Joint Venture Eligibility Refresher on Requirements for Government Contractors
Beyond Hospice: And They’re Off! The OIG’s Nationwide Review of Hospice Eligibility Has Begun
Podcast: Non-binding Guidance: Breakthrough Devices Program
Over 35 health care provisions were included in the One Big Beautiful Bill Act of 2025. These provisions span Medicaid, the Children’s Health Insurance Program (CHIP), the Affordable Care Act (ACA) marketplaces, Medicare and...more
For skilled nursing facility residents applying for long-term care Medicaid benefits, under federal regulation, all state agencies are required to issue an eligibility determination on the application within 45 days of the...more
In our day-to-day work representing skilled nursing facilities, we are regularly asked by our clients to assist in securing Medicaid benefits for their residents. This often entails seeking the cooperation of the resident or...more
As discussed here, D.K. et al. v. United Behavioral Health et al. is a case that has been carefully watched in the health benefits space for its impact on what health plan administrators must include in adverse benefit...more
Two recent sets of guidance affecting employers’ operations of employee benefit plans have been issued by the Internal Revenue Service (the IRS) and the Department of Labor (the DOL). ...more
As a result of the ongoing COVID-19 pandemic, we are observing all sorts of never-before-seen changes in the fully-insured group health plan space. Many insurers are liberally waiving their normal rules to accommodate the...more
The Ohio Department of Insurance (ODI) has issued guidance pursuant to Governor Mike DeWine’s emergency declaration and March 9, 2020, order directing state agencies to implement procedures consistent with recommendations...more
A U.S. District Court in Connecticut recently issued an order that highlights the importance of understanding exactly what the term “medically necessary” means in an ERISA health plan....more