Healthcare
On August 1, 2007, New York’s Governor Spitzer signed into law S.3986-A, a bill intended to decrease friction between managed care plans and their participating providers on certain sensitive issues. Most significantly, if a health plan requires that certain health care services be preauthorized in order to be covered, then once a service has been preauthorized and performed, the plan may not thereafter deny coverage for the service.
Important National Health Care Reform Bills Awaiting Action By Congress
By Troutman Pepper Locke on
On January 17, 2007, lawmakers in the House and Senate introduced identical bills (H.R. 506 and S. 325) aimed at funding innovative State initiatives that expand coverage and access to the uninsured and improve quality and efficiency in the health care system. The bills, the “Health Partnership Act”
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Massachusetts Mandatory Health Insurance
By Troutman Pepper Locke on
On April 12, 2006, Massachusetts Governor Mitt Romney signed a health care bill, known as “An Act Providing Access to Affordable, Quality, Accountable Health Care (the “Act”)”, into law.
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Blues, Physicians Reach Settlement in Love Case
By Troutman Pepper Locke on
Posted in Healthcare, United States
The Blue Cross and Blue Shield Association, along with a majority of its nationwide affiliated “Blues plans,” has reached settlement with a class of approximately 900,000 physicians, to resolve a class action suit brought in the Southern District of Florida. …
Connecticut Outlaws Post-Claim Underwriting by Health Insurers
By Troutman Pepper Locke on
The Connecticut General Assembly recently enacted legislation (Public Act 07-113), signed into law by Governor M. Jodi Rell on June 12, to prohibit health insurers or HMOs (termed “health care centers” under Connecticut law) from engaging in the practice of “post-claim underwriting.”
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NCOIL to Review Potential Long Term Care Abuses
By Troutman Pepper Locke on
The National Conference of Insurance Legislators’ (NCOIL) Long Term Care and Health Retirement Issues Committee announced that it will discuss and review potential abuses in the long term care (LTC) insurance market at the upcoming NCOIL meeting in Seattle.
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Group Health Incorporated Spots Insurance Fraud in Alleged Brain Surgery Scam
By Troutman Pepper Locke on
Posted in Healthcare, United States
Given the escalating costs of covering legitimate health care services, the last thing the health insurance industry needs is to be paying for services that were never rendered. Fortunately, state and federal laws provide harsh penalties for this sort of fraud.
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