News & Analysis as of

Department of Health and Human Services (HHS) Health Care Providers Insurance Industry

Stevens & Lee

New Changes to Medicare and Private Prior Authorization Processes

Stevens & Lee on

Both the Centers for Medicare & Medicaid Services (CMS) and dozens of the nation’s largest insurance companies have revealed upcoming changes to their prior authorization processes. These changes aim to reduce the prevalence...more

Proskauer - Health Care Law Brief

No Surprises Here! Fifth Circuit Holds NSA Provides No Private Right of Action to Enforce IDR Awards, Deepening Judicial Divide...

In a recently issued opinion, the Fifth Circuit has added yet another chapter to the growing debate over whether providers may seek judicial enforcement of Independent Dispute Resolution (“IDR”) awards issued under the No...more

Foley & Lardner LLP

Unpacking the Federal Anti-Kickback Statute’s Application to Payments to Medicare Advantage Agents and Brokers

Foley & Lardner LLP on

On December 11, 2024, the U.S. Department of Health & Human Services’ Office of Inspector General (OIG), issued a Special Fraud Alert (Alert) focusing on financial arrangements involving Medicare Advantage (MA) Organizations...more

Bass, Berry & Sims PLC

Healthcare Regulatory & Compliance Summit 2025 Recap

Health Policy Fireside Chat: What to Expect from the New Administration - Bill Mathias, Member at Bass, Berry & Sims, engaged in a fireside chat with Colin Roskey, Principal at FHP Strategies, former Deputy Assistant...more

Fennemore

Nursing Impact Litigation – A Tale of Two Matters

Fennemore on

This article highlights legal disputes central to APRNs’ ability to practice independently, the use of professional titles, insurance discrimination, and broader healthcare competition dynamics. Around the country, Advanced...more

Saul Ewing LLP

Trump on Transparency: Making America Healthy Again Through Executive Order 14221; How Plan Sponsors Can Respond

Saul Ewing LLP on

One mandate under the PPACA required health care providers, non-grandfathered health insurance issuers and self-insured group health plans to provide consumers with access to information about the cost of services before they...more

Kerr Russell

The Difference Between ‘Non-Covered’ vs. ‘Disallowed’ Services

Kerr Russell on

Question: I have had several colleagues describe their experience with dental plan audits. All of them have had to pay something back. Sometimes they say this is due to a service being deemed a “noncovered service.” Other...more

ArentFox Schiff

No More Surprise Medical Bills: Fifth Circuit Affirms Vacatur of Arbitration Provisions of Surprise Billing Rules (TMA II)

ArentFox Schiff on

On August 2, health care providers scored yet another significant victory when the US Court of Appeals for the Fifth Circuit affirmed the vacatur of various federal regulations regarding the arbitration procedures used to...more

Spilman Thomas & Battle, PLLC

The Health Record - Healthcare Law Insights, Issue 3, July 2024

Welcome to our third issue of The Health Record - our healthcare law insights e-newsletter! We are winding down the summer with our talented group of law students and they have continued to research and write, shadow...more

McDermott+

Regs, Regs and More Regs: The Biden Administration Releases Spring 2024 Unified Agenda

McDermott+ on

We are in the midst of a storm of regulations that are being released by the Centers for Medicare & Medicaid Services (CMS) and the US Department of Health and Human Services (HHS), including the Calendar Year (CY) 2025...more

ArentFox Schiff

NYS Insurance Regulators to Health Insurers: Ensure Your Networks Are Adequate

ArentFox Schiff on

On February 21, Superintendent Adrienne A. Harris of the New York State Department of Financial Services (DFS) unveiled a proposed regulation, 11 NYCRR 38. If adopted, this regulation, would establish network adequacy...more

Foley & Lardner LLP

HRSA Uninsured Program Covid-19 Services: OIG Audit Finds HRSA Paid for Claims that did not Comply with Federal Requirements

Foley & Lardner LLP on

On July 13, 2023 the Office of Audit Services of the Department of Health & Human Services Office of Inspector General (OIG) released the long-awaited audit (A-02-21-01013) of the Health Resources and Services Administration...more

Zuckerman Spaeder LLP

Whither Insurance Coverage for Preventive Health Services? District Court Decision Striking Down Affordable Care Act’s Preventive...

