184 matches.
- Media CoverageHelaine Fingold Quoted in “'Watching the Clues': Uncertainty Clouds Medicare Broker Conference”3 minute read
- EventsThe Road Traveled and the Path Ahead: Predictions for the Future of Medicare Marketing1 minute read
- Media CoverageHelaine Fingold Quoted in “MedPAC Members Will Hear Out Agents, Brokers After Slamming `Flawed System’”2 minute read
- EventsTrump 2.0: What It Means for Health Insurers1 minute read
- EventsHot Topics in VBE Fraud and Abuse, Compliance, and Investigations - On-Demand WebinarFebruary 20252 minute read
- Media CoverageHelaine Fingold Quoted in “Trump Regulation Freeze Could Put Chill on Medicare Advantage Funding”2 minute read
- Media CoverageHelaine Fingold Quoted in “Trump 2.0 Faces Lingering Legal Questions Regarding RADV Audits, Stars, Broker Pay”3 minute read
- PublicationsCMS Rule for CY 2026 Highlights AI, Behavioral Health, Anti-Obesity Drug Coverage, and More24 minute read
- Events2024 Health Law Year in Review and What’s in Store in 20252 minute read
- Media CoverageHelaine Fingold Quoted in “In a Twist, Medicare Advantage Insurers Try to Avoid Selling Plans”2 minute read
- EventsNABIP Maryland Medicare Summit: The Future of Medicare Managed Care and Qualified Health Plan Marketing and Enrollment1 minute read
- BlogsTexas Judge Sides with Challengers on CMS Rule Limiting Medicare Agent/Broker Payments6 minute read
- Media CoverageHelaine Fingold Quoted in “MAOs, Brokers, Agents Get Relief with Legal Pause on Policy Changes”2 minute read
- Media CoverageHelaine Fingold Quoted in “Court Pauses CMS Broker Compensation Rule for Medicare Advantage Plans”3 minute read
- EventsNational Medicare Advantage Summit: Update on the MAPD Final Rule, Increasing Regulation of MA Supplemental Benefit Offerings, and Best Practices for Compliance1 minute read
- EventsNew CMS Medicare Advantage Final Rule: Beneficiary Data, Agent Compensation, Behavioral Healthcare Access, and More2 minute read
- Media CoverageHelaine Fingold Quoted in “FMO Lawsuits Could Delay Agent and Broker Compensation Rules”3 minute read
- Media CoverageHelaine Fingold Quoted in “Finalized Broker Pay Cap Appears to Exclude FMOs, but Impact Remains Unclear”2 minute read
- Media CoverageHelaine Fingold Quoted in “3 Years In, 'No Surprises' Gets Mixed Reviews from Providers”2 minute read
- EventsMedicarians 2024: Reading the Legislative and Regulatory Tea Leaves for Medicare Advantage Marketing1 minute read
- PublicationsAdvancing Interoperability and Improving Prior Authorization: No One Said It Would Be Easy!18 minute read
- Media CoverageHelaine Fingold Quoted in “No Surprises IDR Portal Is Back; Prepare for New Info Requirements”2 minute read
- PublicationsMedicare Advantage, Part D, and More: Proposed Rule Outlines Significant Policy and Technical Changes for CY 202535 minute read
- EventsMedicare Advantage Marketing for Plan Year 2024: How to Manage the Risks & Challenges Presented by the New Medicare Marketing Rules1 minute read
- Media CoverageHelaine I. Fingold Quoted in “The Medicare Advantage Marketing Problem and Where It’s Headed”3 minute read
- Media CoverageHelaine Fingold Quoted in “Reports of Cold Calling, False Promises Put Medicare Marketers on Alert”3 minute read
- BlogsTexas Federal Court Issues Fourth Ruling Invalidating Parts of the Administration’s No Surprises Act Regulations3 minute read
- BlogsIndependent Dispute Resolution Process Halted Following the Government's Third Major No Surprises Act-Related Loss in Federal Court4 minute read
- Media CoverageHelaine Fingold Quoted in “2022 Medicare Advantage Audit Report Reflects Modest Penalties, Familiar Failures”3 minute read
- PublicationsCMS Announces the Making Care Primary Model, a Multistate Initiative to Strengthen Primary Care9 minute read
