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Common control or overlapping ownership can change how to identify the "employer" for PPACA purposes

  • Baker & Hostetler LLP
  • -
  • USA
  • -
  • August 15 2012

This is the third in a series of Executive Alerts in the Special Health Care Reform Series

Ohio's ‘Healthcare Simplification Act' imposes new restrictions on provider contracting and credentialing

  • Baker & Hostetler LLP
  • -
  • USA
  • -
  • March 28 2008

Ohio House Bill 125the ‘Healthcare Simplification Act'was unanimously approved by the Senate on March 11, 2008, and signed into law by Ohio Governor Ted Strickland on March 25, 2008

IRS announces delay in nondiscrimination rules for insured medical plans

  • Baker & Hostetler LLP
  • -
  • USA
  • -
  • January 7 2011

On December 22, 2010, the Internal Revenue Service released IRS Notice 2011-1 (to be published in the Internal Revenue Bulletin on January 10, 2011) delaying the implementation of new nondiscrimination rules for fully insured medical plans

Medicaid DSH calculation -- insurance won't cover the patient's claim; no worries -- relief may be on the way!

  • Baker & Hostetler LLP
  • -
  • USA
  • -
  • January 19 2012

CMS recently issued a proposed rule clarifying what constitutes uncompensated care for purposes of the Medicaid disproportionate share hospital (DSH) payment limit

Group health plan and insurance coverage: final guidance issued on summary of benefits and coverage

  • Baker & Hostetler LLP
  • -
  • USA
  • -
  • February 16 2012

The U.S. Departments of the Treasury, Labor (DOL) and HHS (collectively, the "Departments") recently released final regulations governing the summary of benefits and coverage and the uniform glossary for group health plans and health insurance coverage

Preventive care mandate update: burden shifts from religious organizations to insurers; unanswered questions remain

  • Baker & Hostetler LLP
  • -
  • USA
  • -
  • February 16 2012

On February 10, 2012, President Obama announced a policy change intended to address the concerns of many religiously affiliated organizations over the preventive care mandate that requires nongrandfathered group health plans to provide FDAapproved contraceptive and sterilization procedures to women with no cost sharing

California providers turn the tables in out-of-network dispute with Aetna

  • Baker & Hostetler LLP
  • -
  • USA
  • -
  • July 19 2012

The California Medical Association is headlining a suit with several other medical societies and provider plaintiffs that sued Aetna in California state court on July 3, alleging that Aetna is retaliating against patients, physicians and out-of-network facilities alike for using out-of-network benefits

OIG sees through a radiology provider's plan and allows preauthorization services

  • Baker & Hostetler LLP
  • -
  • USA
  • -
  • August 30 2012

The U.S. Office of Inspector General (OIG) issued Advisory Opinion 12-10 on August 23, 2012, finding that a radiology group's proposal to offer free insurance preauthorization services to physicians and patients would be permissible

OIG oks insurance preauthorization processing services

  • Baker & Hostetler LLP
  • -
  • USA
  • -
  • October 2 2008

On September 19, 2008, the Office of Inspector General (OIG) issued Advisory Opinion No. 08-12 regarding a legal entity -- "Newco" -- to be formed by the Requestor to provide administrative insurance preauthorization processing and submission services for radiology and imaging centers

Group not protected by an insurer's bad faith settlement under a physician's malpractice policy

  • Baker & Hostetler LLP
  • -
  • USA
  • -
  • December 11 2008

In a recent case, the Seventh Circuit held that a medical group could not pursue a claim against an insurer for refusing to settle a malpractice claim against one of the group's physicians, within the physician's malpractice policy limits, where the group was not an insured under the policy