News & Analysis as of

Physicians Insurance Claims Health Care Providers

ArentFox Schiff

Dispute Not Resolved: BCBSGA Sues Providers for Alleged Misuse of NSA Arbitration Process

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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

Dentons

Ep. 59 – Treating Medicare Beneficiaries as a Cash-Based Practice

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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

Troutman Pepper Locke

Massachusetts AG Indicts Health Care Providers and Owners for Submission of Allegedly False Medicaid Claims

Troutman Pepper Locke on

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

J.S. Held

Inside the Healthcare Industry: The Critical Role of Medical Coding, Billing & Nurse Review

J.S. Held on

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

Patrick Malone & Associates P.C. | DC Injury...

Better Health Care Newsletter - March 2024

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

Goodwin

American Academy of Ophthalmology Pushes Back Against Bevacizumab Biosimilar Use in Treating Ophthalmic Conditions

Goodwin on

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

Zuckerman Spaeder LLP

[Webinar] A Step-by-Step Strategy for Maximizing Insurance Coverage Under ERISA - July 22nd, 2:00 pm - 3:00 pm ET

Zuckerman Spaeder LLP on

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

Roetzel & Andress

Malpractice Insurance: What Providers Need to Know

Roetzel & Andress on

Roetzel health law attorneys and HealthLaw HotSpot co-hosts Ericka Adler and David Hochman are joined this week by Mike Madey, the vice president of business insurance at The Horton Group, in a discussion of malpractice...more

American Conference Institute (ACI)

[Webinar] Navigating New Risks and Litigation Challenges Facing Payors in the COVID-19 Context and Beyond - May 13th, 12:00 pm -...

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

K&L Gates LLP

K&L Gates Triage: Activation of Validation Edits for OPPS Providers with Multiple Service Locations

K&L Gates LLP on

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

Farrell Fritz, P.C.

New York Court of Appeals Rules that an Insurer May Withhold Payments to a Medical Service Corporation Improperly Controlled by...

Farrell Fritz, P.C. on

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

Michigan Auto Law

No-Fault: How do doctors get paid by insurance companies?

Michigan Auto Law on

For years, doctors’ and hospitals’ medical bills have been slashed by No-Fault insurers using the insurers’ own de facto medical-provider fee schedules - How do doctors get paid by insurance companies under Michigan...more

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