Healthcare

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Healthcare matters remained highly relevant throughout the month of September, as comments were released on important home health regulations, as a lawsuit appeared likely to move forward, and as lawmakers and the President marked the six-month anniversary of the new healthcare reform law. …
Read More Healthcare News from Capitol Hill and the Department of Health and Human Services – September 27, 2010

Aetna, Anthem Blue Cross, Cigna, Humana, WellPoint, and the Golden Rule subsidiary of UnitedHealth are among the companies that have decided to stop selling child-only policies rather than comply with the new Patient Protection and Affordable Care Act (PPACA) requirement that they cover children with pre-existing conditions effective September 23, 2010. …
Read More Some Large Insurers Stop Offering Children’s Policies

Insurers authorized in Mexico must consider the issue of potential liability in connection with selecting physicians for their medical network to provide services to their insureds.  A federal collegiate court in Mexico recently ruled, in a 10-year long case, that insurers can be held jointly liable with professionals that form part of their medical network. …
Read More Mexican Court Finds Insurer Jointly Liable For Medical Error

In early September, the Centers for Medicare and Medicaid Services (CMS) released a proposed rule that seeks to repeal specific elements of Medicaid prescription drug regulations that were published in 2007. …
Read More Healthcare News from Capitol Hill and the Department of Health and Human Services – September 13, 2010

The Centers for Medicare and Medicaid Services (CMS) announced on August 18 that states have until September 24 to request an extension of the enhanced Federal Medical Assistance Percentage (FMAP) – the federal government’s share of Medicaid funding. …
Read More Healthcare News from Capitol Hill and the Department of Health and Human Services – August 30, 2010

Earlier this month, the Massachusetts Division of Insurance (the “Division”) struck a deal with Health New England to settle a dispute over rate increases.  In the winter of 2009, Health New England, a Springfield, Massachusetts health insurer, attempted to increase its health insurance premiums by a range of 11.5% to 21.3% for about 21,000 customers.  The Division denied this increase on April 1, 2010, along with other insurers who sought double-digit increases. …
Read More Massachusetts Health Insurer Settles With Division of Insurance On Rate Increases

CMS PROPOSES CHANGES TO “36 MONTH RULE” FOR HOME HEALTH:  In late July, the Centers for Medicare and Medicaid Services (CMS) published a proposed rule for the Medicare Home Health Prospective Payment System (HH PPS) Rate Update for Calendar Year 2011.  As anticipated, the proposed rule promulgates changes to the so-called “36 month rule” for home health agencies (HHAs) that went into effect in January 2010. …
Read More Healthcare News from Capitol Hill and the Department of Health and Human Services – August 9, 2010

Last week, the Massachusetts legislature passed House Bill No. 4935, An Act relative to insurance coverage for autism (“H. 4935”), which requires that benefits be provided on a nondiscriminatory basis for the diagnosis and treatment of Autism Spectrum Disorders.  H. 4935 prohibits dollar or unit of service limitations on coverage for the diagnosis and treatment of autism that are lower than dollar or unit of service limitations applicable to the diagnosis and treatment of physical conditions. …
Read More Massachusetts Passes Autism Coverage Legislation

In response to the Centers for Medicare and Medicaid Services’ (CMS’) proposed hospital inpatient rule for FY 2011, lawmakers urged the agency to reconsider payment reductions in a July 12 letter.  The following week, the agency released its proposed rules for home health and skilled nursing facilities.  In other news, the Department of Health and Human Services (HHS) issued final rules for achieving “meaningful use” of electronic health records. …
Read More Healthcare News from Capitol Hill and the Department of Health and Human Services – July 26, 2010

The Patient Protection and Affordable Care Act and the Health Care and Education Reconciliation Act of 2010 (collectively, the “Affordable Care Act”) require group health plans and insurers that provide dependent coverage to extend health care coverage to adult children until they reach age 26. …
Read More Extension of Group Health Plan Coverage to Adult Children