By Brado Bizarro, Esq – The Phia Group, LLC Background Texas General Hospital is a private, acute care facility located in Grand Prairie, Texas. It is outside of UnitedHealthcare’s (“United”) provider network. In January of 2015, Texas General was the subject of intense scrutiny
By Jack Craver Activists and politicians on both sides of America’s never-ending debate on abortion are closely watching as the Supreme Court hears arguments Wednesday over a Texas law aimed at making it more difficult to operate an abortion clinic.
From the February 18, 2016 EBIA Weekly [Health Care Serv. Corp. v. Methodist Hosps. of Dallas, 2016 WL 530680 (5th Cir. 2016)] Available at http://www.ca5.uscourts.gov/opinions/pub/15/15-10154-CV0.pdf The Fifth Circuit has ruled that a third-party administrator (TPA) of employer-spons
EBIA Weekly A federal district court has ruled that ERISA does not preempt the Texas Prompt Payment Act as it applies to TPAs of self-insured benefit plans. The state law generally requires “insurers” to pay benefit claims within 30 or 45 days (depending on the claim’s format), or fac
By Denis Storey All we read about is PPACA. But rest assured there are other threats to the benefits business. One such threat has emerged in the unlikeliest of places – Texas – where a quiet, but pitched, battle rages on over the future of telemedicine. Read more…
Texas health plans seeking reimbursement via subrogation, are now forced to deal with new guidelines. C.P.R.C. c. 140, governing subrogation, went into effect January 1, 2014; enacting H.B. 1869, which was passed months prior; but the finer points are still being explored. Who Does Th
By Rachel Landen A last-minute shift to more community and local outreach along with other grass-roots marketing strategies helped state exchanges and enrollment organizations boost Latino signups just before the March 31 deadline after months of lagging enrollment in Obamacare plans.
By Keith Speights Is disaster on the way for your state? When it comes to the Affordable Care Act, commonly known as Obamacare, some states appear to be in much worse shape than others. For certain states, total enrollment has been nothing short of abysmal — particularly when co