New York Updates Value Based Payment (VBP) Roadmap for Medicaid Managed Care

The New York State Department of Health (“DOH”) recently published its 2016 update of the Value Based Payment (“VBP”) Roadmap, which establishes guidelines and timelines for the dramatic overhaul of … Continue Reading →


Department Of Financial Services Files Health Republic Liquidation Proceeding

At long last, the New York State Department of Financial Services filed a special proceeding on Friday, April 22, 2016 in the Supreme Court, New York County, to liquidate Health … Continue Reading →


Assignment of Benefits Gives Providers The Right To Sue For Non-Payment

The Third Circuit Court of Appeals recently held that in the context of employer funded health insurance plans, health care providers, including doctors and hospitals, who treat “out-of-network” patients and … Continue Reading →


Blurred Lines: What Networks and Benefit Plans Are You Really Participating In?

Health plans used to offer only a handful of products each, making it fairly simple for health care providers to determine the networks and benefit plans in which they participated. … Continue Reading →


Providers, Are Your Medicare Advantage Plans Taking Advantage?

When Congress enacted its budget sequestration reductions in 2013, it reduced premium payments to Medicare Advantage Plans (“MA Plans”) by 2%, but many MA Plans found a creative way to … Continue Reading →