Health Care Counsel Blog
816 total results. Page 3 of 33.
Caroline Turner English, Alison Lima Andersen, Jack R. Bierig, Pascal Naples
Last week, the US Court of Appeals for the Ninth Circuit, in its third opinion in the case, reversed a lower court’s decision allowing patients challenging United Behavioral Health’s (UBH) internal mental health coverage guidelines to seek reprocessing of their benefits claims.
Debra Albin-Riley, Fernanda Sanchez Jara
California health care employers that apply mandatory vaccination policies objectively can take great comfort in a recent California Court of Appeal decision.
Caroline Turner English, Pascal Naples
On July 25, 2023, the US Departments of Labor (DOL), Treasury (USDT), and Health and Human Services (HHS) (the Departments) released a much-anticipated interim final rule to ensure that group health plans comply with the Mental Health Parity and Addiction Equity Act (MHPAEA).
Douglas A. Grimm, Gayland O. Hethcoat II
In Advisory Opinion No. 23-04, the US Department of Health and Human Services (HHS) Office of Inspector General (OIG) analyzed certain proposed changes to the functionality of a health care technology company’s online provider marketplace.
Thomas E. Jeffry, Jr., Gayland O. Hethcoat II
A final rule published on July 3, 2023, empowers the US Department of Health and Human Services (HHS) Office of Inspector General (OIG) to impose civil monetary penalties (CMP) of up to $1 million for unlawful acts of information blocking.
Stephanie Trunk
It is the annual summer pastime for the pharmaceutical community. Time to review the Centers for Medicare & Medicaid Services (CMS) release of the 2024 proposed Hospital Outpatient Prospective Payment System (HOPPS) and Physician Fee Schedule (PFS) rules.
D. Jacques Smith, Randall A. Brater, Michael F. Dearington, Nadia Patel, Mattie Bowden, Heather M. Zimmer
Headlines that Matter for Companies and Executives in Regulated Industries
Anne M. Murphy, Jill A. Steinberg, Gayland O. Hethcoat II
In this installment of our post-Dobbs risk assessment series for hospitals and academic medical centers, we consider the ongoing impact of Dobbs v. Jackson Women’s Health Organization on delivery of clinical services beyond abortion.
Dan Jasnow, Jo-Ann Marchica, Mindy Pittell Hurwitz, Stephen Blake
For better or worse, generative artificial intelligence (AI) is already transforming the way we live and work. Within two months of its initial release to the public, ChatGPT reached 100 million monthly active users, making it at the time the fastest-growing consumer application in history.
D. Jacques Smith, Randall A. Brater, Nadia Patel, Mattie Bowden, Michael F. Dearington
Headlines that Matter for Companies and Executives in Regulated Industries
Douglas A. Grimm
No personal services are more important than health care. The use of artificial intelligence (AI), involving machines to perform tasks normally requiring human intelligence, is leading to an expansion of the term “personal.”
Gayland O. Hethcoat II, Mariam Al-Koshnaw Creedon
As more states adopt consumer data privacy laws, Nevada and Washington stand out for their recent passage of legislation aimed specifically at protecting “consumer health data.”
Cissy Jackson, Daniel Sjostedt*
In November of 2022, we predicted a fertile post-election congressional landscape for Pharmacy Benefit Manager (PBM) practice reform.
D. Jacques Smith, Randall A. Brater
On June 16, 2023, in United States, ex rel. Polansky v. Executive Health Resources, Inc., the US Supreme Court addressed the government’s authority to dismiss a qui tam False Claims Act (FCA) suit over a relator’s objection when the government initially declines to intervene in the litigation.
Annie Chang Lee, Gayland O. Hethcoat II, M.H. Joshua Chiu
The recently passed Consolidated Appropriations Act (CAA) of 2023 includes a new Stark Law exception and Anti-Kickback Statute (AKS) safe harbor, allowing hospitals and other health care entities to offer their physicians programs to improve mental health and resiliency.
Douglas A. Grimm, Gayland O. Hethcoat II
Telehealth experienced massive growth during the COVID-19 pandemic, due in no small part to various regulatory and reimbursement policies that federal agencies implemented.
D. Jacques Smith, Randall A. Brater, Michael F. Dearington, Nadia Patel, Laura Zell
Headlines that Matter for Companies and Executives in Regulated Industries
Caroline Turner English, David S. Greenberg, Alison Lima Andersen
In the year following the implementation of the arbitration process established under the federal No Surprises Act (NSA), more than 330,000 disputes have been submitted for resolution.
Anne M. Murphy, Stephen Blake
Throughout 2021 and 2022, states have been seeking to include or have successfully included medical respite to Medicaid 1115 waivers. These experimental Medicaid-reimbursed programs are reviewed and approved by the Secretary of Health and Human Services to promote the objectives of Medicaid.
Publicizing home health agency and hospice agency ownership information furthers President Biden’s goal to promote competition and make data more transparent for consumers, as noted in his July 2021 Executive Order.
Anne M. Murphy, Stephen Blake
An outcome of the COVID-19 pandemic has been the attractiveness of innovative care alternatives, for patients and providers alike.
D. Jacques Smith, Randall A. Brater, Nadia Patel, Michael F. Dearington, Apeksha Vora
Headlines that Matter for Companies and Executives in Regulated Industries
Gayland O. Hethcoat II
On February 17, 2023, the US Department of Health and Human Services Office for Civil Rights (OCR) released two companion reports to Congress detailing its actions in 2021 to enforce the privacy, security, and breach notification requirements under HIPAA.
Anne M. Murphy, Mark A. Angelov, Mike Guippone
Over 2500 hospitals across the country historically have relied upon Disproportionate Share Hospital (DSH) Medicaid payments for financial stability.
Jill A. Steinberg, Anne M. Murphy, Gayland O. Hethcoat II
In the landmark case of Dobbs v. Jackson Women’s Health Organization, the US Supreme Court overturned its prior rulings in Roe v. Wade and Planned Parenthood of Southeastern Pennsylvania v. Casey, which had recognized a constitutional right to abortion protected from government interference.