Firm AnnouncementsEpstein Becker Green Earns National Recognition and High Rankings in the 2023 Edition of Legal 5003 minute read- Media CoverageHelaine Fingold Featured in “The 2024 Final Rule: Insights from a Medicare Marketing and Compliance Attorney”2 minute read
- EventsNew Medicare Marketing Requirements and Best Practices for ComplianceApril 27, 20231 minute read
- Media CoverageHelaine Fingold Quoted in “CMS Rule Finalizes Marketing Changes, Leaves Out Ban on Sharing Beneficiary Contact Info”3 minute read
- PublicationsFederal Judge in Texas Strikes Down ACA's Preventive Services Coverage Mandate12 minute read
- EventsInvesting in Digital: Responding to the Shift in How Consumers Shop for Medicare CoverageMarch 28, 20231 minute read
- EventsSupplemental Benefits Under Medicare Advantage: Optimizing Product Design Toward Growth and Profitability2 minute read
The PACE Program: What Changes May Be Coming Soon?- PublicationsBiden Administration Prioritizes Health Equity in Proposed Reforms to Medicare Managed Care33 minute read
- PublicationsNo Surprises Act: HHS Extends Enforcement Moratorium on Co-Provider & Co-Facility Good Faith Estimates5 minute read
- PublicationsMedicare Advantage Provider Network Adequacy Regulatory Changes for 20242 minute read
- Media CoverageHelaine Fingold Quoted in “Surprise Medical Billing Disputes Pile Up as Lawsuit Unfolds”2 minute read
- Media CoverageHelaine Fingold Quoted in “Senate Democrats Push for MA Marketing Fixes, but Not All May Be Feasible”4 minute read
- Media CoverageHelaine Fingold Quoted in “Medicare Advantage Insurers Face High Marketing Stakes”4 minute read
- PublicationsAt Nine Months, No Surprises Act Can Barely Crawl2 minute read
- Media CoverageHelaine Fingold Quoted in “No Surprises IDRs Stall, but New Rules More Likely to Favor Providers”2 minute read
- Media CoverageHelaine Fingold Quoted in “‘Not So Optimistic’: Surprise Billing Arbitrations Cause Frustration”2 minute read
- PublicationsCMS Framework for Health Equity: An Opportunity for Client Advocacy9 minute read
- BlogsNo Surprises Act Update – New IDR Guidance3 minute read
- Media CoverageHelaine Fingold Quoted in “Surprise Bill Resolutions' Path Forward Hinges on Final Rule”2 minute read
- PublicationsMental Health Parity: Increased Enforcement Efforts Highlighted in 2022 Report to CongressSpring 20222 minute read
- Media CoverageHelaine Fingold Quoted in “Slim Marketing Guidelines Stress Importance of Reviewing Regs”3 minute read
- Publications2022 Mental Health Parity Report to Congress Highlights Increased Enforcement Efforts20 minute read
- Media CoverageHelaine Fingold Quoted in “CMS Rule Seeks More Oversight of TPMOs, ‘Chain of Enrollment’”3 minute read
- EventsNortheast Business Group on Health: 2022 Employer Compliance Reboot—The Buck Stops With You!1 minute read
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No Surprises Act: New Rules and Guidance for Stakeholders (Part 2)
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No Surprises Act: New Rules and Guidance for Stakeholders (Part 1)
Getting Ready for the No Surprises Act- EventsMaking Sense of the No Surprises Act and Interim Final RulesNovember 9, 20212 minute read
- PublicationsU.S. Department of Labor Settles Unprecedented Lawsuit Against United Healthcare for Alleged Violations of the Mental Health Parity and Addiction Equity Act2 minute read
- PublicationsMore Surprises on Surprise Billing: Will Federal or State Law Control?2 minute read
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No Surprises Act: Considerations for Plans and Providers
- PublicationsU.S. Department of Labor Settles Unprecedented Lawsuit Against United Healthcare for Violations of the Mental Health Parity and Addiction Equity Act12 minute read
