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17 Nov 2021, 2:44 pm by Cynthia Marcotte Stamer
The rule requires health plans, health insurance issuers offering group or individual health insurance coverage, and health benefits plans offered to federal employees to submit key data to the Departments, which will work through the HHS Assistant Secretary for Planning and Evaluation (ASPE) to publish a report on prescription drug pricing trends and rebates, as well as their impact on premiums and consumers’ out-of-pocket costs. … [read post]
3 Mar 2022, 9:32 pm by Cynthia Marcotte Stamer
Change Healthcare Inc. headquartered in Nashville, Tennessee, is a leading independent health care technology company providing health care analytics, software, services and data to health care providers, health insurers and other software and services firms in the health care industry. [read post]
2 Mar 2016, 5:00 pm by Cynthia Marcotte Stamer
When Vermont sought to require the Plan’s third-party administrator, Blue Cross Blue Shield of Massachusetts, Inc. [read post]
27 Sep 2021, 1:01 pm by Cynthia Marcotte Stamer
An impending change in the Medicare Secondary Payer (”MSP”) recordkeeping system could slightly lighten group health plan reporting burdens. [read post]
17 Mar 2024, 5:42 pm by Cynthia Marcotte Stamer
Change Healthcare Ransomware Attack On February 21, 2024, a ransomware attack executed by the Blackcat1234 ransomware group took control of and shut down the payment, revenue cycle management and related tools and systems of UHG Subsidiary Change Healthcare. [read post]
3 Aug 2015, 12:07 pm by Cynthia Marcotte Stamer
Since employers risk excise tax exposure if their group health plan does not comply with the out-of-pocket limitation, this means that employers may wish to with legal counsel about steps that the employer should consider taking to build a record to help mitigate excise tax exposures from potential violations of these requirements including ensuring their group health plan properly defines and distinguishes essential from non-essential benefits, obtaining… [read post]
11 Jul 2015, 2:14 pm by Cynthia Marcotte Stamer
The heavy reliance by group health plans and health insurers upon internet based applications and portals to carry out online enrollment, claims administration and payment, reporting and a host of other key health plan functions makes it particularly important for health plans, their employer or other sponsors, fiduciaries, vendors, and other involved in health plan administration or using or accessing health plan data to verify… [read post]
29 Mar 2022, 5:04 pm by Cynthia Marcotte Stamer
The ACA preventive care and other mandates generally apply to individual health insurance coverage, fully insured small- and large-group coverage, and self-insured group plans that are not grandfathered or otherwise exempt. [read post]
24 May 2023, 5:16 pm by Cynthia Marcotte Stamer
While MedEvolve’s customers generally were medical practices or other health care providers, self-insured health plans, health insurers and health plan service providers subject to HIPAA as covered entities and business associates often also rely upon third-party systems or services that involve sharing of health plan PHI with or rely upon third party provided servers, technology or other resources to collect and administer health… [read post]
15 Mar 2019, 8:19 am by Cynthia Marcotte Stamer
Past Chair of the ABA Managed Care & Insurance Interest Group and, a Fellow in the American College of Employee Benefit Counsel, the American Bar Foundation and the Texas Bar Foundation, heavily involved in health benefit, health care, health, financial and other information technology, data and related process and systems development, policy and operations throughout her career, and scribe of the ABA JCEB annual Office of Civil Rights agency meeting, Ms. [read post]
25 Apr 2017, 3:21 pm by Cynthia Marcotte Stamer
  Sponsors and plan fiduciaries also need to be concerned about other risks beyond sponsoring employers’ excise tax liability exposures for sponsoring a non-compliant group health plan. [read post]
16 Feb 2017, 3:01 pm by Cynthia Marcotte Stamer
A $5.5 million settlement payment that Memorial Healthcare Systems (MHS) just paid the U.S. [read post]
2 Mar 2020, 11:04 am by Cynthia Marcotte Stamer
Proposed Coverage Transparency Rule The Proposed Coverage Transparency Rule would require most employer-based group health plans and health insurance issuers offering group and individual coverage to disclose price and cost-sharing information to participants, beneficiaries, and enrollees up front. [read post]
13 Jul 2018, 10:37 pm by Cynthia Marcotte Stamer
(R-TX), would provide individuals receiving subsidies to help purchase health care coverage through the Obamacare-created health insurance exchange the option to use their premium tax credit to purchase health care coverage from qualified plans offered outside of the exchanges. [read post]
30 Sep 2021, 4:50 pm by Cynthia Marcotte Stamer
In addition to updating plan documents, contracts, and processes, health plans, their sponsors, fiduciaries, administrative service providers and others likely need to review budget forecasts, stop loss and other insurance, participant and provider communications, systems, and a host of other operating features of their programs. [read post]
2 Mar 2020, 7:29 am by Cynthia Marcotte Stamer
Scribe for the ABA JCEB Annual Agency Meeting with OCR, Vice Chair of the ABA International Section Life Sciences Committee, past Chair of the ABA Health Law Section Managed Care & Insurance Interest Group and the ABA RPTE Employee Benefits & Other Compensation Group, Ms. [read post]