The Guilty Shall Remain Nameless – Yet I shall Shame Them… Again

By Tim Callender, Esq. In this second installment of “The Guilty Shall Remain Nameless” I can’t help but think back to an encounter I had with a walk-in clinic in Las Vegas, Nevada. Now… it’s worth noting that any walk-in clinic, one block from The Strip, is highly likely to be an int
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4 main tenets of the GOP’s ACA replacement plan

By Emily Rappleye House Republicans gathered Thursday to discuss a policy memo detailing their ACA replacement plan, according to The Washington Post. While the meeting put many rank-and-file members at ease, they said the details presented at the meeting did not comprise a full-on pl
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15 things to know about Stark Law

By Ayla Ellison Enacted more than two decades ago with the simple purpose of curbing physician self-referral, Stark Law has evolved into a complex set of regulations, which some argue impede efforts to transition away from a fee-for-service system. Here are 15 things to know about Sta
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Healthcare Need Not Be a Headache

By: Christopher Aguiar, Esq. My PCP is a great doctor, but I hate visiting him. I only live 2 minutes from his office, but somehow, my quick visits usually turn into long excursions. Luckily, I’ve educated myself, understand how my benefit plan works, and have an urgent care clinic ne
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S B C, It’s as Easy as 1, 2, 3… Don’t Forget the NEW Template

By: Kelly Dempsey, Esq. The new Summary of Benefits and Coverage (SBC) template is applicable for plans that have open enrollment periods beginning on or after April 1, 2017. If there is no open enrollment period, it applies for plans renewing on or after April 1, 2017. Changes to the
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House G.O.P. Leaders Outline Plan to Replace Obama Health Care Act

By ROBERT PEAR and THOMAS KAPLAN WASHINGTON — House Republican leaders on Thursday presented their rank-and-file members with the outlines of their plan to replace the Affordable Care Act, leaning heavily on tax credits to finance individual insurance purchases and sharply reducing fe
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In the Spotlight… Or the Crosshairs?

By: Ron Peck, Esq. Yesterday we presented a webinar regarding issues that pop up when employers don’t act with consistency between their plan, handbook, behavior, and law.  We talked about situations where the employer is responsible (by contract) but stop-loss won’t reimburse; becaus
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How expensive are knee replacements in the 20 largest US cities?

By Laura Dyrda Total knee replacement surgery price varies by geographic region. The total price includes hospital services, physician services and anesthesia, according to Healthcare Blue Book. The hospital services assume a four day admission and the physician fee is for the procedu
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CMS projects next decade of health expenditures: 5 takeaways

By Ayla Ellison National health spending is expected to grow at an average annual rate of 5.6 percent from 2016 through 2025, with expenditures projected to hit $5.5 trillion in 2025, according to new estimates from CMS’ Office of the Actuary published Wednesday in Health Affair
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First Proposed ACA Rule Changes

By: Jen McCormick, Esq. Today we got our first new proposed ACA rule changes from the Trump Administration.  One of the proposals was to decrease the open enrollment window for individuals to sign up on the insurance exchanges.  Specifically, the window which is currently November 1 t
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