Private Insurers

Rivkin Health Attorneys Write the Book on Federal AKS and Safe Harbors
July 10, 2020 | Rivkin Rounds Staff | Electronic Health Records | Employer/Employee | False Claims Act | Fraud and Abuse | Hospitals | Legislation and Public Policy | Litigation | Medical Devices and Wearables | Pharmaceuticals | Private Insurers
Eric Fader, Jeff Kaiser, Chris Kutner, Ada Kozicz and Ben Malerba are authors of the newly released book, “The Federal Anti-Kickback Statute and Safe Harbors: A Practical Guide.” Published by the American Bar Association, the book covers all safe harbors currently in place, as well as the interplay between the Anti-Kickback Statute (AKS) and other …
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Hospital Price Transparency Rule Upheld
June 24, 2020 | Eric D. Fader | Affordable Care Act | Hospitals | Legislation and Public Policy | Litigation | Private Insurers
On June 23, the U.S. District Court for the District of Columbia ruled against the American Hospital Association and other associations and individual hospitals that had sued the U.S. Department of Health and Human Services (HHS) to block a new price transparency rule that will take effect on January 1, 2021. The rule, which was finalized …
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Navajo National Collaboration Could Greatly Boost Molina’s Flagging Fortunes in New Mexico
June 2, 2020 | Rivkin Rounds Staff | Medicare and Medicaid | Private Insurers | Telehealth
A recent article in Health Payer Specialist, “Navajo National Collaboration Could Greatly Boost Molina’s Flagging Fortunes in New Mexico,” discussed how Molina Healthcare, through the Navajo Managed Care Organization (MCO), is working to better the healthcare of the Navajo Nation while bolstering its own bottom line. Rivkin Radler’s Chris Kutner was quoted in the article. …
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Assess Legal Risk, Payer Policies to Head Off Hidden Dangers of COVID-19 Reopening
May 21, 2020 | Rivkin Rounds Staff | Legislation and Public Policy | Litigation | Private Insurers
A May 18 article in Part B News, “Assess legal risk, payer policies to head off hidden dangers of COVID-19 reopening,” discussed how medical practices should take steps to protect themselves from legal and insurance issues. Rivkin Radler’s Robert Iseman was quoted in the article, which advises medical practices that are beginning to reopen on …
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Supreme Court Rules in Favor of Health Insurers Under ACA Program
April 29, 2020 | Mark J. Wagner Jr. | Affordable Care Act | Litigation | Private Insurers
On April 27, the U.S. Supreme Court ruled in favor of commercial health insurers that were seeking $12 billion under the Affordable Care Act’s risk corridor program, acknowledging that the ACA “obligated the government to pay the full amount of risk corridor payments.” The ACA established the risk corridor program to mitigate the risks assumed …
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COVID-19 Business Briefing: Telehealth
April 7, 2020 | Rivkin Rounds Staff | Behavioral Health | Cybersecurity | HIPAA | Home Health | Hospitals | Legislation and Public Policy | Private Insurers | Telehealth
On April 6, Rivkin Radler’s Eric Fader presented a COVID-19 Business Briefing on Telehealth. The Briefing covered recent developments in federal and state law and policy, and changes in private insurers’ policies, that have been aimed at encouraging the use of telehealth during the current public health emergency. This Business Briefing was the second in …
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CARES Act: Diagnostic Testing and Laboratory-Related Provisions
March 26, 2020 | Geoffrey R. Kaiser | FDA | Legislation and Public Policy | Medicare and Medicaid | Private Insurers
Several of the provisions in the Coronavirus Aid, Relief, and Economic Security Act (CARES Act) passed by the Senate on March 25 relate to laboratory diagnostic testing for the COVID-19 virus. Within Division A of the CARES Act, titled “Keeping Workers Paid and Employed, Health Care System Enhancements, and Economic Stabilization,” there are four sections …
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Rivkin Radler Launches Coronavirus Resource Center
March 24, 2020 | Rivkin Rounds Staff | HIPAA | Home Health | Hospitals | Legislation and Public Policy | Medicare and Medicaid | Private Insurers | Telehealth
Rivkin Radler has launched a Coronavirus Resource Center on the firm’s website. All of the firm’s COVID-19-related articles and blog posts, across our many practice groups, are now compiled in one place for easy reference. We’ll continue adding to the Resource Center as the pandemic continues. …
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NYS Takes Emergency Steps to Encourage Telehealth
March 19, 2020 | Eric D. Fader | Margarita Christoforou | Home Health | Legislation and Public Policy | Medicare and Medicaid | Private Insurers | Telehealth
On March 17, the New York State Department of Financial Services (DFS) announced the issuance of a new emergency regulation requiring insurance companies in the state to waive cost-sharing, including deductibles, copayments, and coinsurance, for in-network telehealth visits, whether or not related to coronavirus. The new regulation will “encourage New Yorkers to seek medical attention …
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CMS and ONC Release New Interoperability Rules
March 12, 2020 | Ada Kozicz | Electronic Health Records | HIPAA | Hospitals | Legislation and Public Policy | Medical Devices and Wearables | Medicare and Medicaid | Private Insurers | Telehealth
The Centers for Medicare & Medicaid Services (CMS) and Office of the National Coordinator for Health Information Technology (ONC) have finalized two highly anticipated rules that are intended to give patients “unprecedented safe, secure access to their health data.” ONC will establish a certification process for application programming interfaces (APIs) that will meet certain interoperability …
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