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Mintz - Health Care Viewpoints

CMS’s ACA Marketplace Integrity and Affordability Proposed Rule – What it may mean for Health Plans

Earlier this month, the Centers for Medicare & Medicaid Services (CMS) released its 2025 Marketplace Integrity and Affordability Proposed Rule (Proposed Rule), proposing a number of enrollment and eligibility policies...more

Rumberger | Kirk

Eleventh Circuit: Disagreement Over Valuation Is Not Per Se Bad Faith

Rumberger | Kirk on

A little more than one year after Progressive scored a bad faith win in Eres v. Progressive American Ins. Co., 998 F.3d 1273 (11th Cir. 2021), Progressive came away with another victory in Deary v. Progressive American Ins....more

Ward and Smith, P.A.

North Carolina Cases Involving Traumatic Brain Injuries

Ward and Smith, P.A. on

A traumatic brain injury ("TBI") results from a specific traumatic event causing some type of damage to the brain. Such trauma could be the head being struck by an object or being jolted by a collision, or even having an...more

Bradley Arant Boult Cummings LLP

Trigger for Hurricane and Named Storm Deductibles

Recent damage from Hurricanes Harvey, Irma, and Maria have focused attention on special “named storm” and “hurricane” deductible endorsements found in most property insurance policies issued for coastal areas. Such...more

BakerHostetler

Texas Surgical Centers: Aetna Improperly Denies or Underpays Out-of-Network Claims

BakerHostetler on

Aetna is now facing another set of claims calling into question its determination and payment methodology for out-of-network reimbursement. On September 4, 2015, six surgical centers in Texas (Allied Center for Special...more

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