Health Care / Medicine
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Health Care / Medicine
DC Circuit: Insurers Have To Report Medicare Advantage Overpayments To CMS
Overturning a district court's decision that had earlier vacated the Medicare Advantage Overpayment Rule, the DC Circuit opened a Pandora's Box of DOJ False Claims Act litigation last week. -
Health Care / Medicine
HHS Cites Real-World Data For COVID-19 Boosters; WHO Says The Science Is Still Out
In announcing plans to offer Covid-19 booster shots, the U.S. Department of Health and Human Services cited declining vaccine efficacy shown by real-world studies. But the World Health Organization said the science is less than clear about booster shots, adding that it’s ethically wrong to give third shots when so many around the world are waiting for their first one. - Sponsored
Is The Future Of Law Distributed? Lessons From The Tech Adoption Curve
The rise of remote work has dramatically reshaped the relationship between Lawyers and Law Firms, see how Scale LLP has taken the steps to get… -
Health Care / Medicine
Judge Blocks HHS From Requiring Religious Providers To Perform Gender-Transition, Abortion Procedures
The permanent injunction prevents HHS from interpreting a section of the ACA, which bans discrimination, to include gender identity and pregnancy status. This move prohibits the federal agency from penalizing religious providers for refusing to perform or provide insurance coverage for gender-transition surgeries and abortions.
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Health Care / Medicine
UnitedHealth Subsidiaries Settle Mental Health Parity Allegations For $15.6M
UnitedHealthcare and United Behavioral Health agreed to the settlement to resolve allegations that they illegally denied coverage for mental health and substance use disorder treatments. The allegations are related to business practices they no longer use, parent company UnitedHealth Group said. -
Health Care / Medicine
Lawsuit: Mission Health Purchase Enabled HCA To Create Monopoly In North Carolina
A class-action lawsuit, filed by six North Carolina residents, alleges that HCA Healthcare bought Mission Health to gain monopolistic control in the Western part of the state, enabling it to drive up prices while lowering the quality of care. -
Health Care / Medicine
What Will Happen With CMS’ Policy To Cover Breakthrough Medical Devices?
Two former officials with CMS and the FDA shared what considerations the agencies will be making as they review this policy. -
Health Care / Medicine
CMS Proposes Revoking ‘Most Favored Nation’ Drug Pricing Model
Following several legal battles and opposition from providers, CMS is proposing nixing the Most Favored Nation Model, which matches payments for Medicare Part B drugs to the lowest price paid by other wealthy countries. -
Health Care / Medicine
Teva’s Generic Label Not Skinny Enough To Protect From $234M Damages To GSK
When is a skinny label skinny enough to protect a generic drug from claims of patent infringement? The answer remains up to interpretation after an important, controversial decision from the Federal Circuit. - 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
Providers Will Likely Face More Lawsuits Against Vaccine Mandates. But They Are Also More Likely To Win.
Providers' legal defense against lawsuits aiming to tear down vaccine mandates is wide-ranging, from making the argument that allowing an unvaccinated worker into their facilities could pose a direct threat to the worker to invoking a 1905 precedent set by the Supreme Court. -
Health Care / Medicine
CMS Repeals MA Rate Disclosure Requirement, Boosts Hospital Payments By $2.3B
CMS has finalized its 2022 inpatient payment rule, which will not only repeal part of the price transparency requirements related to Medicare Advantage rates and increase payments to hospitals but will also require facilities to report COVID-19 vaccination uptake among its employees. -
Health Care / Medicine
Justice Department Joins False Claims Lawsuits Against Kaiser Permanente
The government has intervened in complaints alleging Kaiser Permanente entities defrauded Medicare out of ‘tens of millions of dollars’ by knowingly submitting false diagnoses for Medicare Advantage beneficiaries. Kaiser denies the allegations, saying it is in compliance with program requirements. -
Health Care / Medicine
Texas Law Eases Prior Auth Burdens, But Payers See It As A Dangerous Move
The law, which will take effect in September, prohibits payers from requiring pre-approval from certain providers. While providers believe the law will cut administrative burdens, and improve care delivery, payers say it could lead to patient harm. -
Health Care / Medicine, Sponsored Content
A Return To In-Person Healthcare Could Bring Novel Challenges
The challenges are not what you might expect.
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Generative AI In Legal Work — What’s Fact And What’s Fiction?
Zach Warren from the Thomson Reuters Institute discusses the potential and the pitfalls.
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Navigating Financial Success by Avoiding Common Pitfalls and Maximizing Firm Performance
In this CLE-eligible webinar, we’ll explore the most common accounting pitfalls and how to avoid them for your firm.
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Is The Future Of Law Distributed? Lessons From The Tech Adoption Curve
The rise of remote work has dramatically reshaped the relationship between Lawyers and Law Firms, see how Scale LLP has taken the steps to get…
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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…
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The Business Case For AI At Your Law Firm
ChatGPT ushers in the age of generative AI – even for law firms.
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Health Care / Medicine
BCBS Of Kansas City Sues COVID-19 Testing Provider Over Alleged Price Gouging
GS Labs, a COVID-19 testing provider, has submitted over $9.2 million in claims to the insurer as a result of its grossly inflated prices, the lawsuit states. The testing company rejected the claims, saying its 'prices accurately reflect the level of service' it provides. -
Health Care / Medicine
Only 5% Of Hospitals Are Compliant With Price Transparency Rule. Here’s How They Did It.
The hospitals that were found to be fully compliant with the federal price transparency rule had a few strategies in common, including picking the right technology partner and beginning their efforts early — in some cases before the rule was even proposed. -
Health Care / Medicine
With Eviction Moratorium Set To End, Millions Of People Are Still Behind On Rent
With the CDC’s eviction moratorium set to lift at the end of the month, many people are still struggling with rent payments and utility debt. Insurance and healthcare technology leaders shared how they’re preparing and what’s needed to address the housing shortage in the long term. -
Health Care / Medicine, Sponsored Content
Telehealth Eases Pressure On An Overtaxed System
The use of telehealth accelerates by 'at least a decade.' -
Government, Health Care / Medicine
Fight Over 'Pay For Delay' Heats Up In Washington
Legislators threaten to ban settlements where branded companies 'pay' generics makers to 'delay' market entry, while drugmakers say the current framework balances competition and innovation. Who will prevail? -
Health Care / Medicine
Cost-Cutting Generics And Biosimilars Stuck In Legal Limbo
Many believe that the biosimilar industry can address the issue of spiraling drug costs, but first it has to make it through a thicket of challenges. -
Health Care / Medicine
CMS Proposes Fining Hospitals Up To $2M Annually For Not Following Price Transparency Rule
CMS' latest proposed rule, which includes stringent penalties for hospitals that are found to be flouting the price transparency rule, comes on the heels of an analysis showing that a vast majority of hospitals are not in compliance with the regulation that went into effect on Jan. 1.