The Internal Revenue Service (IRS) has moved aggressively to ensure that tax-exempt hospitals are complying with financial assistance, billing and collection requirements under the Affordable Care Act (ACA).
Recently, California Governor Jerry Brown signed into law “surprise medical bill legislation,” seeking to curb out-of-network medical bills. This law, designated AB 72, amends California’s Health and Safety Code to limit the ability of out-of-network physicians who provide ...
California's "End of Life Option Act" (the Act) went into effect this June—making California the fifth state (behind Oregon, Washington, Vermont and Montana) to allow terminally ill adults with fewer than six months to live to receive drugs that will allow them to end their life.
In Brandt v. Superior Court, the California Supreme Court held that when a plaintiff proves that an insurance company withheld policy benefits in bad faith, attorneys' fees reasonably incurred to compel payment of the benefits are recoverable as an element of damages.
Justice Antonin Scalia's death apparently impacted only one of the four major healthcare cases pending before the United States Supreme Court this term.
On June 6, 2016, the Supreme Court issued a unanimous decision in the Medicaid case of Universal Health Services, Inc. v. United States ex rel. Escobar, adopting a form of the "implied certification" theory of knowingly fraudulent representations under the False Claims Act (FCA).
It is not every day that the words “innovative” and “nimble” are used when referring to an agency of the federal government bureaucracy. Yet, after studying the playbook of sophisticated corporations, the Health Care Fraud Prevention and Enforcement Action Team (HEAT), run ...
On March 1, 2016, the United States Supreme Court, in Gobeille v. Liberty Mutual Insurance Company, No. 14-181, reaffirmed the broad preemptive effect of the Employee Retirement Income Security Act of 1974, 29 U.S.C. §§ 1001, et seq. (ERISA).
If a healthcare plan and provider agree to arbitrate disputes under a provider contract, can the provider compel arbitration against third-party payers that access those same contract rates?
Reducing an employee's hours simply to avoid the requirements set by the Affordable Care Act (ACA) may constitute a violation of the Employee Retirement Income Security Act (ERISA), a New York federal court judge has ruled, refusing to dismiss a class action suit against Dave & Buster's.