Health Care / Medicine
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Health Care / Medicine
CMS Proposed Rule Aims To Boost ACA Enrollment, Reinstate Navigator Duties
A new CMS proposed rule aims to make significant changes to Affordable Care Act marketplaces, including increasing the annual open enrollment period by a month and restoring the duties of navigators who help consumers from underserved populations enroll in plans on the federally facilitated exchange. -
Health Care / Medicine
CMS Nixes Medicaid Work Requirements In Arizona, Indiana
After scrapping work requirements for Medicaid eligibility in four states, CMS has added Arizona and Indiana to the list. These requirements have long been controversial, facing litigation and strong opposition, but proponents say they incentivize people to find jobs. - Sponsored
Legal AI: 3 Steps Law Firms Should Take Now
If 2023 introduced legal professionals to generative AI, then 2024 will be when law firms start adapting to utilize it. Things are moving fast, so… -
Health Care / Medicine
Scripps Health Hit By 4 Class-Action Lawsuits On Heels Of Ransomware Attack
Patients are filing lawsuits against the health system alleging it failed to adequately protect their data and exposed them to several risks, including identify theft.
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Courts, Health Care / Medicine
SCOTUS Limits Patent Judges’ Power But Preserves PTAB Review
The justices ruled that the authority of the judges of the Patent Trial and Appeal Board is unconstitutional, but by giving the USPTO director greater oversight, the highest court likely saved this favored tool of generic patent challengers. -
Health Care / Medicine
Supreme Court Upholds ACA, Dismissing Constitutional Challenge
Industry stakeholders celebrated the Court's long-awaited decision. -
Health Care / Medicine
Providers Win Deadline Extension For Use Of CARES Funds, But It May Cause Some Confusion
The HHS has extended some of the deadlines for using provider relief funds and reporting on that use. Though the move is mostly positive for providers — who were clamoring for this extension — there may be some additional work required to prevent confusion. -
Health Care / Medicine
CMS Ups Medicare Payment For At-Home Vaccinations To About $75 Per Dose
CMS is increasing the payment for administering at-home COVID-19 vaccinations from around $40 to $75 per dose. The move comes amid the Biden administration's push to boost vaccinations nationwide, including among older adults who may not be able to access vaccine sites. -
Health Care / Medicine
Emergency Physicians Oppose New UnitedHealth Policy Enabling Retroactive ED Claims Denial
UnitedHealthcare is instituting a new policy beginning July 1 that changes how the payer assesses emergency department claims, allowing it to retroactively deny ones it deems "non-emergent" or not an emergency. The American College of Emergency Physicians has made its opposition clear, stating the policy may violate federal law. - Sponsored
Early Adopters Of Legal AI Gaining Competitive Edge In Marketplace
How to best leverage generative AI as an early adopter with ethical use. -
Health Care / Medicine
Coverage Parity For Mental Health, Substance Abuse, A Key Focus For Insurance Regulators
Health insurers are prohibited from placing unfavorable limits on mental health and substance abuse benefits, and yet, many do. Federal and state regulators are taking aim at these practices and making the enforcement of the Mental Health Parity and Addiction Equity Act of 2008 a key focus. -
Health Care / Medicine
What Does A Former Seema Verma Advisor Think Of Brooks-LaSure, The Incoming CMS Administrator?
To know how Chiquita Brooks-LaSure will lead the Centers for Medicare and Medicaid Services, we sat down with Matthew Hittle, a former senior adviser to Seema Verma, who led the agency under the former president. -
Health Care / Medicine
100+ Workers Sue Houston Methodist Over Mandatory COVID-19 Vaccination Policy
The lawsuit alleges that the policy is akin to forcing employees to participate in a medical experiment as none of the vaccines available have received full FDA approval. But Houston Methodist rebutted these claims saying the vaccines are safe and effective, and requiring employees to get vaccinated is in the best interest of the patient. -
Health Care / Medicine
FDA Faces Big Questions As It Takes A Closer Look At AI Regulations
An action plan shared by the FDA earlier this year showed how the regulator is thinking about future regulations for AI and machine learning in healthcare. But the agency still has several big questions to address as it prepares to roll out new guidance. -
Health Care / Medicine
Saving Private Practice? Navigating The Legal And Ethical Minefield Of Physician-Private Equity Deals
While physicians face incredible pressures to consolidate or receive investment to survive, there are ethical, legal, and practical considerations doctors must seriously consider before deciding to take private equity.
Sponsored
Sponsored
Legal AI: 3 Steps Law Firms Should Take Now
If 2023 introduced legal professionals to generative AI, then 2024 will be when law firms start adapting to utilize it. Things are moving fast, so…
Sponsored
How Generative AI Will Improve Legal Service Delivery
Learn how emerging tools will likely change and enhance the work of lawyers for years to come in this new report.
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Lexis Create provides simple access to internal and external knowledge — directly within Microsoft Word.
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Profit Powerhouse: Elevating Law Firm Financial Performance
In this CLE-eligible webinar on April 10th, we’ll explore the most common accounting pitfalls and how to avoid them for your firm.
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Early Adopters Of Legal AI Gaining Competitive Edge In Marketplace
How to best leverage generative AI as an early adopter with ethical use.
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Health Care / Medicine
7 Insurers Sue CVS For Allegedly Inflating Drug Prices
For the second time in the span of one year, a group of insurers has filed a lawsuit against CVS alleging it overcharged them for generic drugs. CVS refuted the claims, calling them 'baseless.' -
Health Care / Medicine
CMS’ Next Generation ACO Model To End This Year
In a move that ACOs found 'disappointing,' CMS has declined to extend the Next Generation ACO Model beyond 2021. Though evaluations have found that the model did not generate net savings for Medicare, proponents argue that the program was successful. -
Health Care / Medicine
Expanding Health Equity Through COVID-Driven State Medicaid Legislation
COVID has pushed state health agencies to use Medicaid in ways that would never have been imagined before. With one in five Americans saying they are unable to afford healthcare, how are state governments using this historic moment to expand equitable access to care? -
Health Care / Medicine
Texas Lawsuit: Biden Administration Threatening Funding To Force Medicaid Expansion
Filed by the Texas attorney general, a new lawsuit seeks to prevent the Biden administration from revoking the Trump-era approval of a Medicaid waiver extension that could cost the state billions in funds. The revocation was a political move intended to force the state to expand Medicaid under the ACA, the lawsuit claims. -
Health Care / Medicine
32 Hospitals In Non-Medicaid Expansion States Sue HHS Over Payments For Low-Income Patients
The hospitals are pushing HHS to recognize patients eligible for Medicaid under the ACA as 'low-income' when calculating Medicare disproportionate share hospital payments in states that did not expand Medicaid. The agency's refusal to do so resulted in the hospitals receiving lower reimbursements for three years, the lawsuit claims. -
Health Care / Medicine, In-House Counsel
In-House Q&A: Bryan Huffman Of Prime Therapeutics
The pharmacy benefits company's Senior Legal Counsel discusses how his efforts in public service ultimately allowed him to meet a career goal with an in-house position. -
Health Care / Medicine
Hospitals Caught In Crossfire Of Battle Between Rhode Island AG, PE-Owned Operator
Amid a heated battle over an ownership change, Prospect Medical Holdings has threatened to close two of its hospitals in Rhode Island in response to conditions the state's attorney general proposed. The hospital chain's private equity owner is looking to sell its majority stake but requires state approval to move forward.