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Results: 1-10 of 167

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


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


Darwinian Insurance
  • Baker & Hostetler LLP
  • USA
  • April 20 2017

This case demonstrates the need for providers to know and follow the notification provisions set forth in their insurance policies in order to avoid


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


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 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


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


Ohio "Healthcare Simplification" Bill passes House; seeks to simplify provider contracting, eliminate "predatory" contract provisions
  • Baker & Hostetler LLP
  • USA
  • November 15 2007

On October 9, 2007, the Ohio House of Representatives, by a vote of 95 to 5, passed House Bill 125 ("HB 125"), a "Healthcare Simplification Act" that legislators and the Ohio State Medical Association ("OSMA") claim will let providers focus on providing health care services and reduce time spent on administrative matters by setting standards for transparency in contracting with insurers, standardizing credentialing, and establishing web-based insurance-eligibility verification


FTC continues crackdown on unlawful collective fee negotiations
  • Baker & Hostetler LLP
  • USA
  • June 25 2009

The Federal Trade Commission's (FTC) aggressive enforcement of the antitrust laws regarding collective fee negotiations continued this month when the FTC sued a California independent practice association (IPA) for allegedly fixing the prices charged to healthcare insurers