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NJ Adopts Individual Mandate
On May 30, New Jersey Governor Phil Murphy signed into law the Health Insurance Market Preservation Act, making New Jersey the second state to adopt an individual health insurance mandate. Massachusetts' mandate has been in effect since 2006.
United States
5 Jun 2018
New Medicare Cards Could Spell Trouble For Doctors, Seniors
A March 30 article in Health Care on Bloomberg Law, "New Medicare Cards Could Spell Trouble for Doctors, Seniors," discussed whether new Medicare identification cards that do not contain Social Security numbers will deter fraud or end up encouraging scammers and hindering physician billing
United States
11 Apr 2018
Is The Federal Insurance Exchange Secure?
A September 20 article in Bloomberg BNA's Health Care Daily Report and other publications, entitled "Is the Federal Insurance Exchange Secure?,"...
United States
27 Sep 2017
Two Hospitals Say They Are Being Downgraded to Tier 2 of Horizon's OMNIA Plans
Day Pitney's Michael Furey was quoted in a Politico article about two hospitals that will be downgraded to second-tier status by New Jersey's largest insurer, Horizon Blue Cross Blue Shield of New Jersey, in its value-based health plan called OMNIA.
United States
13 Sep 2017
CareCore National Settles Whistleblower Suit for $54 Million
CareCore National LLC, a healthcare utilization management company, agreed earlier this month to pay $54 million to settle allegations that it allowed its insurance company customers to inappropriately bill the Medicare and Medicaid programs.
United States
23 May 2017
New Florida Law Puts End To "Surprise Bills"
On April 14, Florida became the latest state to protect consumers from "surprise" medical bills when Gov. Rick Scott signed into law HB 221, preventing balance billing by out-of-network healthcare providers...
United States
11 May 2016
The Valley Hospital, Holy Name Medical Center Win Right To See Report On Tiered Insurance Plan
Day Pitney's Michael Furey was quoted in an article, "The Valley Hospital, Holy Name Medical Center win right to see report on tiered insurance plan," in The Record.
United States
30 Mar 2016
New HIPAA Settlement: The Other Shoe Drops On PR Insurer
Nearly two years after being hit with an unprecedented $6.8 million fine (later reduced to $1.5 million), a Puerto Rico insurer has agreed to a new $3.5 million settlement with the Office for Civil Rights ..
United States
2 Dec 2015
Proposed NJ Bill Would Eliminate "Surprise Bills"
A new proposed bill in New Jersey would require healthcare providers to disclose to patients in advance whether their services are covered in-network by the patient's health insurance plan.
United States
30 Nov 2015
NY Insurance Co-op To Cease Operations This Month
Health Republic is one of many struggling or failed co-ops ("Consumer Operated and Oriented Plans") created under the ACA...
United States
17 Nov 2015
NY Urgent Care Centers Settle With Attorney General On Disclosure
Kaiser Health News recently reported that four New York urgent care centers have agreed to improve their disclosure of insurance and pricing information...
United States
6 Nov 2015
Conflicting Court Decisions Put Legality Of ACA Subsidies In Doubt
Two different U.S. Courts of Appeals issued conflicting decisions regarding the legality of the federal government's provision of subsidies to enrollees for coverage in "federally facilitated" health insurance exchanges.
United States
26 Oct 2015
Most Health Insurance Co-ops Are Losing Money
According to a recent audit by the Office of Inspector General of the U.S. Department of Health and Human Services, 22 of the 23 Consumer Operated and Oriented Plans created under the Affordable Care Act lost money in 2014.
United States
7 Sep 2015
Most Purchasers Of Insurance In Exchanges Were Uninsured, Survey Finds
The qualified success of the exchanges is undoubtedly due, in part, to the availability of income-based premium subsidies that help many new enrollees pay for coverage.
United States
20 Aug 2015
Supreme Court Upholds ACA Subsidies
On June 25, the U.S. Supreme Court ruled in a 6-3 decision that consumers who purchase health insurance in "federally facilitated exchanges" established under the Affordable Care Act (ACA) can continue receiving subsidies.
United States
1 Jul 2015
Update: House Passes "Doc Fix" Bill
Under H.R. 2, the SGR will be replaced with annual payment increases of 0.5% beginning later this year through 2019.
United States
1 Apr 2015
Medicare To Continue Shift To Value-Based Reimbursement
On January 26, the U.S. Department of Health and Human Services (HHS) announced that it is testing new healthcare payment models to improve the quality of care and reduce the cost of providing it.
United States
11 Feb 2015
Enforcement Of Health Plan Identifier Rules Delayed
The CMS Office of e-Health Standards and Services announced a delay in enforcement of the Health Plan Identifier rules for electronic healthcare transactions.
United States
4 Nov 2014
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