It’s time for a wake-up call!

By: Jen McCormick, Esq. Healthcare has received so much attention over the past 10 years. Everyone has something to say about its current form, how comprehensive it should be, or who should be have a role in providing the coverage. The most contentious piece of the conversation, howev
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Full Billed Charges: A Question of Geography

By: Jon Jablon, Esq. It is increasingly common within the self-funded industry for medical providers to demand full billed charges for non-contracted claims. As we know, no one is actually required to pay full billed charges – but when push comes to shove, that tends to be the prevail
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Behind Closed Doors

By: Brady C. Bizarro, Esq. Anyone paying attention to national politics in the past six months knows that Washington has a problem with leaks; leaks from the White House, leaks from the intelligence community, and unsurprisingly, leaks from Capitol Hill. While many of these leaks come
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“Stay away from Back Surgery”: A Warning from NBA Coach Steve Kerr

By: Jason Davis Steve Kerr’s comments can be viewed as a warning for self-funded payers and their administrators to educate their members on the shortcomings of some surgeries which are extremely expensive and often unnecessary. According to the American Journal of Orthopedics, over a
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A Win for the Good Guys!

By: Chris Aguiar, Esq. Subrogation added another case to the win column last week when the 5th Circuit ruled in favor of a benefit plan’s reimbursement rights even though the Plan only had an SPD, and that SPD referenced another, nonexistent document.  I know what you are thinking … “
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The Rules of the Game are Still Changing

By: Kelly Dempsey, Esq. It’s clear the rules of the Health Care Reform game we’ve been playing for the last seven years are going to be changing.  If you’ve been living under a rock and haven’t heard about the ongoing debates on Capitol Hill, you’ll be unaware of the fact that an ACA
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