The Duty to Cooperate Under a Liability Policy
Best Practices for Negotiating Manuscript Exclusions
AGG Talks: Healthcare Insights - Episode 1: A Primer for Providers When Insurance Companies Refuse to Pay
Hinshaw Releases Second Edition of Duty to Defend: A Fifty-State Survey
Hinshaw Insurance Law TV – Transaction Insurance Solutions
The Standard Formula Podcast | Understanding Insurance Resolution Regimes
Policyholders vs. Insurers: 3 Arguments to Make When Selecting Defense Counsel & Hourly Rates
Cracking the Code: Getting the Most Out of Your Cyber Insurance Policy
Insurers Take Note: New Changes to Florida Law Mean Changes in Claims Handling & Roof Repairs in the Sunshine State
An Uncompromising Insurer: What is a Policyholder to Do?
Five Tips to Improve Your Insurance Coverage Claim
Is Captive Insurance Right for Your Business? A Deep Dive with AkinovA
A Deeper Dive Into Insurance Topics for Nonprofits: Special Events Coverage and Considerations When Making Claims
Nonprofit Basics: Insurance Coverage for the New Nonprofit
Loading and Unloading Under GL and Auto Policies: 2022
Sending Up the Mediation Smoke Signal: Tools that Policyholders Have Available to Settle A Claim With A Recalcitrant Insurer
The Calm Before the Storm: Planning for Catastrophic Weather Events
Insurance Renewals: Know When to Hold ‘ Em, Know When to Walk Away
Do R&W Insurers Still Pay Claims? Following Up on Lowenstein’s 2020 Survey
Hinshaw Insurance Law TV: Recent Changes in Florida Property Insurance Law and How They Will Affect First Party Insurance
Health care providers who have treated or provided services, equipment, or supplies to patients insured by Blue Cross Blue Shield (BCBS) between July 24, 2008 and October 4, 2024 may be entitled to compensation under a $2.67...more
The Center for Medicare and Medicaid Innovation (CMMI) recently announced a six-year payment model for 2026-2031 called the Wasteful and Inappropriate Service Reduction (WISeR) Model. WISeR will test the use of artificial...more
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
There has been a flurry of recent activity in a case originally filed by six air ambulance companies claiming $20 million in unpaid emergency services invoices. ...more
Pioneer Construction Company, Inc., Eastern Alliance Insurance Company, and employers Alliance, Inc. v. Insight Pharmaceuticals, LLC d/b/a Insight Pharmacy; No. 867 C.D. 2022; filed May 12, 2025; Judge Covey - A workers’...more
On June 12, the U.S. Court of Appeals for the Fifth Circuit issued a significant opinion in the case involving Guardian Flight, LLC and Med-Trans Corporation, two air ambulance providers, against the defendant insurance...more
On May 27, Blue Cross Blue Shield Healthcare Plan of Georgia, Inc. (BCBSGA) filed a lawsuit in the Northern District of Georgia US District Court, alleging that a group of health care providers, along with their third-party...more
Cash-based practices, or providers who neither participate with nor bill insurers, are becoming increasingly common, especially in certain specialties such as primary care, women’s health, and mental health. While providers...more
As the regulation of artificial intelligence (AI) tools in healthcare settings rapidly evolves, state medical boards and related agencies are at the forefront of development and enforcement. While some states have taken...more
In her 2025 State of the State, Gov. Kathy Hochul outlined several proposals aimed at improving access to medical care within the New York State Workers’ Compensation system. These initiatives, detailed in her “Fighting for...more
The Office of Massachusetts Attorney General (AG) Andrea Campbell announced the criminal indictment of several Massachusetts-based health care providers and their owners in connection with allegedly false claims they...more
Join the industry’s top litigators and leading plan counsel at ACI’s 16th Annual Advanced Forum on Managed Care Disputes and Litigation, for two days of discussions designed to address emerging areas of concern for MCOs in...more
In what is already a highly regulated industry, it is becoming increasingly difficult for healthcare organizations to navigate the growing volume, complexity and enforcement of laws, regulations and guidance that surround...more
The United States District Court for the Eastern District of Pennsylvania, applying Pennsylvania law, has held that a letter notifying the insured of the sender’s intent to file a joinder complaint, i.e., a third-party claim,...more
The US District Court for the Eastern District of New York in Manalapan Surgery Ctr., et al. v. 1199 SEIU National Benefit Fund, No. 23-CV-03525 (EDNY March 12, 2025), recently granted a motion to dismiss a complaint filed by...more
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
Ortiz v. Winn-Dixie, Inc., No. 1D2021-0885, Fla. 1st DCA 2024, DCA#: 1D2021-0885, Decision date: Dec. 23, 2024 - The First District Court of Appeal issued another opinion in the ongoing statute of limitations saga triggered...more
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
Cyberattacks and technology disruptions in healthcare don’t just cost organizations financially — they can threaten patient safety and put organizational reputations at risk. How ready is your organization for a potential...more
On September 27, California Governor Gavin Newsom signed into law two bills that will impact health care service plans and insurers in the state....more
No health insurance benefit program, no matter how high profile, is immune to the temptations of insurance fraud. In the past, multiple former NFL players pleaded guilty to defrauding the NFL Player Health Reimbursement...more
The Audit Process - While Medicaid audits are meant to ensure integrity and efficiency of the Medicaid Program, they can often be incredibly cumbersome and challenging for medical providers to navigate. During an audit,...more
The owner of Bergen Alliance Counseling Services in Paramus, New Jersey pleaded guilty to a run-of-the-mill healthcare fraud scheme in District Court in Newark on March 19. Maria Cosentino of Garfield, a licensed clinical...more
Is Medicare Advantage really a Disadvantage for seniors and taxpayers? Our nation is graying rapidly. Every day, 10,000 baby boomers, members of one of the largest generations in U.S. history, hit the traditional...more
With the surge of interest in artificial intelligence (AI), it should be no surprise that health insurers have come under scrutiny concerning their use of AI predictive tools to deny medical insurance claims. The question...more