Searching Content indexed under Food, Drugs, Healthcare, Life Sciences by Nili Yolin ordered by Published Date Descending.
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New York (Again) Seeks To Regulate Pharmacy Benefit Managers
On January 15, 2019, Governor Cuomo released the 2019-2020 Executive Budget, which proposes substantial legislative changes that would affect pharmacy benefit managers (PBMs).
United States
27 Mar 2019
New Jersey Regulates Out-Of-Network Billing
News alert for all New Jersey health care providers! A new law went into effect yesterday (August 30, 2018) that changes billing requirements for out-of-network services in New Jersey.
United States
6 Sep 2018
New York Executive Budget Proposes Corporate Ownership Of Retail Clinics, Tax On Not-For-Profit Health Insurance Conversions
Last week, Governor Andrew Cuomo unveiled his proposed $168 billion budget for fiscal year 2019, which proposes several changes to New York's healthcare landscape.
United States
26 Jan 2018
OIG Reaffirms Permissibility Of Certain Gainsharing Arrangements
The Department of Health and Human Services Office of the Inspector General (OIG) has issued an Advisory Opinion (Opinion) in connection with a hospital's gainsharing arrangement (Arrangement) ...
United States
11 Jan 2018
New York Medical Society Warns Providers To Avoid Percentage-Based Fees
A series of recoupment letters from the New York State Medicaid Fraud Control Unit to healthcare providers who have management or billing company arrangements based on a percentage of collections...
United States
28 Mar 2017
California Joins New York And Florida, Passes Out-Of-Network Legislation
Last month the California legislature passed AB-72, which amends the Health & Safety Code to address reimbursement for out of network providers who provide services at in-network facilities, such as hospitals and laboratories.
United States
21 Sep 2016
After New York, Florida Curbs Surprise Bills For Emergency And Out-Of-Network Services
It is generally understood that if a managed care member utilizes the services of a non-participating provider, the member could incur significant out of pocket expenses.
United States
3 May 2016
CMS Takes Action Against Network Transparency While New Jersey Legislation Hits A Snag
State regulation of provider directories is not new – more than half the states have such guidelines, including New Jersey.
United States
11 Feb 2016
"Two-Midnight" Rule Needs Tweaking, Says Federal Judge
A Federal Judge found that the Department of Health and Human Services failed to comply with the Administrative Procedure Act when it cut hospital inpatient payments by 0.2% as part of its "two-midnight" rule.
United States
30 Sep 2015
The Corporate Practice Prohibition In New York: What We Can Learn From The ADMI Settlement
One of the most frequently asked questions posed to healthcare lawyers is whether State X has a prohibition on the corporate practice of medicine, nursing or other profession, and if so, whether the prohibition is enforced.
United States
31 Jul 2015
FTC Says New York’s Medicaid Redesign Program May Promote Anticompetitive Behavior
In an April 22, 2015 letter to the New York State Department of Health (DOH), the Federal Trade Commission (FTC) cautioned that part of the State’s Medicaid reform program may sanction anticompetitive behavior.
United States
9 May 2015
Proposed GME Legislation Looks To Increase Residency Slots
Last week, new bi-partisan legislation was introduced to increase the number of graduate medical education (GME) slots over the next five years at teaching hospitals and academic medical centers.
United States
5 May 2015
How New York’s Emergency Medical Services And Surprise Bills Law Impacts Providers And Plans
Last year New York passed legislation known as the "Emergency Medical Services and Surprise Bills" law, a much-heralded consumer protection law primarily intended to guard against surprise bills for out of network health care services.
United States
22 Apr 2015
New York’s Surprise Medical Bill Law Goes Into Effect
Once the health plan pays the provider an amount that it determines is reasonable, the provider can dispute that amount through the independent dispute resolution (IDR) process.
United States
7 Apr 2015
New York Passes Telemedicine Reimbursement Legislation
New York became the 22nd state to sign into law legislation that will require commercial and Medicaid plans to provide coverage of telehealth and telemedicine services.
United States
16 Jan 2015
New Jersey Court Supports Peer Review Immunity For Hospital
The New Jersey Appellate Division affirmed a lower court’s decision to dismiss a physician’s lawsuit against a hospital based on federal and state statutory immunity provisions.
United States
3 Dec 2014
NYS Department Of Health Proposes Changes To Certificate Of Need Process
On October 15, 2014, the New York State Department of Health released proposed changes that will simplify the certificate of need process.
United States
29 Oct 2014
New York Enacts Out-Of-Network Transparency And Coverage Reform
A woman sued a health plan, claiming that she was misled about which physicians were participating providers in the company’s online health insurance exchange.
United States
9 Jul 2014
Unified Residency Accreditation System To Be Launched
The ACGME, AOA, and the AACOM will be forming a unified, single accreditation system for allopathic and osteopathic physicians in 2015.
United States
16 Apr 2014
Five Tips For Addressing Disruptive Physician Behavior
Recently, a colleague and I spoke at the NAMSS 37th Educational Conference & Exhibition to nearly 200 medical directors, chief medical officers, and credentialing staff about what constitutes disruptive physician conduct in the hospital setting, and what hospitals can do to manage it.
United States
7 Nov 2013
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