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Next steps for SCHIP? Medicare reform?

Baker & Hostetler LLP
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USA
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October 25 2007

Last week, the U.S. House of Representatives failed to override the President's veto of legislation to reauthorize the State Children's Health Insurance Program (“SCHIP”) H.R. 976 for another five years

OIG oks insurance preauthorization processing services

Baker & Hostetler LLP
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USA
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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

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

Baker & Hostetler LLP
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USA
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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

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

Baker & Hostetler LLP
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USA
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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

Healthcare coverage in a post-reform world

Baker & Hostetler LLP
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USA
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June 11 2009

The Senate Health, Education, Labor and Pensions (HELP) Committee has released a 615-page working "draft of a draft" of its legislative proposal for expanding access and coverage entitled the "American Health Choices Act" along with a 34-page narrative detailing various legislative options for consideration by the Committee

National pattern for physician rankings set by New York Attorney General

Baker & Hostetler LLP
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USA
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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

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

Baker & Hostetler LLP
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USA
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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

FTC continues crackdown on unlawful collective fee negotiations

Baker & Hostetler LLP
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USA
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June 25 2009

The Federal Trade Commission's (FTC) aggressive enforcement of the antitrust laws regarding collective fee negotiations continued this month when the FTC sued a California independent practice association (IPA) for allegedly fixing the prices charged to healthcare insurers

Finance Committee plan drops public option; provides wiggle room for employer mandate

Baker & Hostetler LLP
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USA
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June 25 2009

Bullet-point presentations currently circulating among members of the Senate Finance Committee offer a snapshot of the options and alternatives being considered for the Committee's reform bill which is slated for markup in mid-July, although this timing may shift

Genetic Non-discrimination Act - GINA's three wishes

Baker & Hostetler LLP
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USA
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December 10 2009

Title II of the Genetic Information Non-discrimination Act of 2008 (GINA) took effect on November 21, 2009, even though the Equal Employment Opportunity Commission (EEOC) has not yet published final regulations

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