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66 results found

Article

Seyfarth Shaw LLP | USA | 7 Jul 2011

Amendments to claims & appeals regulation

This is the twenty-first issue in our series of alerts for employers on selected topics in health care reform.

Article

Reed Smith LLP | USA | 28 Jun 2011

Obama administration issues amendment to ACA insurance appeals rules

On June 24, 2011, the Department of Health and Human Services (HHS), the Internal Revenue Service, and the Employee Benefits Security Administration published an amendment to their July 23, 2010 interim final rule on internal claims and appeals and external review processes for group health plans and health insurance coverage in the group and individual markets under the Affordable Care Act (ACA).

Article

Bricker & Eckler LLP | USA | 20 Jun 2011

What's new for the week of June 20, 2011

Amendments to the July 23, 2010 interim final regulations implementing the requirements regarding internal claims and appeals and external review processes for group health plans and health insurance coverage in the group and individual markets; the rules are intended to respond to feedback from a wide range of stakeholders on the interim final regulations and to assist plans and issuers in coming into full compliance with the law through the implementation process.

Article

King & Spalding LLP | USA | 13 Jun 2011

CMS issues final rule banning Medicaid payment for preventable illnesses and injuries

On June 6, 2011, the Centers for Medicare and Medicaid Services (CMS) published a final rule implementing Section 2702 of the Patient Protection and Affordable Care Act (PPACA) that requires the Department of Health and Human Services to adopt Medicaid payment adjustments for health care-acquired conditions.

Article

Faegre Baker Daniels LLP | USA | 8 Jun 2011

HHS issues proposed HIPAA rule for accounting of disclosures

New proposed rules under HIPAA provide guidance on accounting of disclosures by covered entities and business associates that is, telling patients and health plan participants when their health information is given out and to whom.

Article

Reinhart Boerner Van Deuren SC | USA | 20 May 2011

FAQ about Affordable Care Act implementation Part IV

The Department of Health and Human Services (HHS), the DOL, and the Department of the Treasury (the Departments) continue to release additional guidance regarding the implementation of the market reform provisions of the Patient Protection and Affordable Care Act (PPACA) in the form of new questions and answers to help people understand the new law.

Article

Baker & Hostetler LLP | USA | 14 Apr 2011

U.S. Supreme Court to review Medicaid physician pay cuts

The U.S. Supreme Court has granted the state of California's petition for writ of certiorari in three cases where the Ninth Circuit Court of Appeals granted injunctions prohibiting the state from implementing pay cuts to the Medi-Cal program.

Article

Foley & Lardner LLP | USA | 4 Apr 2011

House sends Medicaid reform legislation to the Senate largely unchanged, while Senate continues debate in committee

On Wednesday and Thursday, the House passed H.B. 7107 and H.B. 7109, bills which transition the delivery system for Florida's Medicaid program to statewide managed care.

Article

King & Spalding LLP | USA | 21 Mar 2011

HHS proposes to allow state data mining for Medicaid fraud

On March 17, 2011, the OIG published a proposed rule that would allow State Medicaid Fraud Control Units (MFCUs) to use federal matching funds to identify fraud through screening and analyzing State Medicaid claims data, a technique known as data mining.

Article

Locke Lord LLP | USA | 22 Feb 2011

House appropriations efforts

Given that the Fiscal Year (FY) 2011 appropriations process was not completed before the adjournment of the 111th Congress in December 2010, the federal government has been operating under a Continuing Resolution (CR) that is funded at FY 2010 spending levels.