spalding on

On September 1, 2015, CMS unveiled a new Medicare Advantage Value-Based Insurance Design (MA-VBID) model, which will allow Medicare Advantage plans to offer clinically-nuanced benefit packages aimed at improving quality of...more

Foley & Lardner LLP

Medicare Advantage Value-Based Insurance Design Model

Foley & Lardner LLP on

CMS, through the Center for Medicare and Medicaid Innovation, announced on September 1, 2015, the introduction of the Medicare Advantage Value-Based Insurance Design (VBID) Model as part of the Health Plan Innovations...more

Dickinson Wright

Healthcare Legal News: Volume 5, Number 1

Dickinson Wright on

CMS ANNOUNCES NEW RULES THAT MAKE OWNER DOCTORS LIABLE FOR ALL PRACTICE MEDICARE DEBTS - Even after they leave the Practice. CMS announced its final rules on "Medicare Provider Oversight" on December 3, 2014. ...more

Akerman LLP - Health Law Rx

A Quick Look at Healthcare Issues Expected to Make News in 2015

Akerman LLP - Health Law Rx on

As we look into our crystal balls, we do not expect a lot of new issues in 2015. Rather, we believe that most of the significant issues will be a continuation of issues that arose in 2014 or earlier. ...more

Katten Muchin Rosenman LLP

Impact of Health Care Reform on Provider Liability

Katten Muchin Rosenman LLP on

In this presentation: - The Changing Healthcare Landscape - Key Features of an ACO/CIN - ACO Standards and Quality Metrics - Examples of Quality Standards - Impact on Board and Corporate...more

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