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
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
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
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
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
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
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
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
On May 3, 2023, the Seventh Circuit Court of Appeals, in Astellas US Holding Inc. v. Federal Insurance Co., held that a liability insurer was required to contribute its limits toward its insured’s payment to settle potential...more
Medicaid providers and suppliers have likely discovered this the hard way. A provider’s or supplier’s enrollment in the Medicaid program may be insufficient to assure that their provision of a covered and medically necessary...more
On July 29, 2021, the American Academy of Ophthalmology (AAO) released a statement urging the Centers for Medicare & Medicaid Services (CMS) to prohibit Insurance companies from requiring ophthalmologists to use new...more
Building on our recent overview presentation “Six Lessons Patients and Providers Need to Know," we invite you to join us as we examine a single medical provider/patient encounter, in order to identify the concrete steps a...more
What will the post-pandemic world look like? What risks and challenges will it raise and how to navigate the new litigation landscape? These are the most relevant questions amid the pandemic. To respond to them and provide...more
The Centers for Medicare and Medicaid Services (CMS), recently announced that it plans to activate systematic validation edits for Outpatient Prospective Payment System (OPPS) providers with multiple service locations that...more
On June 11, the New York Court of Appeals, in Andrew Carothers, M.D., P.C. v. Progressive Insurance Company, 2019 NY Slip Op 04643, decided that an insurer may withhold payment for services provided by a medical services...more
Now is the time to double and triple check your Medicare Provider Enrollment, Chain, and Ownership System (PECOS) enrollment file to make sure all information for off-campus provider-based service locations is correct. ...more