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Results: 1-10 of 158

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


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


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


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


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


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


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


Is it a violation to help?
  • Baker & Hostetler LLP
  • USA
  • May 30 2014

In a May 21, 2014, letter to the President of the American Hospital Association (AHA), U.S. Department of Health and Human Services (HHS) Secretary