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Hospitals Centers for Medicare & Medicaid Services (CMS) Insurance Industry

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

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

Better Health Care Newsletter - March 2025

The giant firms  that track trends for big businesses have glum news for all of us: Health care costs are spiking anew this year. The rise, one consultancy predicts, will be the highest in 13 years....more

Health Care Compliance Association (HCCA)

Early returns on MA plans’ two-midnight rule interpretations: A compliance nightmare

The Centers for Medicare and Medicaid Services (CMS) issued regulations applicable to Medicare Advantage (MA) plans—also commonly referred to as managed Medicare or Part C Medicare—in April 2023 (CMS 4201–F) that address,...more

Spilman Thomas & Battle, PLLC

The Health Record - Healthcare Law Insights, Issue 3, July 2024

Welcome to our third issue of The Health Record - our healthcare law insights e-newsletter! We are winding down the summer with our talented group of law students and they have continued to research and write, shadow...more

McDermott+

Regs, Regs and More Regs: The Biden Administration Releases Spring 2024 Unified Agenda

McDermott+ on

We are in the midst of a storm of regulations that are being released by the Centers for Medicare & Medicaid Services (CMS) and the US Department of Health and Human Services (HHS), including the Calendar Year (CY) 2025...more

King & Spalding

Court of Appeals Upholds CMS Rule Requiring Public Disclosure of Prices Negotiated Between Hospitals and Insurance Companies

King & Spalding on

On December 29, 2020, the U.S. Court of Appeals for the District of Columbia Circuit upheld a CMS final rule promulgated in November 2019 that requires hospitals to disclose various forms of pricing information related to the...more

Foley & Lardner LLP

Massachusetts Governor Proposes Facility Fee Ban

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. This is the first in a series of blog posts to...more

Jones Day

A Dramatic Shift in Health Care Pricing Transparency

Jones Day on

The Issue: On June 24, 2019, President Trump signed an executive order, which instructed the Department of Health and Human Services to publish rules requiring hospitals to publicly disclose their negotiated rates for...more

Foley & Lardner LLP

Insurer Wrongfully Passed Sequestration Cuts Through to Providers

Foley & Lardner LLP on

A Pennsylvania judge found, on May 6, 2015, that a Medicare Advantage Plan had no right under its participation agreements to pass CMS sequestration reductions through to participating providers. Judge R. Stanton Wettick Jr....more

Faegre Drinker Biddle & Reath LLP

Hospitals and Health Insurers Prodded on Same-Sex and Transgender Issues

In separate actions yesterday, CMS and the New York State insurance regulatory authority took steps to (a) assure equal treatment of same-sex spouses by hospitals and (b) insurance coverage of medically necessary transgender...more

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