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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


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


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


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


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


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
  • USA
  • 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


Changing financial landscape for medical debts of the uninsured
  • Baker & Hostetler LLP
  • USA
  • June 12 2014

The implementation of the ACA has afforded many with the opportunity to obtain insurance coverage. Despite the opportunity, a large number of


Medicaid DSH: little-noticed CMS rule interpretation creates serious financial shortfalls for impacted hospitals
  • Baker & Hostetler LLP
  • USA
  • December 12 2013

In what may have been a largely unnoticed rule interpretation affecting hospitals that treat a high percentage of children in the Medicaid program


Clash of the circuits: federal exchange subsidies at risk?
  • Baker & Hostetler LLP
  • USA
  • July 24 2014

These four words "established by the state," at first blush do not appear obtuse or particularly vague. But these four words form the basis for the


HHS settles HIPAA violations related to a breach for $1.5m
  • Baker & Hostetler LLP
  • USA
  • March 15 2012

BlueCross BlueShield of Tennessee was the victim of a theft in 2009 when an intruder stole 57 hard drives which contained protected health information of more than 1 million customers