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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

Healthcare Authority Newsletter - April 2025 #4

News Briefs - High Court to Hear Case Challenging ACA Free Preventive Care - The Supreme Court is set to hear arguments in a case challenging a provision of the Affordable Care Act that requires private insurers to cover...more

Venable LLP

Amgen Launches Wezlana™ as the First Stelara® Interchangeable Biosimilar through Optum’s Nuvaila

Venable LLP on

On January 1, 2025, Amgen launched the first interchangeable biosimilar of Janssen / Johnson & Johnson’s Stelara® (ustekinumab), Wezlana™ (ustekinumab-auub), as a private label product through Optum Health’s Nuvaila....more

Epstein Becker & Green

A Win for Out-of-Network Providers

Epstein Becker & Green on

In a major win for healthcare providers, on September 20th a Louisiana state court jury awarded $421 million in favor of an out-of-network provider in its long dispute with Blue Cross Blue Shield of Louisiana (“BCBS of...more

BakerHostetler

OHCA Proposes Material Updates to CMIR Regulations

BakerHostetler on

California’s Office of Health Care Affordability (OHCA) released a set of proposed revisions to its sweeping Cost & Market Impact Review (CMIR) regulations yesterday afternoon. ...more

Jones Day

California Health Care Providers to Face Greater Headwinds as State Implements Health Care Cost Targets

Jones Day on

Pursuant to California's Health Care Quality and Affordability Act (the "HCQA"), the newly created Office of Health Care Affordability ("OHCA") recently proposed statewide health care cost targets and standards and goals for...more

Robinson & Cole LLP

Health Law Diagnosis - July 2023

Robinson & Cole LLP on

Connecticut Governor Signs Health Care Bill Revising Connecticut’s Facility Fee Law - On June 27, 2023, Connecticut Governor Ned Lamont signed into law Public Act 23-171 entitled “An Act Protecting Patients and Prohibiting...more

Robinson+Cole Health Law Diagnosis

Connecticut Health Care Bill Revises Provider-Payor Contracting Requirements to Address Competitive Concerns

On June 7, 2023, the Connecticut Legislature passed HB6669, “An Act Protecting Patients and Prohibiting Unnecessary Health Care Costs” (“the Act”), which includes a prohibition on certain contractual clauses in agreements...more

Maynard Nexsen

Taking the Pulse, A Health Care and Life Sciences Video Podcast | Episode 117: Chris Severn, Co-Founder & CEO, Turquoise Health

Maynard Nexsen on

This week, Chris Severn of Turquoise Health joins Matthew and Tina for the 2nd time on Taking the Pulse to give us an update on all things price transparency. Chris provides insight on the market’s reaction to the price...more

Maynard Nexsen

Taking the Pulse, A Health Care and Life Sciences Video Podcast | Episode 115: Dr. Michael Havig, CEO, HealthMe

Maynard Nexsen on

Matthew and Amanda welcome Dr. Michael Havig, HealthMe founder and CEO, to episode 115. Michael is an orthopedic surgeon and sports medicine specialist who created HealthMe to help patients find the best health care and save...more

Patrick Malone & Associates P.C. | DC Injury...

Better Healthcare Newsletter from Patrick Malone - July 2022

The 21st century American reality is if you get sick, really sick,you're in for a money nightmare on top of the emotional and physical toll of serious disease. Medical costs keep skyrocketing with no sign of easing....more

McAfee & Taft

No Surprises Act – Overview of IDR process

McAfee & Taft on

The No Surprises Act (NSA) became effective on January 1, 2022. It prohibits surprise billing in certain circumstances. Surprise billing occurs when a patient receives an unexpected bill, often for a large amount, from an...more

Akerman LLP - Health Law Rx

UPDATE: No Surprises Here – Portions of the No Surprises Act Regulations Invalidated

The No Surprises Act (the Act) continues to bump through its initial implementation phase. As we discussed in our prior blog, out-of-network physicians and facilities (OON Providers), and their allies, are pushing back...more

Pullman & Comley - Connecticut Health Law

The Federal No Surprises Act: 10 Things Connecticut Providers Should Know Now

The Federal No Surprises Act (42 USC §300gg-111 et seq.), effective for plan years beginning January 1, 2022, restricts surprise bills for patients with job-based or individual health care coverage who receive...more

Tyson & Mendes LLP

No Tort Liability for Insurer Underpayment of Hospital Bills

Tyson & Mendes LLP on

On November 4, 2021, the Second District Court of Appeal, Division 2, ruled against establishing tort liability for insurers who paid less than what the hospital believed to be the “reasonable and customary value.” This...more

Payne & Fears

The Many Unpleasant Surprises in the No Surprises Act Regulations

Payne & Fears on

The Federal No Surprises Act (“Act”), which goes into effect on January 1, 2022, contains provisions designed to protect insured patients from unexpected hospital and physician bills when they receive emergency services in an...more

Akerman LLP - Health Law Rx

Providers Get Unpleasant Surprise from Latest Provisions to the No Surprises Act

Efforts to stop surprise medical costs are continuing to evolve. The Departments of Health and Human Services (“HHS”), Labor, and Treasury (collectively, the “Departments”), and the Office of Personnel Management issued an...more

Morgan Lewis

Biden-Harris Administration Issues Part I of Surprise Billing Rule

Morgan Lewis on

The US Departments of Treasury, Labor, and Health and Human Services (the Departments) along with the Office of Personnel Management (OPM) issued Requirements Related to Surprise Billing; Part I on July 1. ...more

Patrick Malone & Associates P.C. | DC Injury...

Biden extends special sign-up period for Obamacare with increased subsidies

The Biden Administration has further expanded a special sign-up season for health insurance plans offered on Obamacare exchanges, giving consumers until Aug. 15 to enroll in coverage that also may be much cheaper....more

Patrick Malone & Associates P.C. | DC Injury...

$1.9-trillion Biden law takes major steps to reshape U.S. health and health care

The Biden Administration’s $1.9 trillion coronavirus pandemic relief law, called the American Rescue Plan, tackles one of the leading concerns expressed by American voters in repeated recent political campaigns: our health...more

Patrick Malone & Associates P.C. | DC Injury...

Better Healthcare Newsletter from Patrick Malone - March 2021

IN THIS ISSUE - As patients struggle with unreal prices, health reformers zero in on hospitals - Smart ways to negotiate a bill down - With public outcry rising on health costs, governments and employers are...more

Wilson Sonsini Goodrich & Rosati

Forecasting Healthcare Regulatory Developments in a Biden Administration

President Joe Biden was sworn into office on January 20, 2021. As with any incoming administration, new policies will be pursued while those of the previous administration are furthered, abandoned, or undone. The federal...more

BakerHostetler

Self-Funded Employer Health Plans are Changing: What to Watch

BakerHostetler on

The healthcare industry is rapidly changing, and self-funded employer sponsored health plans have more options to consider when creating solutions for their employees. In today’s episode, Jennifer Mills and Susan Hughes...more

Mintz - Health Care Viewpoints

Health Plan Transparency Rule: Comment Period Ends This Week

In November 2019, the U.S. Department of Health and Human Services, along with the U.S. Department of Treasury and the U.S. Department of Labor, (collectively, the Departments) released a proposed rule requiring group health...more

Foley & Lardner LLP

Telehealth: Massachusetts’ Proposed Act to Improve Health Care by Investing in Value

Foley & Lardner LLP on

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. Foley & Lardner LLP will be addressing each of...more

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