On May 1, 2018, the U.S. Departments of Labor, Health & Human Services and the Treasury (Departments) clarified the Patient Protection and Affordable Care Act’s (ACA) “greatest-of-three” regulation (GOT regulation) in response to an entry of summary judgment against the ...
On June 4, 2018, the Supreme Court issued its opinion in Masterpiece Cakeshop, Ltd. v. Colorado Civil Rights Commission, Case No. 16-111.
On September 23, 2016, the California Legislature passed, and Governor Jerry Brown signed, Assembly Bill 72 (AB 72 or the Act), creating a new regime for the regulation of “surprise bills.”
In an increasing number of cases, courts have used Federal Rule of Civil Procedure 23(b)(2) to certify classes seeking injunctive and declaratory relief that includes, among other things, an injunction ordering the defendant to “reprocess” past claims for healthcare benefits.
The free exercise clause is found in the First Amendment of the Bill of Rights and provides that “Congress shall make no law respecting an establishment of religion or prohibiting the free exercise thereof.”
On April 9, 2018, the Centers for Medicare & Medicaid Services (CMS) issued a Health & Human Services (HHS) Notice of Benefit and Payment Parameters for 2019 (final rule).
Imagine representing a party in a lawsuit concerning coverage for mental health services. The lawsuit was brought by the parents of a minor child.
In United States ex rel. Petratos v. Genentech, Inc., 855 F.3d 481 (3d Cir. 2017), the Third Circuit affirmed the district court’s order dismissing an FCA complaint on the grounds that the relator could not establish materiality based on the guidance set forth in Escobar.
On November 1, 2017, the Centers for Medicare & Medicaid Services (CMS) issued the final rule with comment period revising the Medicare hospital outpatient prospective payment system (OPPS) and the Medicare ambulatory surgical center (ASC) payment system for 2018.
Health insurers may have experienced uncertainty in 2017 when they were setting 2018 rates for individual plans sold on federal and state exchanges pursuant to the Affordable Care Act (ACA).