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Health Insurance › Third Party Administrators › Patient Protection and Affordable Care Act (PPACA)

McDermott Will & Schulte

Key updates on the US health benefits and reimbursement landscape

McDermott Will & Schulte on

The world of health benefits is constantly evolving. Recent policy shifts and legislative developments are expected to impact the economic landscape and have significant implications for employer plan sponsors, insurers,...more

King & Spalding

Strategies for Addressing Reference-Based Plans

King & Spalding on

The move by some employer plans to a “reference-based” pricing model has created a need for healthcare providers to develop a strategy to confront payment challenges that these plans create. A prevalent model of...more

Littler

“Medical Necessity” Isn’t Well-Defined Unless It Is Well-Defined

Littler on

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

Seyfarth Shaw LLP

Eighth Circuit Grants Slight Reprieve To Mother Of Transgender Son In ACA Discrimination Suit

Seyfarth Shaw LLP on

Seyfarth Synopsis: The Eighth Circuit upheld dismissal of Title VII claims challenging an employee benefit plan’s blanket transgender exclusion because the exclusion impacted the employee’s transgender son, not the employee....more

McDermott Will & Schulte

HHS Issues Final ACA Nondiscrimination in Health Programs and Activities Regulation

McDermott Will & Schulte on

In Depth - On Friday, May 13, 2016, the US Department of Health and Human Services (HHS) Office for Civil Rights (OCR) finalized regulations that provide explicit protections from discrimination on the basis of gender...more

Mintz - Health Care Viewpoints

Government Finalizes Religious Accommodation, But What About Health Plans, TPAs and PBMs?

Mintz - Health Care Viewpoints on

In a set of rules published last week, the government finalized a July 2010 interim final rule (“IFR”) related to coverage of certain preventive services and an August 2014 IFR regarding the definition of an eligible...more

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