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BakerHostetler

Alive and (Anti)Kicking: EKRA Prosecutions on the Rise in California with Multiple Recent Indictments

BakerHostetler on

In the past few months, federal prosecutors in California have brought multiple indictments under the Eliminating Kickbacks in Recovery Act (EKRA) charging the owners of substance abuse treatment facilities and their...more

Maynard Nexsen

Taking the Pulse, A Health Care and Life Sciences Video Podcast | Episode 244: The Future of Independent Physician Practices with...

Maynard Nexsen on

On episode 244, Lynnsey and Matthew are joined by Ray Waldrup, Co-Founder and CEO of The Leaders Rheum, a national network of leading rheumatology practices. Drawing on 3 decades of experience in healthcare leadership, Ray...more

Wiley Rein LLP

Colorado Court of Appeals Permits COVID-19 Coverage Suit to Proceed Based on Health Care Endorsement Coverage

Wiley Rein LLP on

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

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

Arnall Golden Gregory LLP

OIG Approves Arrangement Incentivizing Medigap Policyholders to Seek Treatment From PHO Network Hospitals

Arnall Golden Gregory LLP on

The Department of Health and Human Services, Office of Inspector General (“OIG”) recently released a favorable advisory opinion, OIG Advisory Opinion No. 24-01 (the “Opinion”), to a Medicare Supplemental Health Insurance...more

Hall Benefits Law

Lawsuit Claims UnitedHealthcare Uses AI to Deny Majority of Medicare Advantage Extended-Care Facility Claims

Hall Benefits Law on

As the healthcare industry has begun to use artificial intelligence (AI) algorithms in its claims determination process, litigation has ensued. In a recent class action lawsuit, plaintiffs claim that UnitedHealthcare used its...more

Foley & Lardner LLP

Behavioral Health & Substance Abuse Services: Massachusetts Proposal Reflects Focus on Expanding Access and Coverage

Foley & Lardner LLP on

... 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

Sheppard Mullin Richter & Hampton LLP

Surprise Billing Initiatives Face Not-So-Surprising Resistance

Sheppard Mullin Richter & Hampton LLP on

“Surprise billing,” also known as “balance billing,” is one of few areas that garners bipartisan support. Surprise billing occurs when a patient inadvertently goes out of his or her insurer’s network, resulting in a “surprise...more

Foley & Lardner LLP

Massachusetts Governor Proposes Facility Fee Ban

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Massachusetts Governor Charlie Baker has restarted the discussion on health care cost containment in the Commonwealth with a proposed bill that contains a raft of initiatives. This is the first in a series of blog posts to...more

K&L Gates LLP

HHS Proposes Rules for Nondiscrimination in Health Care

K&L Gates LLP on

On September 8, 2015, the U.S. Department of Health and Human Services (“HHS”) proposed new regulations implementing Section 1557 of the Patient Protection and Affordable Care Act (“ACA”). Section 1557 prohibits...more

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