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Essential health benefits continue to be clarified by state insurance departments

USA - March 3 2014 On February 27, 2014, the D.C. Department of Insurance, Securities, and Banking (DISB) released a bulletin reminding insurers that medically necessary…

CMS adds to the growing guidance on third party premium payments

USA - February 19 2014 On February 7, 2014, the Centers for Medicare and Medicaid Services (CMS) issued a memorandum that adds to the growing library of federal guidance on…

Ohio Senate Bill 140 proposes sweeping changes to Ohio insurance laws

USA - August 6 2013 Introduced on June 4, 2013, Ohio S.B. 140 proposes to make some of the most significant changes to Ohio's insurance laws since perhaps the Ohio…

“This is managed care” – a reminder that federal law actually encourages patient steerage

USA - June 25 2013 "[T]his is managed care," observed the U.S. District Court for the Northern District of California in its June 3rd order granting Sutter Health's…

In case you were wondering, CMS takes compliance seriously: lessons from a Medicare Part D plan sponsor’s contract termination for all Medicare contractors and providers

USA - May 29 2013 The Centers for Medicare and Medicaid Services ("CMS") has historically used its authority to immediately terminate Part D plan sponsors only…