The Medicare program continues to face long term financial pressures associated with inflationary effects on health care costs and the growing wave of aging baby boomers. The Medicare Trust Fund, which is often viewed as a...more
2/28/2025
/ Affordable Care Act ,
Centers for Medicare & Medicaid Services (CMS) ,
CMMI ,
Health Care Providers ,
Health Insurance ,
Healthcare Reform ,
Insurance Industry ,
Medicaid ,
Medicare ,
Medicare Advantage ,
Medicare Part A ,
Medicare Shared Savings Program ,
Value-Based Care
Providers and provider organizations are increasingly contracting with payors to manage specific patient pools and diseases on a risk basis. They are taking new and increasing financial risk to better align with payors’...more
Welcome to the Payor/Provider Convergence Series of the Health Care Law Today blog. This series is dedicated to exploring the intersection between payors and providers in the health care space; in particular, the evolving...more
5/4/2023
/ Centers for Medicare & Medicaid Services (CMS) ,
CMMI ,
False Claims Act (FCA) ,
Fee-for-Service ,
Health Care Providers ,
Health Insurance ,
Healthcare ,
Knox Keene ,
Medicare Advantage ,
No Surprises Act (NSA) ,
Public Health Emergency
Telemedicine providers can sell their services in a number of ways. Consumers, self-funded health plans, and health insurance companies are all important and growing customers for many telemedicine providers. Telemedicine...more
7/3/2018
/ Fee-for-Service ,
Health Care Providers ,
Health Insurance ,
HMOs ,
Insurance Code ,
Physicians ,
Risk Mitigation ,
Self-Funded Health Plans ,
Service Contracts ,
Telehealth ,
Telemedicine
Section 1557 of the Affordable Care Act (“ACA”) establishes a broad prohibition on discrimination on the basis of race, color, national origin, sex, age or disability in health programs and activities. After almost 3 years of...more
Telehealth opportunities continue to grow at an exponential rate, aligning with the concurrent growth of retail and consumer-focused medicine. Capturing the retail sentiment, companies are looking to offer subscription-based...more
10/6/2015
/ Alternative Payment Models (APM) ,
Fees ,
Fixed Price ,
Fixed-Fee ,
Health Care Providers ,
Health Insurance ,
Licensing Rules ,
Retail Market ,
Risk-Based Approaches ,
Telehealth ,
Telemedicine