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Physicians Insurance Industry

Maynard Nexsen

Taking the Pulse, A Health Care and Life Sciences Video Podcast | Episode 244: The Future of Independent Physician Practices with...

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On episode 244, Lynnsey and Matthew are joined by Ray Waldrup, Co-Founder and CEO of The Leaders Rheum, a national network of leading rheumatology practices. Drawing on 3 decades of experience in healthcare leadership, Ray...more

McDermott+

Digesting a giant reg: the CY 2026 Medicare Physician Fee Schedule proposed rule

McDermott+ on

Earlier this week, the Centers for Medicare & Medicaid Services (CMS) issued the calendar year (CY) 2026 Medicare Physician Fee Schedule (PFS) proposed reg. Stakeholders have highly anticipated the release of this reg, as it...more

Davis Wright Tremaine LLP

Navigating Aetna's Expanded Claim Edits: What Providers Need To Know and Do Before September 1, 2025

Aetna recently announced that effective September 1, 2025, its Claim and Code Review Program (CCRP) will expand to include additional claim coding edits for all commercial, Medicare, and Student Health claims. While the...more

Arnall Golden Gregory LLP

Federal Court Permits MultiPlan Antitrust MDL to Proceed: Court Upholds Federal and State Antitrust and Consumer Protection...

On June 3, 2025, Judge Matthew F. Kennelly of the U.S. District Court for the Northern District of Illinois issued a sweeping ruling in In re MultiPlan Health Insurance Provider Litigation, largely denying motions to dismiss...more

Arnall Golden Gregory LLP

Healthcare Authority Newsletter - June 2025 #2

News Briefs - Appeals Court Set to Rehear No Surprises Case - An appeals court is set to rehear a case from providers trying to restrict what factors insurers consider in calculating a key metric that arbiters use to...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

Fox Rothschild LLP

Florida’s Medical Malpractice Reform: Navigating the Shifting Landscape for Providers

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Florida’s healthcare providers and their insurers are on the verge of a significant adjustment to the state’s medical malpractice landscape. For over three decades, a controversial provision within Florida’s medical...more

McDermott Will & Schulte

Trending in Telehealth March 2025

Trending in Telehealth highlights monthly state legislative and regulatory developments that impact the healthcare providers, telehealth and digital health companies, pharmacists, and technology companies that deliver and...more

Weber Gallagher Simpson Stapleton Fires &...

PA Supreme Court Approves OTC Supplements & CBD Oil for Workers’ Compensation

In a unanimous opinion issued today, the Pennsylvania Supreme Court has ruled that any item that is part of a health care provider’s treatment plan falls within the purview of medical services and the broad-encompassing...more

McDermott Will & Schulte

How PPM Health Plans Can Solve the MEWA Problem

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

ArentFox Schiff

California Claps Back on Insurer Use of AI to Deny Needed Medical Care Decisions

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California is leading the way in ensuring that determinations of medically necessary health care services are made by licensed physicians and not artificial intelligence (AI) algorithms....more

Ward and Smith, P.A.

Lessons Learned: Wisdom from Professional Licensing Attorneys

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Having been in the company of literally thousands of physicians, dentists, psychologists, nurses, and just about every other kind of health professional as they undergo investigations, reviews, and prosecutions of their...more

DLA Piper

California Implements New AI and Software Regulations for Insurers

DLA Piper on

On September 28, 2024, California enacted SB 1120, which regulates the use of artificial intelligence (AI), an algorithm, or “other software tool” in utilization review and utilization management (UR/UM) functions by...more

Marshall Dennehey

Pharmacy Staffed by Pharmacist Provided by an Employee Leasing Agency is a Provider as Defined by Section 109 of the Act. When a...

Marshall Dennehey on

700 Pharmacy v. Bureau of Workers’ Compensation Fee Review Hearing Office & SWIF; No. 660 C.D. 2020; No. 617 C.D. 2020; filed May 16, 2024; President Judge Cohn-Jubelirer - In this case, 700 Pharmacy filed five Fee Review...more

Womble Bond Dickinson

California Supreme Court Expands Ability of Public Interest and Non-Profit Trade Groups to Sue for Alleged Unfair Business...

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Can an organization sue you simply because it chose to divert resources to respond to your allegedly unfair business practices by claiming your practices are a perceived threat to its mission? The California Supreme Court...more

McDermott Will & Schulte

Top Takeaways | Specialty Spotlight: Women’s Health and Fertility

In this session, Brian Hall, a partner in McDermott’s Healthcare practice group, moderated a panel to discuss the opportunities for growth and investment in the women’s health and fertility space....more

McDermott Will & Schulte

Top Takeaways | Employer Market Perspective

In this session, McDermott Will & Emery Partner Patrick Healy moderated a panel that examined the expansion of value-based care in the employer market. We summarize the panel’s insights on how stakeholders can successfully...more

Kennedys

New trends in fragment billing: Non-facility companies billing for facility-bundled services

Kennedys on

When one receives surgery, it is common to receive a separate invoice from the physician and the facility. The physician bills for performing the surgery, and the facility bills for providing the products and services...more

Kerr Russell

Understanding Your Professional Liability Insurance Policy

Kerr Russell on

Professional liability insurance is important to physicians for various reasons. Its primary purpose is to fund the costs to defend claims alleging professional negligence and to fund the payment of any loss determined by...more

McDermott Will & Schulte

Top Takeaways - Cybersecurity & Insurance Coverage in the Age of Telehealth: Understanding and Mitigating Your Risk

With more frequent and more severe ransomware attacks against health care platforms and vendors and the increasing use of telemedicine, it is critical to understand how to proactively defend your organization using robust...more

Cozen O'Connor

Recent Bad Faith Cases Regarding Reasonableness of Medical Treatment

Cozen O'Connor on

In two recent cases, the courts showed substantial deference to patients’ treating physicians in determining the reasonableness of medical treatment. This deference appears to reflect a reluctance of courts to decide what...more

McDermott Will & Schulte

[Webinar] Cybersecurity & Insurance Coverage in the Age of Telehealth: Understanding and Mitigating Your Risk - April 8th, 12:00...

Amid the demands of the COVID-19 pandemic, telemedicine became a vital resource for physicians and patients alike. Even with a potential “new normal” on the horizon, telemedicine is here to stay. But with the expansion of...more

Roetzel & Andress

Malpractice Insurance: What Providers Need to Know

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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

White and Williams LLP

Congress Bans Surprise Medical Bills

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On December 21, 2020, as part of the nearly 5,600-page coronavirus economic relief package, a measure entitled the “No Surprises Act” was included to ban surprise medical bills. Once the “No Surprises Act” goes into effect...more

McDermott Will & Schulte

[Webinar] Around The Corner: Digital Health at Scale: The Payor's Perspective - July 29th, 12:00 pm - 1:15 pm EDT

The COVID-19 pandemic has catalyzed efforts by health insurers to expand reimbursement for telehealth services and digital health tools, and develop and invest in their own digital health tools. Health insurers, who...more

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