Entries by McDermott, Will and Emery, LLP

Surprise Billing Arbitration Is Still a Mess

Despite a two-year-old ban on surprise medical billing, insurers and providers are struggling to resolve unpaid claims. In this Axios article, McDermott+Consulting’s Jeffrey Davis offers perspective on the state of the claims resolution process. Read more here.
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States Move to Standardize Healthcare Licensing Requirements

Numerous states—including Alaska, Wisconsin, Ohio and Oregon—have been busy finalizing rulemaking and legislation advancing hybrid healthcare models, modernizing licensure infrastructures and incentivizing telehealth. What have these states been up to over the last month? Read more here.
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Employer Due Diligence Lessons from UK Share Scheme Case

The recent decision in Ponticelli Limited v Gallagher provides a salient reminder that the right to participate in a share incentive plan can transfer to a new employer under the Transfer of Undertakings (Protection of Employment) Regulations. The right applies even if the employee’s right to participate in the plan arose outside of the contract of […]
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The Misbehaving CEO: Sexual Harassment Remains a Big Concern for Boards

Most responsible corporate boards took measures to address codes of conduct issues and sexual harassment in the wake of the “MeToo” movement. However, a flurry of recent stories involving misbehaving CEOs suggests otherwise. In this Forbes article, Michael Peregrine says these scandals should be a wake-up message to corporate boards. Access the article.
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States Move to Regulate Telehealth-Related Youth Services

Numerous states—including Louisiana, Ohio, California, Tennessee and New Jersey—have been finalizing rulemaking and legislation that create or amend professional practice standards to incorporate telehealth. Several of these states have also proposed regulations or laws related to the provision of care to youths. Read more here.
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Illinois Mandates Pay and Benefits Information for Job Postings

Illinois recently amended its Equal Pay Act to require employers with 15 or more workers to include pay and benefits information for each covered job posting. There is, however, a delayed start date: This amendment will take effect on January 1, 2025. Learn more here.
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New MHPAEA Guidance Regarding NQTLs: Network Access and Composition

Federal regulators recently announced new mental health parity proposed rules that may add significant new compliance burdens for health plan sponsors, insurers and service providers. The proposed rules may also impact the operation of health plans. A Technical Release accompanied the rules that further explains and invites comment on certain provisions of the proposed rules […]
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The Proposed MHPAEA Regulations’ ‘Meaning of Terms’ Part One: Benefits

This post continues our investigation of proposed regulations under the Mental Health Parity and Addiction Equity Act (MHPAEA) issued by the US Departments of Labor, Health and Human Services and the Treasury (the Departments). Our previous MHPAEA content is available here. The purpose of MHPAEA is to ensure that participants and beneficiaries in a group health […]
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Texas District Court Overturns Portions of the IDR Process

On August 3, 2023, the US District Court for the Eastern District of Texas ruled on the implementation of the No Surprises Act in Texas Medical Association, et al. v. US Department of Health and Human Services, et al. (TMA IV). In TMA IV, the plaintiffs challenged two things: The increased administrative fee to participate […]
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The ‘Data Evaluation Requirement’ for NQTLs Under the Newly Proposed MHPAEA Regulations

Last week’s post examined the “no more restrictive” requirement that would apply to non-quantitative treatment limitations (NQTLs) set out in recently proposed regulations under the Mental Health Parity and Addiction Equity Act (MHPAEA). (Our description of the proposed regulations is available here.) The proposed regulations deal principally with NQTLs, which are non-numeric benefit coverage limits […]
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