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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


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


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


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


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


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


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


Second policy options paper offers details for reforming everything including the kitchen sink
  • Baker & Hostetler LLP
  • USA
  • May 14 2009

On May 11, 2009, the second of three expected policy options papers on health system reform was released by the Senate Finance Committee


New federal oversight structure for insurance market reforms
  • Baker & Hostetler LLP
  • USA
  • April 29 2010

As the first of what may be multiple new offices created to oversee implementation of health reform, the U.S. Department of Health and Human Services (HHS) recently established the Office of Consumer Information and Insurance Oversight (OCIIO) within HHS "to provide leadership for implementing the provisions of the health reform bill that address private insurance."


Insurer sues out-of-network hospitals for waiving patient's out-of-pocket expenses
  • Baker & Hostetler LLP
  • USA
  • 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