Results for Health Care

The Supreme Court of the United States heard oral arguments today in the consolidated cases titled California et al. v. Texas et al. and Texas et al. v. California et al., which could determine the fate of the Affordable Care Act (“ACA”), its protections, and the health insurance coverage of 20+ million Americans. Tens of millions of Americans gained insurance coverage under the ACA, which includes popular provisions such as guaranteeing coverage for individuals with pre-existing conditions and forbidding insurers from denying them coverage or charging them more.

The Centers for Medicare and Medicaid Services (“CMS”) is working with participating provides and suppliers to ensure they have the funds necessary to continue operating without disruption. During the current public health emergency caused by the COVID-19 pandemic, the Medicare Accelerated and Advanced Payment Program (the “Program”) will lend most providers or suppliers as much as 100% of the amount it received during the preceding six (6) month period.

In the mist of the COVID-19 pandemic, medical practices are overwhelmed with the number of patients seeking testing and office visits related to COVID-19. Interpol has released a “purple notice” to its 194 member countries warning them of the heightened ransomware threat during the pandemic.

Pharmacy Benefit Managers (PBMs) control pharmacy networks for a number of insurers and there are not that many PBMs, so a PBM contract is the sole gateway to a number of insurers for pharmacy service claims. However, the PBM role is not merely processing claims; they hold a great amount of power over pharmacies because PBMs set payment criteria and policies.

On June 25, 2019 the Governor of Florida approved SB 732, a new statute modifying the rules related to office surgery and surgical centers. The question many bare doctors in Florida are asking is whether SB 732 requires doctors working at surgical centers to carry malpractice insurance. The answer is no it does not.