AGG Talks: Healthcare Insights Podcast - Episode 4: What to Do When Insurance Companies Deny Behavioral Health Claims
Best Practices for Negotiating Manuscript Exclusions
Coverage Issues Arising Out of Assault and Battery Claims
Long-Term Effects of Russia/Ukraine on Insurance
Mediating Complex Insurance Coverage Disputes Series Part 3 – Breaking the Log Jam
Cyberside Chats: There is a war in Europe. What does that mean for your cyber insurance policy?
Mediating Complex Insurance Coverage Disputes Series Part 2 – What Goes on in Mediation?
Mediating Complex Insurance Coverage Disputes Series Part 1 – Preparing For The Mediation
Out With a Bang: Current State of Play on Coverage for COVID-Related Losses
Settling a Claim: Get Comfortable With Being Uncomfortable
NGE OnDemand: The Importance of Timely Reporting Occurrences, Claims and Suits to Insurers with Paul Walker-Bright
Lowenstein’s New Insurance Recovery Podcast Series, “Don’t Take No for an Answer”
Ledgers and Law: Roadblocks Facing the Cannabis Industry
Subro Sense - The ABC's of RCV and ACV
WEBINAR: COVID-19 Insurance Coverage Class Actions
What to Do When Your Insurance Carrier Says No: How to Protect Yourself from Coverage Denials
Join the industry’s top litigators and leading plan counsel at ACI’s 16th Annual Advanced Forum on Managed Care Disputes and Litigation, for two days of discussions designed to address emerging areas of concern for MCOs in...more
In this episode, AGG Healthcare Litigation co-chair Jason Bring is joined by AGG Healthcare Litigation partners Rich Collins and Damon Eisenbrey to discuss what you can do when insurance companies deny behavioral health...more
Lots of health care service providers find themselves in the position of needing to file a Medicare appeal. Despite the systematic nature of modern Medicare billing, wrongful denials remain common, and errors during Medicare...more
On January 17, 2024, the Centers for Medicare & Medicaid Services (CMS) issued the CMS Interoperability and Prior Authorization final rule (Final Rule) (fact sheet, CMS’ interoperability website), which aims to improve prior...more
Background - Revisiting the topic from an article published earlier this year, another plaintiff has successfully challenged a commercial insurer’s internal Proton Beam Radiation Treatment (“PBT”) policy. PBT is a proven...more
On May 3, 2023, the Seventh Circuit Court of Appeals, in Astellas US Holding Inc. v. Federal Insurance Co., held that a liability insurer was required to contribute its limits toward its insured’s payment to settle potential...more
Building on our recent overview presentation “Six Lessons Patients and Providers Need to Know," we invite you to join us as we examine a single medical provider/patient encounter, in order to identify the concrete steps a...more
Report on Medicare Compliance 30, no. 17 (May 3, 2021) - With the pandemic in its second year, coding and documentation of long-haul COVID-19 patients who are admitted or readmitted to the hospital may be a sleeper risk....more
In two recent cases, the courts showed substantial deference to patients’ treating physicians in determining the reasonableness of medical treatment. This deference appears to reflect a reluctance of courts to decide what...more
Report on Medicare Compliance 30, no. 8 (March 1, 2021) - After the 2021 Medicare Physician Fee Schedule extended coverage of many telehealth services until the end of the public health emergency (PHE), including...more
In this week’s episode, Carla DewBerry and Kelsey Jernigan discuss issues in mental health parity in the context of recent California legislation. In particular, the presenters discuss how a new California bill has sparked a...more
This 21st edition of Unprecedented, our weekly update on COVID-19-related litigation, pairs defense victories with new claims. Lenders obtained the dismissal of a lawsuit claiming agent fees under the PPP program, and...more
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
This 15th edition of Unprecedented, our weekly update on COVID-19-related litigation, showcases new and evolving trends. This week we note how COVID-19 has accelerated a pre-existing trend toward class action litigation. And...more
What will the post-pandemic world look like? What risks and challenges will it raise and how to navigate the new litigation landscape? These are the most relevant questions amid the pandemic. To respond to them and provide...more
... 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
A key component to any claims-made policy is the existence of an “interrelated wrongful acts” provision. Claims-made policies typically provide coverage only for claims first made during the given policy period. Interrelated...more
It will come as no surprise that patients who are thinking about getting certified for medical marijuana use have a number of questions relating to the cost of obtaining medical marijuana products....more
Health care providers are likely familiar with the Affordable Care Act's (ACA) prohibitions on discriminating against the recipients of their services, but providers also must be mindful that the ACA may also make them...more
Aetna is now facing another set of claims calling into question its determination and payment methodology for out-of-network reimbursement. On September 4, 2015, six surgical centers in Texas (Allied Center for Special...more