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Results: 1-10 of 158

Insurer Actions Cut the Heart Out of Out-of-Network Providers
  • Baker & Hostetler LLP
  • USA
  • April 21 2016

Aetna Life Insurance Company recently won a $37 million verdict against a group of Northern California surgical centers, Bay Area Surgical Management


When a Published Data Breach is a Covered Data Breach
  • Baker & Hostetler LLP
  • USA
  • April 19 2016

Can an inadvertent Internet posting of a patient's medical information trigger insurance coverage for liability stemming from a data-breach class


The 2017 Exchange Regulations: Network Adequacy Challenges Remain
  • Baker & Hostetler LLP
  • USA
  • March 10 2016

The Centers for Medicare and Medicaid Services (CMS) recently issued the final 2017 Benefit and Payment Parameters Rule (Final Rule) and concurrently


OIG emphasizes proactive enforcement of privacy rule and monitoring of repeat offenders
  • Baker & Hostetler LLP
  • USA
  • November 11 2015

The Office of Inspector General's (OIG) recently released Privacy Standards report assessed the Office for Civil Rights' (OCR) oversight of covered


Texas surgical centers: Aetna improperly denies or underpays out-of-network claims
  • Baker & Hostetler LLP
  • USA
  • September 24 2015

Aetna is now facing another set of claims calling into question its determination and payment methodology for out-of-network reimbursement. On


340B guidance: eight key points covered entities should consider
  • Baker & Hostetler LLP
  • USA
  • September 10 2015

On August 27, 2015, the Health Resources and Services Administration (HRSA), an agency of the U.S. Department of Health and Human Services (HHS


Waivers of co-pays and deductibles: insurance benefit exclusions grow
  • Baker & Hostetler LLP
  • USA
  • August 13 2015

Recent changes to policy and plan language and increased litigation by third-party payers suggests that out-of-network providers who waive co-pays and


Providers get rare win in new Texas law protecting out-of-network referrals
  • Baker & Hostetler LLP
  • USA
  • July 2 2015

On June 1, 2015, Texas Governor Greg Abbott signed House Bill 574 into law protecting physicians and other providers from having their participating


Medicaid managed care Proposed Rules: the intersection of private insurance and government programs
  • Baker & Hostetler LLP
  • USA
  • June 8 2015

Approximately a quarter of all Medicaid expenditures is spent on the more than half of all beneficiaries (approximately 39 million by 2011 figures


Provider competition matterseven for “reference pricing”
  • Baker & Hostetler LLP
  • USA
  • October 9 2014

In a recent blog post, three Federal Trade Commission (FTC) economists splashed some cold water on advocates of “reference pricing” that seem to