The No Surprises Act: A Cost Saving Opportunity for Employer Plan Sponsors
Video: Getting Ready for the No Surprises Act - Thought Leaders in Health Law
Welcome to the strange and mysterious world of medical billing. If ever there was an industry in which the charges and the payments have no correlation, the medical industry is it. Medical billing can indeed be quite...more
Nonparticipating providers have often struggled to recover fair reimbursement from vertically integrated, well-resourced Medicare Advantage Organizations (“MAOs”) through out-of-network litigation. The pattern is...more
An appeal brought before the Texas Supreme Court could unleash a wave of legal action by out-of-network ER physicians pursuing insurers for underpayment of claims. Unlike in-network providers who negotiate reimbursement...more
In a blow to out-of-network providers pursuing underpayments from Medicare Advantage plans, the U.S Court of Appeals for the Ninth Circuit Court of Appeals recently held in Global Rescue Jets, LLC v. Kaiser Foundation Health...more
In December 2020, Congress passed the “No Surprises Act” (NSA) as part of the Consolidated Appropriations Act of 2021. The NSA applies most commonly in situations where a patient receives out-of-network medical services from...more
Please join us as Rivkin Radler Partner Eric D. Fader provides an overview of changes in the provision of telehealth services and federal and state regulation of them, since the beginning of the COVID-19 pandemic. New rules...more
In the closing days of 2020, Congress passed federal legislation aimed at protecting patients against surprise medical bills and facilitating payment dispute resolutions among providers and insurers. Slated to take effect on...more
In Mitchell v. Blue Cross Blue Shield of N.D., 2020 U.S. App. LEXIS 8818 (8th Cir. Mar. 20, 2020), the Eighth Circuit upheld the payment of 150% of Medicare rates for an out-of-network air ambulance flight, although the...more
Over the last few weeks, President Trump and lawmakers in both the House and Senate have taken several steps to protect patients from surprise medical bills, the latest signs of bipartisan momentum to address the issue this...more
The New Jersey Department of Banking and Insurance (DOBI) has issued an 18-page Bulletin on implementation of the Out-of-Network Consumer Protection, Transparency, Cost Containment and Accountability Act by health care...more
We expect 2018 to be another year of rapid change within the health care industry. In this episode, Mary Beth Johnston highlights some of the key topics that the health care practice group will monitor in the coming year,...more
As 2017 drew to a close, some health plans and healthcare providers across the country were still busy trying to finalize contracts for in-network services for 2018 and beyond. A number of negotiations made the headlines in...more
On September 23, 2016, Governor Brown signed AB 72, California’s surprise out-of-network law. The bill protects patients who seek care at an in-network facility from balance billing by individual health care providers who are...more