A comprehensive legal resource page with original commentary and key takeaways on critical topics impacting our clients industries.
On Friday, the Departments issued final rules for the No Surprises Act’s (“NSA”) independent dispute resolution (“IDR Process”). These final rules go into effect 60 days after the date of publication in the Federal Register and apply to plan years beginning on or after January 1, 2022.
Many Medicare Advantage Organizations (“MAOs”) are not contracted with providers. When an MAO enrollee presents to the provider for healthcare services, the provider verifies the enrollee’s coverage, obtains authorization where necessary, and renders the requisite services. The provider then submits a claim to the MAO for payment, and the MAO adjudicates payment. Nevertheless, in many
In a unanimous decision issued on May 23, 2022, the U.S. Supreme Court reversed a long-standing requirement in several circuits that parties opposing arbitration demonstrate prejudicial harm before an arbitration clause is considered waived. Morgan v. Sundance, Inc. involved an employment dispute in which the employer engaged in litigation for eight months before seeking to compel arbitration