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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

Foley & Lardner LLP

California Agency Cracks Down on High-Cost Hospitals

Foley & Lardner LLP on

California’s Office of Health Care Affordability (OHCA) is moving beyond broader policy-setting and into direct intervention at the provider level — a shift all hospitals and health systems across the state should take...more

Polsinelli

HCPF Makes Clarifications to Mandatory Facility-Based Professionals’ Reporting Requirements Under Colorado Hospital Discounted...

Polsinelli on

What is Colorado Hospital Discounted Care? Colorado’s Hospital Discounted Care law, effective September 1, 2022, brought a detailed and comprehensive yet highly confounding overhaul to the way hospitals, freestanding...more

Foley & Lardner LLP

Beneficiary Assignment Under the MSSP Final Rule

Foley & Lardner LLP on

This is the fourth post in Health Care Law Today’s series on the final rule. This post addresses how CMS assigns beneficiaries to an ACO participating in the MSSP. In the MSSP ACO Final Rule, CMS finalized new...more

Troutman Pepper

Tax Developments Affecting Health Care Organizations and Investor-Owned Hospital Companies

Troutman Pepper on

Several Treasury regulations, revenue procedures, and other developments have recently been released, which may have important consequences for businesses, including health care organizations. Moreover, changes in regulatory...more

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