Healthcare organizations are prime targets for class action lawsuits.
The “failing firm” defense as a justification for permitting a merger that may otherwise lessen competition gets considerable play in healthcare transactions.
The False Claims Act (FCA) is silent about whether statistical sampling may be used to prove a violation of the Act and, since the case law is varied, there are no clear rules about when or how statistical sampling evidence may be introduced.
There are a few different steps that organizations can and should be taking to prepare for a possible audit. The first is that there should be an internal gap analysis conducted of the organization's HIPAA compliance program. The analysis should include comparing the organization's existing ...
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?
Since implementation of the ACA, more consumers are shopping for health insurance through the individual commercial market. Many of these consumers are obtaining insurance for the first time and must navigate a complex coverage market and make important decisions for themselves and for their ...
Regulators in many states are requiring greater standardization of reporting and transparency of data concerning provider networks and access to care. The increased standardization and transparency means more meaningful plan-to-plan comparisons, including between Affordable Care Act (ACA) and ...