Letter of the Law - Managed Healthcare Executive
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Letter of the Law

Law does not stop payers from buying providers

May 1, 2012

Rise of payers buying providers leads to complex legal issues.

CMS hopes to change payment for dual eligibles

March 15, 2012

Federal and state governments may soon be looking to managed care for a comprehensive solution.

Rate review authority has far-reaching effects

March 1, 2012

The administration's focus on rate review may have had a trickledown effect on states.

PPACA's affordability definition remains unclear

February 1, 2012

When it comes to health insurance and the Patient Protection and Affordable Care Act, defintion "affordable" can be a complex and confounding task.

Be mindful of state law regarding arbitration clauses

January 1, 2012

Despite the Federal Arbitration Act's general rule favoring arbitration provisions in written agreements, state laws may pose challenges for health insurers.

Medicaid and CHIP will overshadow Medicare

December 1, 2011

It is important to consider the impact the federally mandated coverage provisions might have on enrollment.

Supreme Court will rule on individual mandate

November 1, 2011

Most observers recognize that the U.S. Supreme Court will likely have the last say on the individual mandate.

CO-OP plans need capital, intellectual investment

October 1, 2011

The Consumer Oriented and Operated Plan program is designed to foster consumer-governed, private, nonprofit health insurers in every state

Recent amendments apply standards of external review

September 1, 2011

Regulations were designed to provide uniform federal standards to govern consumers' right to appeal denials of claims or coverage by health plans.

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