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Alston & Bird

New Maryland Law Regulates Use of AI in Health Care Utilization Management Reviews

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Our Health Care Group discusses what businesses need to know about a new law in Maryland that creates new requirements for health plans’ use of artificial intelligence in making coverage and treatment decisions....more

Foley & Lardner LLP

Risk Bearing Entity Requirements: Massachusetts

Foley & Lardner LLP on

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

Epiq

How Plaintiff and Defense Attorneys Can Protect Beneficiaries’ Finances and Health Care in MMSEA Section 111 Reporting

Epiq on

Insufficient collaboration between plaintiff and defense attorneys regarding Medicare, Medicaid, and SCHIP Extension Act (MMSEA) Section 111 reporting requirements creates administrative complications which can negatively...more

ArentFox Schiff

Massachusetts Enacts Drug Pricing Legislation: Introducing PBM Licensure, Mandatory Cost Reporting, and Consumer Cost-Sharing...

ArentFox Schiff on

On January 8, Massachusetts Governor Maura Healy signed into law “An Act Relative To Pharmaceutical Access, Costs And Transparency.” The Act will have a profound impact on all parties involved in setting and applying drug...more

McDermott Will & Schulte

How PPM Health Plans Can Solve the MEWA Problem

McDermott Will & Schulte on

While a physician practice management (PPM) structure allows for compliance with corporate practice of medicine laws and ease of administration, it often creates inadvertent health plan issues that should be navigated...more

McDermott Will & Schulte

New York Executive Budget Proposes Amendments to MCO Provider Tax

McDermott Will & Schulte on

The New York State Executive Budget for Fiscal Year (FY) 2026 proposes significant updates to the managed care organization (MCO) provider tax, aiming to enhance Medicaid funding through innovative financial strategies. The...more

ArentFox Schiff

Senior Living Industry: Review of Owner’s Loan Documents Through Management Company Lens

ArentFox Schiff on

Although a senior living property manager is not the party on the hook for the loan, it is important that they review and negotiate certain provisions in the owner’s loan documents that affect their rights and obligations in...more

Akerman LLP - HR Defense

Preparing for the Approaching ACA Reporting Deadlines

Akerman LLP - HR Defense on

With ACA reporting deadlines quickly approaching, many employers should be preparing to address the various reporting requirements in order to avoid the significant fines and penalties associated with non-compliance. As of...more

Franczek P.C.

Employee Benefits Alert - August 2015

Franczek P.C. on

Retirement Plans - IRS Issues Guidance on Benefit Suspension Voting under MPRA - As we have written in prior alerts, the Multiemployer Pension Reform Act of 2014 (MPRA) permits trustees of financially troubled...more

Ballard Spahr LLP

IRS Issues New Forms for ACA Reporting; Congress Increases Penalties for Failure to Meet Requirements

Ballard Spahr LLP on

The IRS has completed drafts of the 2015 forms and instructions for employers, insurers, and other health plan sponsors to use to meet their reporting obligations for the employer and individual mandates under the Affordable...more

Eversheds Sutherland (US) LLP

Legal Alert: IRS Proposes Rules on Health Insurer Fee

Eversheds Sutherland (US) LLP on

The Internal Revenue Service (IRS) has released proposed regulations on the health insurer fee under section 9010 of the Patient Protection and Affordable Care Act (PPACA). The regulations, which were published in the Federal...more

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