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Bringing sunlight to healthcare pricing: the CMS release of hospital charge data

Baker & Hostetler LLP
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USA
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May 16 2013

Former U.S. Supreme Court Justice Louis D. Brandeis once said that "Sunlight is the best disinfectant." The release of charges billed by some 3,337

New Affordable Care Act fess impact group health plans in 2013 and 2014

Baker & Hostetler LLP
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USA
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April 15 2013

On July 31, 2013, the first of various fees will be due that are imposed by the Affordable Care Act on self-insured group health plans andor issuers

Do not pass go, do not collect $200: Michigan statute and regulatory order banning MFN provisions in provider contracts ends government antitrust lawsuit against Michigan Blue

Baker & Hostetler LLP
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USA
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March 26 2013

In the wake of the passage of a Michigan statute and regulatory order banning the use of most favored nation ("MFN") clauses by insurers, health

Medicaid: issues continue to arise following the Supreme Court decision

Baker & Hostetler LLP
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USA
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October 12 2012

In the wake of June's Supreme Court opinion on the Patient Protection and Affordable Care Act (PPACA), government officials at the federal and state level and budget analysts have been thinking about implementation and analyzing the impact of the curve ball thrown by Chief Justice John Roberts and the majority of the Court as to implementation of Medicaid expansion

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

Baker & Hostetler LLP
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USA
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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

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

Baker & Hostetler LLP
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USA
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August 15 2012

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

DOJ and HHS announce anti-fraud partnership with private insurers

Baker & Hostetler LLP
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USA
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August 2 2012

Last week, the U.S. Department of Justice (DOJ) and U.S. Department of Health and Human Services (HHS) announced that they will partner with private insurers to share information and best practices to deter fraudulent billings that implicate both government and private insurance programs, such as Medicare Advantage Plans that are subsidized by Medicare and administered by private insurers

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

Baker & Hostetler LLP
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USA
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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

DOL issues mental health parity guidance

Baker & Hostetler LLP
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USA
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June 7 2012

On May 18, 2012, the U.S. Department of Labor (DOL) issued a set of 14 Frequently Asked Questions (FAQs) regarding the Mental Health Parity and Addiction Equity Act of 2008 (MHPAEA) and the related regulations of the DOL, Department of Health and Human Services, and the Department of the Treasury (collectively "the Departments"

IRS seeks guidance in developing PPACA regulations that directly impact employers

Baker & Hostetler LLP
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USA
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May 10 2012

On April 26, 2012, the Internal Revenue Service (IRS) issued three notices requesting comments relating to forthcoming regulations implementing PPACA's employer mandate, individual mandate and individual tax credit provisions

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