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Arnall Golden Gregory LLP

OIG Approves Arrangement Incentivizing Medigap Policyholders to Seek Treatment From PHO Network Hospitals

The Department of Health and Human Services, Office of Inspector General (“OIG”) recently released a favorable advisory opinion, OIG Advisory Opinion No. 24-01 (the “Opinion”), to a Medicare Supplemental Health Insurance...more

Hall Benefits Law

Lawsuit Claims UnitedHealthcare Uses AI to Deny Majority of Medicare Advantage Extended-Care Facility Claims

Hall Benefits Law on

As the healthcare industry has begun to use artificial intelligence (AI) algorithms in its claims determination process, litigation has ensued. In a recent class action lawsuit, plaintiffs claim that UnitedHealthcare used its...more

Manatt, Phelps & Phillips, LLP

[Webinar] Ten Health Care Imperatives for the Decade Ahead: Ensuring Access to Coverage and Care - March 31st, 4:00 pm - 5:00 pm...

Join Manatt and Innovators From Callen-Lorde and NY State of Health for a Dynamic Roundtable Exploring New Policy Opportunities and Strategies for Advancing Coverage and Care. Access to coverage and care is the linchpin of...more

Foley & Lardner LLP

Behavioral Health & Substance Abuse Services: Massachusetts Proposal Reflects Focus on Expanding Access and Coverage

Foley & Lardner LLP on

... Massachusetts House Bill 4134 includes several provisions aimed at expanding access to treatment for mental health and substance use conditions in the Massachusetts Commonwealth. Most notably, the Bill would require...more

Sheppard Mullin Richter & Hampton LLP

Surprise Billing Initiatives Face Not-So-Surprising Resistance

“Surprise billing,” also known as “balance billing,” is one of few areas that garners bipartisan support. Surprise billing occurs when a patient inadvertently goes out of his or her insurer’s network, resulting in a “surprise...more

Foley & Lardner LLP

Massachusetts Governor Proposes Facility Fee Ban

Foley & Lardner LLP on

Massachusetts Governor Charlie Baker has restarted the discussion on health care cost containment in the Commonwealth with a proposed bill that contains a raft of initiatives. This is the first in a series of blog posts to...more

K&L Gates LLP

HHS Proposes Rules for Nondiscrimination in Health Care

K&L Gates LLP on

On September 8, 2015, the U.S. Department of Health and Human Services (“HHS”) proposed new regulations implementing Section 1557 of the Patient Protection and Affordable Care Act (“ACA”). Section 1557 prohibits...more

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