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Roetzel & Andress

One Big Beautiful Bill: A Boon for Concierge Medicine

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President Trump’s signing of the “One Big Beautiful Bill Act” on July 4, 2025, was a big win for concierge medicine practices, often called direct primary care (DPC). The new law allows favorable treatment for DPC...more

J.S. Held

All Is Not What It Seems, Or When Is A Dollar A Dime?

J.S. Held on

Welcome to the strange and mysterious world of medical billing. If ever there was an industry in which the charges and the payments have no correlation, the medical industry is it. Medical billing can indeed be quite...more

Saul Ewing LLP

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

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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

Nelson Mullins Riley & Scarborough LLP

Gold Dome Report - Legislative Day 22 - February 2025

Lawmakers and lobbyists watching the Georgia State Senate on Monday saw a lot of green and red, but it wasn’t exactly Christmas. While some state agencies and contractors stand to see a few extra greenbacks in the Senate...more

Zuckerman Spaeder LLP

A Pivotal Moment in the Fight for Behavioral Health Equity: New Parity Regulations and More

Zuckerman Spaeder LLP on

The NAADAC 2024 Conference & Hill Day is an annual conference that brings together thousands of addiction counselors, educators, and other addiction-focused health care professionals from across the country. The conference...more

Baker Donelson

Health Plan Compliance Concerns for Year-End 2024

Baker Donelson on

As employers look toward open enrollment for their group health plans, now is a good time to review action items needed for those plans by year-end, as well as upcoming deadlines in the near future. While fully-insured health...more

Ballard Spahr LLP

Health Plan Compliance Deadlines Draw Near

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Regulations under Section 1557 of the Affordable Care Act and HIPAA will require health plans and health care providers to take action in the coming months to meet new requirements. Health plan sponsors and providers that...more

Ballard Spahr LLP

Fifth Circuit Affirms Invalidity of No Surprises Regulations

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The Fifth Circuit Court of Appeals has affirmed the invalidity of regulations governing the independent review process under the No Surprise Billing Rules....more

Hall Benefits Law

9th Circuit Explains ERISA Preemption of State Law Claims Arising from Preservice Coverage Communications

Hall Benefits Law on

The U.S. Court of Appeals for the Ninth Circuit recently issued an opinion with critical implications for the healthcare industry. This court decision clarifies the expansive reach of the Employee Retirement Income Security...more

Hall Benefits Law

Biden’s Proposed FFY 2025 Budget Seeks Mental Health Access Expansion

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The Biden administration unveiled its FFY 2025 budget, which calls for $7.3 trillion in spending. In the proposed budget, Biden maintains his pledge to focus on expanding and transforming the nation’s mental health system. He...more

Akerman LLP - Health Law Rx

Attention, Group Health Plans: New HIPAA Privacy Rule Governing Reproductive Health Care Information Imposes Obligations,...

It is critical for employers and plan fiduciaries/administrators to stay informed of HIPAA privacy and security-related legal developments because most employer sponsored group health plans — regardless of the employer’s...more

Polsinelli

Florida Legislative Session 2024: Health Care Highlights

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The Florida Regular Legislative Session began on January 9, 2024, and ended on March 8, 2024. Below is a summary of relevant health care laws that will be effective July 1, 2024, if they are approved by Governor DeSantis....more

Seyfarth Shaw LLP

Employers Consider Post-Dobbs Playbook in Dealing with Alabama Ruling on IVF Treatments

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Seyfarth Synopsis: Last week, the Alabama Supreme Court ruled that cryogenically frozen embryos are children and are protected from destruction under state law. This is the latest in a series of post-Dobbs judicial rulings...more

Woodruff Sawyer

An Employer’s Guide to Long-Term Care Insurance

Woodruff Sawyer on

Research shows that 70% of Americans may need long-term care at some point in their lives. Although that need is greatest for older adults, anyone at any age may suffer an accident or illness that results in the need for...more

Hall Benefits Law

Health Care Stakeholders Support Passage of The Value in Health Care Act

Hall Benefits Law on

Seventeen healthcare stakeholder groups have come together to support The Value in Health Care Act, a bill that a bipartisan coalition reintroduced in Congress this summer. The bill supports a shift in the medical care...more

McDermott Will & Schulte

New MHPAEA Guidance Regarding NQTLs: Network Access and Composition

Recently proposed regulations attempt to ensure that health plans allow access to mental health or substance use disorder (MH/SUD) benefits as easily as medical or surgical (M/S) benefits. The proposed regulations, issued by...more

Foley & Lardner LLP

High Deductible Health Plan First Dollar Coverages in Flux

Foley & Lardner LLP on

A recent string of lawsuits, regulatory guidance, and market trends have dramatically impacted the types of services that enjoy first dollar coverage under high deductible health plan (HDHP) and health savings account (HSA)...more

Ballard Spahr LLP

Gag-Clause Attestations Due by End of Year

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Summary - By December 31, 2023, health plans and insurers must submit an attestation of compliance with the anti-gag rules of the Consolidated Appropriations Act, 2021 (CAA). The rules apply to all agreements entered into...more

Stoel Rives - Health Law Insider®

Washington’s Law Regulating Health Care Benefit Managers Is Broad and Complex

Washington’s law regulating “health care benefit managers” (“HCBMs”) went into effect on January 1, 2022. Although Washington’s regulatory scheme for HCBMs has some similarities with how other states regulate “third party...more

Ballard Spahr LLP

Court Invalidates Certain Preventive Care Requirements

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Summary - Health plans and insurance policies may no longer be required to cover the full cost of preventive care that carries an A or B rating by the U.S. Preventive Services Task Force (USPSTF), following a recent ruling...more

Stoel Rives - Health Law Insider®

Telehealth Safe Harbor Extended

High deductible health plan (“HDHP”) sponsors take note: the Continuing Appropriations Act, 2023 (“CAA23”) temporarily extends the flexibility for HDHPs to provide pre-deductible coverage of telehealth services without...more

McAfee & Taft

How changes to the “family glitch” affect workplace health plans

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The IRS finalized new rules that change eligibility requirements for the premium tax credit (PTC) created under the Affordable Care Act. It is now easier for an employee’s family members to enroll in subsidized health...more

Morgan Lewis - ML Benefits

New and Updated Women’s Preventive Health Services Guidelines Apply in 2023

The Affordable Care Act (ACA) requires non-grandfathered group health plans (and insurers) to provide coverage for certain preventive health services for all adults, women, and children. Preventive services covered under the...more

Butler Snow LLP

The No Surprises Act – Anticipating Unanticipated Consequences

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The “law of unintended consequences” describes the general sociological principle that for every action there is an unintended or unanticipated outcome. An influential examination of the concept was published in 1936 by...more

FordHarrison

Transparency in Coverage Requirements – Compliance Deadline Approaching

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Summary: For Health Plans, Machine-Readable Files, containing in-network provider charges and out-of-network allowed amounts and billed charges, must be posted on a public website by July 1, 2022....more

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