In this week’s episode, Gary Qualls discusses a recent case decided in the Western District of Louisiana, which highlights how the application of the arbitrary and capricious standard as applied to payor coverage...more
8/6/2020
/ Abuse of Discretion ,
Appeals ,
Arbitrary and Capricious ,
Blue Cross ,
Denial of Benefits ,
Denial of Insurance Coverage ,
Health Care Providers ,
Health Insurance ,
Healthcare Facilities ,
Inpatient Billing ,
Insurance Litigation ,
Medical Necessity ,
Mental Health ,
Motion for Summary Judgment ,
Physicians ,
Substantial Evidence ,
Suicide
The Office of Medicare Hearings and Appeals (“OMHA”) recently expanded the Settlement Conference Facilitation (“SCF”) program, an alternative dispute resolution process, to allow more providers and suppliers with pending Part...more