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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

The sliding scale of health coverage: finding the intersection of cost, access and quality

  • Baker & Hostetler LLP
  • -
  • USA
  • -
  • August 8 2014

While not a new concept, the use of narrow networks has become a lightning rod for the controversy surrounding qualified health plans (QHPs) offered

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

Ohio "Healthcare Simplification" Bill passes House; seeks to simplify provider contracting, eliminate "predatory" contract provisions

  • Baker & Hostetler LLP
  • -
  • USA
  • -
  • November 15 2007

On October 9, 2007, the Ohio House of Representatives, by a vote of 95 to 5, passed House Bill 125 ("HB 125"), a "Healthcare Simplification Act" that legislators and the Ohio State Medical Association ("OSMA") claim will let providers focus on providing health care services and reduce time spent on administrative matters by setting standards for transparency in contracting with insurers, standardizing credentialing, and establishing web-based insurance-eligibility verification

National pattern for physician rankings set by New York Attorney General

  • Baker & Hostetler LLP
  • -
  • USA
  • -
  • November 29 2007

During the summer, New York Attorney General Cuomo threatened to obtain injunctions against a group of major health insurers which had implemented physician ranking programs to identify to their insureds physicians who met certain quality of care and efficiency criteria

Department of Labor issues new model COBRA notices

  • Baker & Hostetler LLP
  • -
  • USA
  • -
  • March 23 2009

On February 17, 2009, President Obama signed into law the American Recovery and Reinvestment Act of 2009 (the "Act"

Second policy options paper offers details for reforming everything including the kitchen sink

  • Baker & Hostetler LLP
  • -
  • USA
  • -
  • May 14 2009

On May 11, 2009, the second of three expected policy options papers on health system reform was released by the Senate Finance Committee

Insurer sues out-of-network hospitals for waiving patient's out-of-pocket expenses

  • Baker & Hostetler LLP
  • -
  • USA
  • -
  • June 11 2009

Horizon Blue Cross Blue Shield of New Jersey (Horizon) filed separate lawsuits against two out-of-network hospital providers, claiming that both providers were waiving the coinsurance, deductibles and other out-of-pocket expenses that patients were contractually required to pay for out-of-network providers