News & Analysis as of

Healthcare › Insurance Claims › Insurance Industry

Bradley Arant Boult Cummings LLP

Texas Court Exposes Key Gap in Professional Liability Coverage for Home Health Franchisors

Bradley Arant Boult Cummings LLP on

In the home health care business? Whether a franchisor, franchisee, or independent agency, beware of bodily injury exclusions in professional liability policies that could eliminate coverage for otherwise covered claims....more

Stevens & Lee

New Changes to Medicare and Private Prior Authorization Processes

Stevens & Lee on

Both the Centers for Medicare & Medicaid Services (CMS) and dozens of the nation’s largest insurance companies have revealed upcoming changes to their prior authorization processes. These changes aim to reduce the prevalence...more

Bradley Arant Boult Cummings LLP

Effective Risk Management for Nursing Facilities: Insurance Insights on Retaliation Claims

Bradley Arant Boult Cummings LLP on

This is the first in a series of articles addressing critical issues in risk management and insurance for skilled nursing facilities. Owners and operators of skilled nursing facilities know that a claim or lawsuit against...more

Whiteford

Understanding Price Transparency Laws and Gag Clauses: A Guide for Healthcare Providers

Whiteford on

Providers continually struggle to get the fair reimbursement they deserve from payers and often feel powerless to negotiate better rates. However, regulatory changes aimed at increasing price transparency and prohibiting gag...more

Arnall Golden Gregory LLP

UnitedHealthcare Must Face State Law Claims in Class Action Suit for AI Driven Coverage Denials of Medicare Advantage Claims

Arnall Golden Gregory LLP on

Daytime television inundates American seniors with advertisements for UnitedHealthcare’s (“UHC”) Medicare Advantage Plans. On its website, UHC claims its Medicare Advantage Plans “stand out from the rest,” providing...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

Fennemore

Regulatory Landscape of Insurance Claims Denial Practices and Suggestions for a Path Forward to a Sustainable Healthcare Future

Fennemore on

In the wake of the December 4, 2024 fatal shooting of UnitedHealthcare’s CEO Brian Thompson, questions were raised about insurance claim denial practices. Several news outlets noted that UnitedHealth Group’s profits have been...more

Faegre Drinker Biddle & Reath LLP

Court Sides with Long-Term Care Insurer Over Claim Denial and Potential Fraud

Faegre Drinker Biddle & Reath LLP on

A judge from the District of Colorado recently issued an opinion that might leave the door open for long-term care insurers to void policies after the contestability period expires if an insured commits fraud. See Meyer v....more

Akerman LLP - Health Law Rx

Healthcare Cyber Insurance? Fortify Your Defenses

Akerman LLP - Health Law Rx on

Healthcare breaches, including ransomware attacks, continue to increase. As a result, many healthcare organizations seeking cyber coverage to help defray the costs associated with a ransomware attack or other data incident...more

Steptoe & Johnson PLLC

The West Virginia Medical Professional Liability Act Applies Broadly to Services Encompassing Patient Care – Not Just the Care...

Steptoe & Johnson PLLC on

The Supreme Court of Appeals of West Virginia issued a new opinion that finds that litigants cannot characterize claims as “corporate” or “general” negligence in an attempt to circumvent the West Virginia Medical Professional...more

10 Results
 / 
View per page
Page: of 1

"My best business intelligence, in one easy email…"

Your first step to building a free, personalized, morning email brief covering pertinent authors and topics on JD Supra:
Sign up Log in
*By using the service, you signify your acceptance of JD Supra's Privacy Policy.
- hide
- hide