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Hospitals Health Insurance

Maynard Nexsen

Taking the Pulse, A Health Care and Life Sciences Video Podcast | Episode 244: The Future of Independent Physician Practices with...

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On episode 244, Lynnsey and Matthew are joined by Ray Waldrup, Co-Founder and CEO of The Leaders Rheum, a national network of leading rheumatology practices. Drawing on 3 decades of experience in healthcare leadership, Ray...more

Ropes & Gray LLP

Hospital and Health Systems Reimbursement Check July 2025

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In the early days of the second Trump Administration, several federal funding agencies announced caps to indirect cost (“IDC”) rates for federally funded research awards. In many cases, these caps would substantially reduce...more

Davis Wright Tremaine LLP

Anthem's New Chargemaster-Based Claim Edits: Which Charges and Providers Will Anthem's New Process Target and How Will It Impact...

Effective August 1, 2025, Anthem will implement a new claims-editing process that adjusts payments for Medicare Advantage (MA) claims based on an undisclosed, customized chargemaster table. The announcement identifies claims...more

Cozen O'Connor

Pennsylvania Perspective for Thursday, July 10, 2025

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Gov. Shapiro Warns About Medicaid Cuts, Rural Hospital Closures - During a press conference in York on Monday, Governor Josh Shapiro (D) sharply criticized Pennsylvania Republicans for supporting a federal reconciliation...more

Robinson+Cole Health Law Diagnosis

Connecticut Enacts Wide-Ranging Health Care Law Modifying Various Existing Rules and Laws

On June 25, 2025, Connecticut Governor Ned Lamont signed into law Public Act No. 25-97, “An Act Concerning Various Revisions to the Public Health Statutes” (the Act). The Act includes a wide range of provisions affecting...more

Davis Wright Tremaine LLP

Navigating Aetna's Expanded Claim Edits: What Providers Need To Know and Do Before September 1, 2025

Aetna recently announced that effective September 1, 2025, its Claim and Code Review Program (CCRP) will expand to include additional claim coding edits for all commercial, Medicare, and Student Health claims. While the...more

Arnall Golden Gregory LLP

Healthcare Providers Keep Singing the Blues About Unfair Reimbursement Rates But Blue Cross Blue Shield Won’t Change Its Tune

After more than a decade of litigation and more than $5 billion in settlements, the Blue Cross Blue Shield Association (“BCBSA”) and its affiliate insurance companies (the “BCBS Entities”) appear to be up to their old tricks....more

Davis Wright Tremaine LLP

Two California Appellate Decisions Highlight Liability Risks Arising From Hospital "Conditions of Admission" Forms and Billing...

In the ever-evolving world of healthcare billing, two recent reported California appellate court decisions, Naranjo v. Doctors Medical Center of Modesto and Dameron Hospital Association v. Progressive Casualty Insurance...more

Arnall Golden Gregory LLP

Federal Court Permits MultiPlan Antitrust MDL to Proceed: Court Upholds Federal and State Antitrust and Consumer Protection...

On June 3, 2025, Judge Matthew F. Kennelly of the U.S. District Court for the Northern District of Illinois issued a sweeping ruling in In re MultiPlan Health Insurance Provider Litigation, largely denying motions to dismiss...more

Foley & Lardner LLP

Risk Bearing Entity Requirements: Massachusetts

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This blog discusses the regulatory requirements that apply to risk-bearing entities in Massachusetts, including recent updates introduced by Chapter 343 of the Massachusetts Acts of 2024 (the Act). This blog is part of Foley...more

Goodwin

Health Headlines: May 2025

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On May 14, 2025, Pennsylvania State Sen. Tim Kearney and State Rep. Lisa Borowski introduced legislation addressing private equity and corporate interests in healthcare. Pennsylvania Gov. Josh Shapiro is touting the companion...more

McDermott+

First Steps in Implementing the Trump Administration’s Price Transparency Agenda

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Recently, the Trump administration took steps toward implementing one of its major priorities: improving price transparency. As discussed in a previous Regs & Eggs blog post, President Trump signed an executive order (EO) on...more

Hogan Lovells

AI Summit panelists offer tips for obtaining reimbursement for innovative health care technology

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Hogan Lovells and the AI Health Care Coalition recently hosted their fourth annual AI Health Law & Policy Summit, where thought leaders and policymakers gathered to discuss a variety of topics including reimbursement issues...more

Lathrop GPM

Administration Issues Cross-Agency Guidance Targeting Health Care Pricing and Focusing on Hospitals and Health Plans

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On May 22, 2025, the U.S. Department of Health and Human Services, Department of Treasury and Department of Labor (the “Agencies”) announced new steps intended to “strengthen healthcare price transparency.” ...more

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

Bass, Berry & Sims PLC

Indiana Enacts Legislation Affecting Health Care Transactions and Imposing Ownership Reporting Requirements

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On May 6, 2025, Indiana Governor Mike Braun signed Indiana HB 1666 into law. This new law grants Indiana’s attorney general authority to investigate market concentration of health care entities, modifies existing requirements...more

Ankura

Quarterly Healthcare Transactions Review: Unveiling the Latest Industry Mergers and Acquisitions

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Ankura is pleased to present an overview of healthcare services transactions announced or closed during Q4 2024 in the United States. Total transactions decreased by 10.4 percent in the fourth quarter of 2024 after decreasing...more

Hogan Lovells

Indiana implements new ownership reporting requirements, authorizes health entity market concentration investigation - Proposal to...

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On May 6, 2025, Indiana state enacted HB 1666, which modifies Indiana’s existing transaction law to exempt certain practitioner-owned practices, grants the Attorney General additional authority to investigate health care...more

A&O Shearman

New German government: Key plans for the Life Sciences and Healthcare sector

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Following the election in February, the party leaderships of CDU, CSU and SPD have agreed on a coalition agreement titled “Responsibility for Germany”. The 146-page document also sets out aspects regarding the healthcare and...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

Mintz

[Podcast] Health Law Diagnosed – Health Care Transaction Review Laws and the New Normal

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In the latest episode of Health Law Diagnosed, host Bridgette Keller discusses the evolving legislative and regulatory landscape impacting health care transactions, particularly for private equities and hedge funds. She is...more

Bass, Berry & Sims PLC

Healthcare Trends & Transactions Q1 2025

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The healthcare mergers and acquisitions (M&A) market began 2025 with a slower start than expected given the easing headwinds and building momentum at the end of last year, with the number of deals reported in Q1 lower than...more

Jones Day

CMS Innovation Center Announces Cost-Saving Restructuring of Value-Based Payment Model Portfolio

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The Center for Medicare and Medicaid Services ("CMS") has announced significant changes to its value-based payment model portfolio projected to save $750 million as part of a shift in the agency's refocused strategy toward...more

Hanson Bridgett

Peer Review by Licentiates Only: Beware Health Care Service Plans!

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On February 19, 2025, the California Court of Appeal published a decision, Lin v. Board of Directors of PrimeCare Medical Network, Inc., 108 Cal.App.5th 1163, emphasizing California Business and Professions Code’s requirement...more

Bricker Graydon LLP

The Impact of Tariffs on Medical Equipment Manufacturing in Kentucky

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In our recent publication, “The Impact of Tariffs on the Insurance Industry,” we explored how the sweeping tariff policy announced by President Donald Trump is affecting various insurance sectors....more

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