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Results: 1-10 of 154

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


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


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


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


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


Professional liability insurance - sexual assault loophole
  • Baker & Hostetler LLP
  • USA
  • September 29 2011

Radiology Associates filed suit against its insurers to compel the insurers to defend Radiology Associates against claims stemming from an employee's alleged sexual assault of a patient while performing an unauthorized examination at their facility


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


In “zombie” class action, Seventh Circuit requires plaintiffs to present evidence to prove home-state exception to CAFA jurisdiction
  • Baker & Hostetler LLP
  • USA
  • August 22 2014

On Tuesday, the Seventh Circuit decided Myrick v. Wellpoint, Inc., Nos. 12-3882, 13-2230, 2014 WL 4073065 (Aug. 19, 2014), which highlights the


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


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