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Health Insurance Risk Management Health Care Providers

Benesch

Dental/DSO Intelligence Monthly Report: July 2025

Benesch on

As government scrutiny of the healthcare industry intensifies, enforcement agencies are casting wider nets to recover funds based on narrowly interpreted violations. This puts not only healthcare providers but also those...more

American Conference Institute (ACI)

[Event] 16th Annual Advanced Forum on Managed Care Disputes and Litigation - May 1st - 2nd, Chicago, IL

Join the industry’s top litigators and leading plan counsel at ACI’s 16th Annual Advanced Forum on Managed Care Disputes and Litigation, for two days of discussions designed to address emerging areas of concern for MCOs in...more

Wiley Rein LLP

[Podcast] Pharmacy Benefit Segmentation: Emerging Models for Health Plans

Wiley Rein LLP on

In this episode of The Wiley Contracting Chronicles, hosts Jordan Ross and Brooke DeLoatch discuss the growing trend of pharmacy benefit segmentation among health plans. They outline three emerging models identified at Wiley:...more

Foley & Lardner LLP

Risk Bearing Entity Requirements: New Jersey and New York

Foley & Lardner LLP on

This blog reviews the regulatory requirements that apply to risk bearing entities (RBE) in New Jersey and New York. New Jersey and New York demonstrate distinct approaches to the registration and regulation of RBEs and...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

Furia Rubel Communications, Inc.

Navigating the Regulatory Complexities of an Evolving Health Care System with Kathleen Fisher Enyeart, Counsel at Lathrop GPM

In this episode of On Record PR, Gina Rubel goes on record with Kathleen Fisher Enyeart, Counsel at Lathrop GPM, to discuss the challenges of complying with health care regulations in a complex and rapidly changing industry....more

American Conference Institute (ACI)

[Event] 2nd Annual Legal, Regulatory and Compliance Summit on Medicare Advantage - November 2nd - 3rd, Nashville, TN

Hosted by American Conference Institute, the 2nd Annual Legal, Regulatory and Compliance Summit on Medicare Advantage returns for another exciting year with curated programming that will address the latest oversight and...more

Polsinelli

Ten Individuals Charged in Business Email Compromise Scheme Targeting Medicare, Medicaid and Other Insurers

Polsinelli on

On November 18, 2022, the U.S. Department of Justice (“DOJ”) announced charges against ten defendants across Georgia, South Carolina and Virginia, resulting from a scheme that allegedly targeted Medicare, state Medicaid...more

Nossaman LLP

CMIA Amendments Increase Health Care Providers’ Responsibility for Protecting Enrollees’ Privacy

Nossaman LLP on

Newly enacted Assembly Bill 1184 (“AB 1184”) will effectuate revisions to the Confidentiality of Medical Information Act that will require significant changes to the operational practices and risk management assessments of...more

Davis Wright Tremaine LLP

[Webinar] 2021 DWT Healthcare Regulatory and Compliance Seminar - A Virtual Series - March 18th, 10:00 am - 12:00 pm PT

Please join us for our annual healthcare compliance seminar to discuss current developments in healthcare regulation and hospital compliance... Registrants will have the option of selecting the sessions they would like to...more

Davis Wright Tremaine LLP

[Webinar] 2021 DWT Healthcare Regulatory and Compliance Seminar - A Virtual Series - March 16th, 10:00 am - 12:00 pm PT

Please join us for our annual healthcare compliance seminar to discuss current developments in healthcare regulation and hospital compliance... Registrants will have the option of selecting the sessions they would like to...more

Davis Wright Tremaine LLP

[Webinar] 2021 DWT Healthcare Regulatory and Compliance Seminar - A Virtual Series - March 11th, 10:00 am - 12:00 pm PT

Please join us for our annual healthcare compliance seminar to discuss current developments in healthcare regulation and hospital compliance... Registrants will have the option of selecting the sessions they would like to...more

Davis Wright Tremaine LLP

[Webinar] 2021 DWT Healthcare Regulatory and Compliance Seminar - A Virtual Series - March 9th, 10:00 am - 12:00 pm PT

Please join us for our annual healthcare compliance seminar to discuss current developments in healthcare regulation and hospital compliance... Registrants will have the option of selecting the sessions they would like to...more

Health Care Compliance Association (HCCA)

[Virtual Event] 2021 Managed Care Compliance Conference - February 1st - 3rd, 9:30 am - 3:45 pm CST

The first ever VIRTUAL Managed Care Compliance Conference will have the great speakers and content you have come to expect from the in-person event. Each year, we look forward to hosting compliance professionals at our...more

McAfee & Taft

A brief history of the future: Healthcare amid the pandemic

McAfee & Taft on

We want to share our perspective about various legal and regulatory issues and business challenges affecting the healthcare industry from COVID-19, along with a few anticipated changes in the legal and regulatory climate. ...more

American Conference Institute (ACI)

[Webinar] Navigating New Risks and Litigation Challenges Facing Payors in the COVID-19 Context and Beyond - May 13th, 12:00 pm -...

What will the post-pandemic world look like? What risks and challenges will it raise and how to navigate the new litigation landscape? These are the most relevant questions amid the pandemic. To respond to them and provide...more

Foley & Lardner LLP

COVID-19: Colorado Issues Emergency Order to Expand Use of Telehealth Services

Foley & Lardner LLP on

To expand the use of telehealth services during the COVID-19 emergency, Colorado Governor Jarod Polis issued Executive Order D 2020 020 (the Order) on April 1, 2020. The Order temporarily suspends or alters certain telehealth...more

Buchalter

The DMHC’s Final Guidance on the General Licensure Regulation (“Restricted Health Plans”) The Lull Before the Storm

Buchalter on

On Friday, June 14, 2019 the Department of Managed Health Care (the “Department”) issued All Plan Letter 19-014 (OLS) (“APL”) containing its formal guidance regarding implementation of the General Licensure Requirements (for...more

American Conference Institute (ACI)

[Event] Obstetric Malpractice Claims – Insights on Complex Medical Litigation for Medical Malpractice Plaintiff and Defense...

Be a part of the nation’s premier obstetric malpractice conference, bringing perspectives from all sides, and ensure that you stay current on the evolving standards of care, emerging theories of liability, and new defense...more

McDermott Will & Schulte

Recent $2.5 Million OCR Settlement Is a Warning to Wireless Health Service Providers

On April 24, the US Department of Health and Human Services (HHS) Office for Civil Rights (OCR) announced a Health Insurance Portability and Accountability Act of 1996 (HIPAA) settlement in the amount of $2.5 million based on...more

McDermott Will & Emery

OCR Enforcement Trends

On April 27, 2015, the U.S. Department of Health and Human Services (HHS) Office for Civil Rights (OCR) announced a resolution agreement with Cornell Prescription Pharmacy (CPP) pursuant to which CPP paid a $125,000...more

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