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15 Jun 2010, 7:44 am by Cynthia Marcotte Stamer
The grandfather rule published June 14 provides certain “routine changes” will not cause a health plan that existed on March 23, 2010 to give up grandfathered status. [read post]
23 Apr 2019, 9:01 am by Green and Associates
 Sutter Health, a non-profit public benefit corporation that provides healthcare services through its affiliates, including hospitals and medical foundations, contracted with certain MAOs to provide healthcare services to California beneficiaries enrolled in the MAOs’ MA Plans. [read post]
20 Jul 2012, 8:15 pm by Cynthia Marcotte Stamer
Both state-regulated insured health plans and federal and state employee plans generally are loaded with a long list of mandated benefits that self-insured health plans don’t provide or provide only on a more limited basis. [read post]
8 Apr 2019, 11:10 am by Kantor & Kantor LLP
  While the Department of Labor touted the regulation as providing a way for small businesses to get more affordable health insurance coverage, critics said that the new regulation was an invitation to fraud, by giving incentives to shady operators to offer cheap plans that are literally too good to be true. [read post]
31 May 2016, 4:05 pm by Cynthia Marcotte Stamer
  Furthermore, where a breach involves 500 or more individuals, the timetable for providing notification to OCR is accelerated and the Plan also is required to provide notification to the media and others. [read post]
10 Jan 2013, 1:21 pm by Cynthia Marcotte Stamer
  For post-September 30, 2014 plan years, the Code provides for further adjustments in the fee based on increases in the projected per capita amount of National Health Expenditures. [read post]
3 Sep 2015, 5:30 pm by Cynthia Marcotte Stamer
November 6, 2015 is the deadline for health care providers, health insurance exchanges, Medicare Advantage plans, Medicaid Advantage plans, health insurers providing coverage in the health insurance marketplaces, their contractors and other concerned parties to comment on a proposed rule on Nondiscrimination in Health Programs and Activities published today by the Department of Health and Human Services (HHS)… [read post]
21 Sep 2021, 5:00 pm by Karen K. Hartford
The Mental Health Parity and Addiction Equity Act (“MHPAEA”) provisions of the Consolidated Appropriations Act, 2021 (“CAA”) introduced a requirement that group health plans and insurance providers offering both medical and surgical benefits (“M/S benefits”) and mental health and substance use disorder benefits (“MH/SUD benefits”) that impose non-quantitative treatment limitations (“NQTLs”) must… [read post]
19 Oct 2022, 9:01 pm by News Desk
Food safety has been included in a One Health action plan published by four international agencies. [read post]
18 Mar 2014, 1:37 pm by Cynthia Marcotte Stamer
  Accordingly, self-insured health plans, their sponsors, TPAs and advisors should review the proposed rules and provide relevant input as soon as possible and no later than the extended April 3, 2014 due date. [read post]
20 Dec 2021, 4:44 pm by Cynthia Marcotte Stamer
MO Health Plan; State of TN Finance & Administration TN Health Plan; Providence Health Plan OR Health Plan as well as a plethora of previously health plan associated breaches reported prior to 2021. [read post]
4 Nov 2014, 4:54 pm by Cynthia Marcotte Stamer
Plans Must Provide “Substantial Coverage” for Both In-Patient Hospitalization & Physician Services To Provide Minimum Value Notice 2014-69 makes it official that the Department of Treasury (including the IRS) and Department of Health and Human Services (collectively the Departments)  believe that group health plans that fail to provide substantial coverage for in-patient hospitalization services or for physician… [read post]
7 Feb 2019, 3:03 pm by Cynthia Marcotte Stamer
Health plans and their employer and other sponsors, fiduciaries, administrators and other service providers, as well as health care providers, health care clearinghouses and their business associates (“Covered Entities”) should reconfirm the adequacy of their Health Insurance Portability and Accountability Act (“HIPAA”) compliance and risk management in light the U.S Department of Health and Human… [read post]
18 Aug 2022, 6:11 pm by Ben Vernia
According to DOJ’s press release: Ventura County Medi-Cal Managed Care Commission doing business as Gold Coast Health Plan (Gold Coast), a county organized health system (COHS) that contracts to arrange for the provision of health care services under California’s Medicaid program (Medi-Cal) in Ventura County, California; Ventura County, which owns and operates Ventura County Medical Center, an integrated health care system that… [read post]
20 Feb 2018, 11:55 am by Seth Hanft
For employees, association health plans may provide an attractive, more cost-effective alternative to the current Obamacare plans. [read post]
29 Mar 2011, 8:04 am
The Parenting Plan provides details about legal custody for the child, as well as physical custody or timesharing. [read post]
13 Dec 2021, 6:20 am by Wachler & Associates, P.C.
These requirements generally apply to items and services provided to individuals enrolled in group health plans, group or individual health insurance coverage, and Federal Employees Health Benefit plans. [read post]
4 Jan 2024, 6:00 am by Evangelina Cantu
Departments of Labor, Health and Human Services, and Treasury (the Departments) may require plans to collect and evaluate as part of the NQTL comparative analysis, with a focus on plan provider networks. [read post]
9 Dec 2021, 8:59 am by Wachler & Associates, P.C.
Effective January 1, 2022 under the No Surprises Act, healthcare providers, facilities, and providers of air ambulance services will be subject to new requirements that generally apply to items and services provided to individuals enrolled in group health plans, group or individual health insurance coverage, and Federal Employees Health Benefit plans. [read post]