On December 30, 2024, the Massachusetts Legislature passed House No. 4653, “An Act Enhancing the Health Care Market Review Process.” This bill includes sweeping changes focused on increased regulatory oversight and healthcare...more
The Press has announced that the Merger Agreement between UPMC and Washington Health System was approved by the Pennsylvania Attorney General with certain conditions, one of which was that UPMC would honor existing employment...more
In the 118th Congress, the US House of Representatives is keenly interested in healthcare price transparency. Three House committees—Energy and Commerce, Ways and Means, and Education and the Workforce—each approved...more
Question: A health plan that I participate with has sent me a notice stating that it has audited some of the claims I have submitted over the past three years. The health plan believes that some of these claims were improper...more
This legislative session, Florida has joined Arkansas and Oklahoma among the most regulatory-minded states with respect to pharmacy benefit plans and programs as well as pharmacy benefit managers (PBMs). Florida's...more
The IRS just released IRS Notice 2022-04 that provides the updated fee for Patient-Centered Outcomes Research Institute (PCORI) paid by fully insured and self-funded health plans for the upcoming tax reporting period...more
On October 8th, 2021, the Governor of California, Gavin Newsom, signed into law Senate Bill No. 510, which requires health care service plan contracts and disability insurance policies that provide coverage for hospital,...more
Since the passage of the Affordable Care Act (the “ACA”) in 2010, Texas has deferred to the federal government with respect to certain aspects of health plan rate review. That’s about to change. On October 19, 2021, the...more
On October 13th our friends over at STAT broke the news [sorry, Paywall] about a “warranty” pilot program from Pfizer that offers both patients and health plans (including Medicare Part D plans) the opportunity to receive a...more
Oklahoma child support is regulated by state statutes, enforced by courts and agencies, and often affects employer programs and payrolls. Child support includes parental payment as well as benefits provision. Employer health...more
Last week, Texas Governor Greg Abbott and the Texas Department of Insurance (TDI) instituted measures to expand the use of telemedicine in response to the COVID-19. A significant part of the federal government’s response to...more
Yesterday, Texas Governor Greg Abbott and the Texas Department of Insurance (TDI) asked Texas-regulated health plans to waive all costs associated with testing and telemedicine visits for the diagnosis of COVID-19. TDI...more
A patient sued her health plan and the plan’s debt collector under various California and federal laws in connection with alleged attempts by the plan to unlawfully collect the balances of the plaintiff’s medical statements...more
The Affordable Care Act (ACA) removed pre-existing condition barriers, defined a broad range of essential health benefits, and improved access to coverage and care for millions of people nationwide. However, the ACA has thus...more
The budget stand-off continued this week. Legislators rolled out a number of mini-budgets this week, but their futures are uncertain. The General Assembly will take a break next week for the Labor Day holiday, so it will...more
Proposed State Health Plan Adjustments - A. PA2019-002, Vitality Senior Living Management, LLC, d/b/a Traditions of Athens, LLC: Proposes to add 32 specialty care assisted living facility beds pursuant to Section...more
The state budget impasse enters its seventh week today, with no visible progress. Some reports claim communication is almost non-existent between the two sides. While the budget remains in gridlock with Medicaid expansion...more
I. Certificate of Need Program - A. AL2019-004, Fresenius Kidney Care Gadsden Acq, LLC, Gadsden, AL: Proposes to expand the existing ESRD facility by adding two (2) home dialysis training stations, for a total of...more
On April 18, 2019, Arizona Governor Doug Ducey signed a new law expanding insurance coverage for telehealth services, including asynchronous telemedicine and remote patient monitoring. The Arizona Legislature passed, nearly...more
Dozens of bills were filed this week as the Senate faced its bill introduction deadline. The House announced that it will publish a budget plan within the next two weeks....more
This week, the General Assembly took action in moving forward substantial proposals dealing with health care, immigration, and school testing. The Governor announced a personnel policy change intended, in part, to reduce...more
This week saw hundreds of new bills filed as the Senate reached its bill filling deadline. In total, 672 bills have been filed in the Senate. The House has filed 626 bills, but has until April 23rd to continue introducing new...more
Activity at the General Assembly continued to accelerate this week as joint appropriations committees held their final meetings and prepared to break-off into their separate, chamber-specific committees....more
New legislation continued to be filed this week with the Senate’s bill filing deadline approaching on Tuesday, April 2nd. The House has a few weeks longer, with their bill filing deadline on Tuesday, April 23rd. Once both...more
The legislature picked up pace this week, with committees meeting regularly and bills moving to the floor for votes. This week, Governor Cooper signed his first bill of the year, Senate Bill 75, which repealed a law that...more