Zuckerman Spaeder LLP on

On May 15, 2023, the Fifth Circuit temporarily stayed a district-court ruling that struck down a key part of the Affordable Care Act (ACA). As a result of the stay, the ACA’s health insurance coverage requirements for...more

Rumberger | Kirk

The Multiple Issues Surrounding Medicare and Past Damages

Rumberger | Kirk on

What amount of past medical expenses can a plaintiff present to the jury when he or she is a Medicare recipient? The short answer: only the amount of past medical expenses the plaintiff is obligated to pay, not the gross...more

Foley & Lardner LLP

CMS Extends Delayed Enforcement of the Good Faith Estimate

Foley & Lardner LLP on

On Friday, December 2, 2022, the Centers for Medicare & Medicaid Services (CMS) issued an FAQ regarding the Good Faith Estimate (GFE) and Convening Provider/Facility requirements in the Federal No Surprises Act. The issued...more

Bradley Arant Boult Cummings LLP

Federal Agencies Release Interim Final Rule to Implement the No Surprises Act

Today, the Departments of Health and Human Services (HHS), Labor, and Treasury (the Departments) published an interim final rule (the Interim Final Rule) implementing certain provisions of the No Surprises Act,[1] which aims...more

Holland & Hart - Health Law Blog

Free COVID-19 Vaccines and Diagnostic Testing

Over a year after the declaration of a nationwide public health emergency due to the Coronavirus Disease 2019 (“COVID-19”) pandemic, providers are in a position to offer patients a variety of COVID-19 medical services,...more

White and Williams LLP

HHS Proposes Significant HIPAA Privacy Rule Changes: Amendments Would Increase Individual and Institutional Access and...

White and Williams LLP on

Advocates for healthcare patients, providers, payors and privacy professionals received good news on Thursday, December 10, 2020 with the announcement of long-awaited and debated proposed amendments to the complex Health...more

King & Spalding

HHS Sending New Round of COVID-19 Funding to Safety Net Hospitals and Medicaid and Children's Health Insurance Program Providers

King & Spalding on

On June 9, 2020, HHS announced that it will distribute, through the Health Resources and Services Administration (HRSA), two new rounds of funding to healthcare providers treating low-income and uninsured patients during the...more

Bass, Berry & Sims PLC

Trump Administration Proposes Transparency Rule for Group Health Plans and Insurers

Bass, Berry & Sims PLC on

On November 15, 2019, the Department of Health and Human Services, the Department of Labor, and the Department of the Treasury (collectively, the Departments), unveiled a proposed rule (scheduled to be published on November...more

Nelson Mullins Riley & Scarborough LLP

Gold Dome Report - March 2019 #11

Although adjournment Sine Die remains two weeks away, the end felt nearer under the Gold Dome today. As legislators and lobbyists shook out the cobwebs from St. Patrick’s Day weekend, end-of-session strategizing filled the...more

Schwabe, Williamson & Wyatt PC

Texas Federal District Court Opines That the Affordable Care Act Is Invalid in Its Entirety: Where Does It Go from Here?

On December 14, 2018, a federal judge in Texas, in response to a lawsuit brought by 20 Republican states, issued a judgment opining that the Affordable Care Act (“ACA”) is invalid in its entirety. That is a very sweeping...more

Nelson Mullins Riley & Scarborough LLP

Gold Dome Report - February 2018 #13

The House and Senate capped off a busy pre-Crossover week with several weighty propositions on their respective floors. In the Senate, members considered the “Keep Faith and Freedom in Adoption and Foster Care Act”, a...more

Nelson Mullins Riley & Scarborough LLP

Gold Dome Report - February 2018 #6

Lawmakers hit the ground running today with Legislative Day 19, riding on good news on tax revenues that emerged late last week. On Friday, Governor Deal announced that the state’s tax revenues for the month of January were...more

Farrell Fritz, P.C.

Medical Marijuana 104: Responsibilities of Health Insurers

Farrell Fritz, P.C. on

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

29 Results
 / 
View per page
Page: of 2

"My best business intelligence, in one easy email…"

Your first step to building a free, personalized, morning email brief covering pertinent authors and topics on JD Supra:
*By using the service, you signify your acceptance of JD Supra's Privacy Policy.
- hide
- hide