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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


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


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


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


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


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


Employer advisory
  • Baker & Hostetler LLP
  • USA
  • April 15 2010

PPACA radically changes the way health, accident and sickness insurance is to be bought, sold and provided in the U.S., principally by reorganizing the commercial health insurance marketplace, generally starting June 21, 2010, and ending December 31, 2013