We use cookies to customise content for your subscription and for analytics.
If you continue to browse Lexology, we will assume that you are happy to receive all our cookies. For further information please read our Cookie Policy.

Search results

Order by: most recent most popular relevance



Results: 1-10 of 158

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


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


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


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


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


Bringing sunlight to healthcare pricing: the CMS release of hospital charge data
  • Baker & Hostetler LLP
  • USA
  • May 16 2013

Former U.S. Supreme Court Justice Louis D. Brandeis once said that "Sunlight is the best disinfectant." The release of charges billed by some 3,337


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


Late push to reauthorize CHIP funding this session
  • Baker & Hostetler LLP
  • USA
  • September 19 2014

Approximately eight million children currently covered by the Children's Health Insurance Program (CHIP) may lose access to their pediatric-specific


Hobby Lobby: likely first of many cases pitting religion against ACA
  • Baker & Hostetler LLP
  • USA
  • July 10 2014

The U.S. Supreme Court on June 30, 2014, ruled 5-4 that a closely held, for-profit corporation can qualify for an exemption from the U.S. Department