Taking the Pulse, A Health Care and Life Sciences Video Podcast | Episode 244: The Future of Independent Physician Practices with Ray Waldrup of The Leaders Rheum
Navigating Legal Strategies for Covering GLP-1s in Self-Insured Medical Plans — Employee Benefits and Executive Compensation Podcast
CareYaya: A Revolutionary Approach to Elder Care
Top Healthcare Compliance Priorities for 2025
AGG Talks: Healthcare Insights Podcast - Episode 8: What Healthcare Companies Need to Know When the Government Comes Knocking
AGG Talks: Healthcare Insights Podcast - Episode 7: National MultiPlan Litigation: A Guide for Healthcare Providers
Defending HIMP-1 Claims in New York
Understanding Pharmacy Benefit Managers: The PBM Landscape Explained
DOJ’s New Self-Disclosure Policy and Corporate Whistleblower Awards Pilot Program
AGG Talks: Healthcare Insights Podcast - Episode 4: What to Do When Insurance Companies Deny Behavioral Health Claims
Video: Braidwood v. Becerra – Challenging the Affordable Care Act’s Preventive Services Coverage Provision – Thought Leaders in Health Law
Updates to Statute 1557 that Healthcare Providers Need to Know
The No Surprises Act: A Cost Saving Opportunity for Employer Plan Sponsors
Podcast: Health Equity – Behind the Buzzwords – Diagnosing Health Care
Opting Out of Medicare: When and How to Do It
The Burr Broadcast April 2023 - The Official End of COVID-19 Emergencies
Video: Health Care's Past, Present, and Future - Diagnosing Health Care Podcast
Taking the Pulse, A Health Care and Life Sciences Video Podcast | Episode 117: Chris Severn, Co-Founder & CEO, Turquoise Health
Taking the Pulse, A Health Care and Life Sciences Video Podcast | Episode 115: Dr. Michael Havig, CEO, HealthMe
Taking the Pulse, A Health Care and Life Sciences Video Podcast | Episode 106: Dr. James McElligott, MUSC & Dr. Shawn Stinson, BlueCross BlueShield of SC
In a June decision, the Supreme Court limited retirees' ability to bring Americans with Disabilities Act (ADA) lawsuits, finding that the ADA generally does not allow claims by retirees or protect post-employment health...more
The New Mexico Court of Appeals has held that cyber policy language affording coverage “for” a security breach was ambiguous and must be construed broadly to provide coverage for a breach of contract claim “because of,”...more
Two recent U.S. Supreme Court rulings support provisions of the Affordable Care Act, one directly and one indirectly....more
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
The U.S. Supreme Court, in a 6-3 decision, ruled that the Medicaid Act’s any-qualified-provider provision does not confer individual rights enforceable under 42 U.S.C. §1983. This decision reverses the Fourth Circuit’s...more
The Colorado Court of Appeals (Division VI), applying Colorado law, partially affirmed a trial court decision dismissing an action seeking insurance coverage for COVID‑19 related losses. Spectrum Retirement Communities, LLC...more
In the ever-evolving world of healthcare billing, two recent reported California appellate court decisions, Naranjo v. Doctors Medical Center of Modesto and Dameron Hospital Association v. Progressive Casualty Insurance...more
On Thursday, June 12, 2025, a panel of the United States Court of Appeals for the Fifth Circuit issued two rulings construing parts of the No Surprises Act (NSA) to limit judicial review of arbitration awards issued under the...more
Congress enacted the No Surprises Act (NSA) to protect patients from unexpected medical bills. A central pillar of the NSA is its independent dispute resolution (IDR) process, under which payers and providers can submit...more
The recent federal district court decision in Faulk Company, Inc. v. Xavier Becerra, et al., No. 24-cv-00609-P (N.D. Tex. 2025) significantly alters the primary mechanism used by the U.S. Department of Health and Human...more
On June 12, the U.S. Court of Appeals for the Fifth Circuit issued a significant opinion in the case involving Guardian Flight, LLC and Med-Trans Corporation, two air ambulance providers, against the defendant insurance...more
The U.S. District Court for the District of Connecticut has become the latest court to weigh in on whether Independent Dispute Resolution (“IDR”) awards issued under the No Surprises Act (“NSA”) are enforceable. In a recent...more
A recent decision from the US District Court for the Eastern District of New York has significant implications for providers navigating the No Surprises Act (NSA) independent dispute resolution (IDR) process....more
UPDATE: On May 30, 2025, the Fifth Circuit granted the TMA III plaintiffs’ petition for rehearing en banc, which was previously filed on December 16, 2024. Of note, the Fifth Circuit’s mandate has not yet been issued, so as a...more
There has been a recent rise in Employee Retirement Income Security Act of 1974 (ERISA) litigation against third-party administrators (TPAs) and other service providers challenging their management of self-funded health...more
The Medicaid application process can be complicated. However, there are several common mistakes made by filers that can make things even more difficult than they need to be, adding unnecessary obstacles. In this article, we...more
On April 10, 2025, a federal court in Texas issued an opinion in the case of Faulk Co. v. Becerra that significantly impacts how the Affordable Care Act’s (ACA) employer mandate can be enforced. The ruling effectively...more
Long-term care facilities, embattled by rising costs and potential Medicaid cuts, are seeing some relief on the horizon following a recent federal court ruling that struck down portions of the Centers for Medicare & Medicaid...more
The U.S. District Court for the District of Maine recently dismissed two separate suits alleging that health plans’ coverage exclusion for weight loss drugs constitutes unlawful disability discrimination. Both complaints...more
The U.S. Court of Appeals for the Eleventh Circuit has concluded that a successful False Claims Act (FCA) claim should “allege not just a scheme, but a scheme that actually led to false claims being submitted to the...more
Within the last month, the US District Court for the Northern District of California rejected efforts by United Behavioral Health (UBH) to dismiss and decertify two class actions seeking relief related to UBH’s processing of...more
On February 19, 2025, the California Court of Appeal published a decision, Lin v. Board of Directors of PrimeCare Medical Network, Inc., 108 Cal.App.5th 1163, emphasizing California Business and Professions Code’s requirement...more
No legislation has garnered more attention in the life sciences industry in recent past than the so-called Drug Price Negotiation Program of the Inflation Reduction Act (the "Program"). ...more
They say March comes in like a lion and out like a lamb, but “they” have never been in the Georgia State Capitol in the run-up to adjournment Sine Die. Monday morning’s meeting of the standing Senate Rules Committee was a...more
In a decision of 20 March 2025 (Appeal No. N 22-23.927), the FR supreme Court ruled that the “product clawbacks” negotiated with the Economic Committee for Health Products (‘CEPS’) on the price of pharmaceutical products...more