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CMS Releases Rule to Streamline Prior Authorizations and Ease Exchange of Health Information

On January 15, 2021, the Centers for Medicare and Medicaid Services (CMS) released a final rule, the CMS Interoperability and Prior Authorization Rule, to streamline prior authorization and patient and provider access to medical records. The rule req… Read More
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Categories: Healthcare

AHA v. Azar

On December 29, 2020, the U.S. Court of Appeals for the D.C. Circuit issued an opinion in American Hospital Association, et al., v. Azar, affirming the district court’s decision to uphold the rule that requires hospitals to disclose negotiated… Read More
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Categories: Healthcare

Trump Administration Releases Final Rule Requiring Insurers to Disclose Prices

On October 29, 2020, the Department of Health and Human Services, the Department of Labor and the Department of Treasury issued a final rule that requires group health plans and health insurers to disclose cost-sharing information to participants and… Read More
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Categories: Healthcare

9th Circuit of Appeals Rules that Anthem Must Cover ER Visits

The U.S. Court of Appeals for the 9th Circuit recently ruled in the case Martin Luther King, Jr., Community Hospital v. Community Insurance Company, d/b/a Anthem Blue Cross and Blue Shield, et al. The District Court previously granted summary judgeme… Read More
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Categories: Healthcare

CMS Approves Georgia and Nebraska Medicaid Expansion with Work Requirements

On October 15, 2020, CMS approved an 1115 Waiver for Georgia called the Georgia Pathways to Coverage demonstration, which will partially expand Medicaid and impose premiums and work requirements on beneficiaries. The demonstration expands Medicaid co… Read More
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Categories: Healthcare

Trump Signs Healthcare Executive Orders

On September 24, 2020 President Trump signed an executive order implementing his “America First Healthcare Plan.” Through the Order, Trump addressed his intent for individuals with pre-existing conditions to maintain insurance coverage, even if t… Read More
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Categories: Healthcare

Missouri to Expand Medicaid

On August 4, 2020, Missouri voters approved expanding Medicaid coverage in the state through an amendment to the state constitution, making Missouri the 38th to expand. The vote narrowly passed, receiving support from 53% of voters. It provides cover… Read More
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Categories: Healthcare

AHA Seeking Overturn Regarding Reduced Outpatient Payments

The American Hospital Association and the Association of American Medical Colleges have announced that they will seek a rehearing of their lawsuit against the U.S. Department of Health in the U.S. Court of Appeals for the District of Columbia Circuit… Read More
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Categories: Healthcare

North Carolina to Delay Medicaid Expansion

North Carolina’s legislature has chosen to delay implementing Medicaid expansion for at least another year. Instead, the legislature passed NC Senate Bill 808, which was signed by Governor Roy Cooper on July 2, 2020. The bill provides funding for t… Read More
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Categories: Healthcare

Oklahoma Approves Medicaid Expansion

On June 30, 2020, the citizens of Oklahoma narrowly approved a state question to expand Medicaid in the state. State Question 802 passed with 50.5% of voters’ support and is predicted to allow at least 200,000 Oklahoma adults to become eligible for… Read More
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Categories: Healthcare

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