The U.S. Supreme Court continues to build its legacy of jettisoning well-established principles and practices.

Over the years, Medicare Advantage (MA) managed care plan violations have made national headlines for lack of transparency in reporting, access to care issues, and questionable financial practices.

Enrollment in HealthCare Sharing Ministry (“HCSM”) plans has been on the rise, with one report finding that more than 1.7 million Americans use HCSMs as their primary health coverage.

Understanding the quality of the claims early can save clients money, aid in determining how much to accept as settlement, and avoid unwanted surprises at the eleventh hour.

Congress enacted the bipartisan No Surprises Act (“NSA”) to end surprise medical bills for emergency services.

The Centers for Medicare & Medicaid Services (CMS) issued a proposed rule outlining a one-time lump sum payment of $9 billion dollars to be given to approximately 1,649 participating 340B hospitals.

On April 5, 2023, the Centers for Medicare and Medicaid Services (“CMS”) issued a final rule for Medicare Advantage (“MA”) Plans, confirming that MA Plans must follow the 2-Midnight Rule, its case-by-case exception, the inpatient-only (“IPO”) list, as well as traditional Medicare coverage criteria.

When Congress enacted the Families First Coronavirus Response Act as a response to the COVID-19 Public Health Emergency Declaration (“COVID PHE”), it provided for a significant increase in federal funding for Medicaid and Children’s Health Insurance Programs on the condition that such programs provide for automatic reenrollment throughout the Public Health Emergency period and for one month after.

Network adequacy regulations ensure that health insurance plans (the “Plans”) have enough in-network healthcare providers and facilities so that members enrolled in the Plan (“enrollees”) can access healthcare in a timely manner.

The Federal Trade Commission (FTC) proposed a rule to ban noncompete clauses from employment contracts.