News & Analysis as of

Reimbursements Health Care Providers Insurance Industry

Kerr Russell

The Difference Between ‘Non-Covered’ vs. ‘Disallowed’ Services

Kerr Russell on

Question: I have had several colleagues describe their experience with dental plan audits. All of them have had to pay something back. Sometimes they say this is due to a service being deemed a “noncovered service.” Other...more

Tyson & Mendes LLP

Shining Light on Phantom Medical Bills–Lessons from Washington on Using Federal Hospital Price Transparency Rules to Fight Back

Tyson & Mendes LLP on

How many of you reading this have had this experience: you get a settlement demand with hundreds of thousands of dollars in claimed hospital bills, but the actual amount owed by the claimant is redacted, or you are told by...more

McDermott Will & Schulte

Trending in Telehealth: September 17 – 30, 2024

McDermott Will & Schulte on

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

Rivkin Radler LLP

High-Profile Sports Insurance Fraud Rings: A Recent Conviction

Rivkin Radler LLP on

No health insurance benefit program, no matter how high profile, is immune to the temptations of insurance fraud. In the past, multiple former NFL players pleaded guilty to defrauding the NFL Player Health Reimbursement...more

Foley & Lardner LLP

Artificial Intelligence in Health Care: Key Considerations for Oncology

Foley & Lardner LLP on

Artificial intelligence (AI) has the power to revolutionize health care. In oncology, there are now opportunities to apply AI to support diagnostics, predictive analytics, and administrative functions. This hot topic was...more

ArentFox Schiff

No More Surprise Medical Bills: Fifth Circuit Affirms Vacatur of Arbitration Provisions of Surprise Billing Rules (TMA II)

ArentFox Schiff on

On August 2, health care providers scored yet another significant victory when the US Court of Appeals for the Fifth Circuit affirmed the vacatur of various federal regulations regarding the arbitration procedures used to...more

Marshall Dennehey

2007 Medicare Part B Non-Facility Limiting Charge is Not a Fee Schedule, and Insurers Are Permitted to Use Rates Established by...

Marshall Dennehey on

Progressive Express Ins. Co. v. SimonMed Imaging a/a/o Hilleri Brown, 6th District, Case No. 6d23-1145. L.T. Case No. 2020-SC-043217-O, (48 Fla. L. Weekly D990a) - This suit involved a dispute regarding application of the...more

Fox Rothschild LLP

THE ABC’S OF THE S.I.U.: What Providers Need To Know

Fox Rothschild LLP on

Medical record requests by payors are commonplace for health care providers. Typically, these requests are received by a front desk employee who responds to the inquiry in short order. Yet, not all requests should be treated...more

McDermott Will & Schulte

New Laws Expand Telehealth in California

California Governor Gavin Newsom recently signed into law two bills that expand the delivery of telehealth services in the state. In particular, the legislation: • Permits providers to prescribe medications without a...more

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