- PublicationsThe No Surprises Act: New and Surprising Challenges for Clinical Laboratories3 minute read
- PublicationsThe No Surprises Act: A Look at the First Round of Federal Regulations on Surprise Billing3 minute read
- PublicationsMore Surprises on Surprise Billing: Will Federal or State Law Control?11 minute read
- Media CoverageHelaine Fingold Quoted in “Surprise Bill Legislation Means Big Changes for Patients and Hospitals”3 minute read
- PublicationsMental Health and Substance Use Disorder Parity Compliance: Documentation Requirements and Federal Enforcement PrioritiesMarch-April 20212 minute read
- PublicationsThe No Surprises Act: Implications for Health Plans, Health Care Facilities, and Health Care Providers19 minute read
- PublicationsNew Health Care Transparency Requirements: Will They Lower Cost and Improve Quality?11 minute read
- BlogsAcceptable Use of CARES Act Provider Relief Funds – Salary Limitation Update4 minute read
- EventsHealthcare Staffing Shortages Due to COVID-19: Licensure, Credentialing, Reimbursement, Malpractice Considerations2 minute read
- BlogsAppropriate Use of CARES Act Provider Relief Funds11 minute read
- BlogsHHS Relief Fund’s Terms and Conditions - Reporting and Public Disclosure of Payments7 minute read
- Media CoverageEight Epstein Becker Green Attorneys Featured in "Law360 Names Attys Who Moved Up the Firm Ranks in Q1"2 minute read
- BlogsLegal Liability of Healthcare Providers for Care Provided During COVID-19 Pandemic4 minute read
- PublicationsCMS Issues Additional Blanket Waivers to Help Medicare Providers and Suppliers Meet Beneficiaries’ Health Care Needs During COVID-19 Emergency20 minute read
- BlogsHHS Office for Civil Rights Bulletin on Civil Rights Issues During the COVID-19 Crisis4 minute read
- PublicationsNew and Pre-Existing Federal Waivers and Flexibilities Available to Health Care Providers During a National Emergency23 minute read
- Media CoverageHelaine Fingold Quoted in "2019 Part D Misclassifications, Formulary Issues Fueled CMPs"2 minute read
- BlogsThe Impact of the Coronavirus on the Provider-Payor Relationship4 minute read
- BlogsThe Impact of the Coronavirus on the Provider-Payor Relationship4 minute read
- BlogsCongress’s COVID-19 Funding Legislation Expands Access to Telehealth Services for Medicare Beneficiaries6 minute read
- Media CoverageHelaine Fingold Quoted in "Quick Fixes to Improve the Medicare Experience"2 minute read
- Media CoverageHelaine Fingold Quoted in "Senior Confusion About Medicare Advantage Creating Headaches for Patients, Providers"2 minute read
- Firm AnnouncementsEpstein Becker Green Announces 2020 Promotions4 minute read
- BlogsFederal Legislators Express Continued Concerns with Oversight of Medicare Advantage Plans3 minute read
- BlogsOngoing Surprises with Congressional Efforts to Develop Surprise Bill Legislation6 minute read
- BlogsCMS Final Rule Offers the Promise of Additional Telehealth Services for MA Plan Enrollees6 minute read
- Events2019 HCCA: 23rd Annual Compliance Institute1 minute read
- Media CoverageHelaine Fingold Quoted in "Updated CMP Methodology Still Provides CMS Latitude"3 minute read
- BlogsCenters for Medicare & Medicaid Services Proposes Changes to the Methodology for Calculating Medicare Advantage/Part D Civil Money Penalties3 minute read
- PublicationsThe Proposed Expansion of Health Reimbursement Arrangements: Is This a Game Changer for Employers?8 minute read
- PublicationsIs the Affordable Care Act a House of Cards? If Yes, What Does the Recent Texas Court Decision Mean for the US Health Insurance Market and Employers?14 minute read
- EventsHealth Plan Alliance: Government Programs and Risk, Compliance, Privacy & Security Value Visit2 minute read
- Media CoverageHelaine Fingold Quoted in "Marketing Guidelines Feature New Flexibilities for MAOs"2 minute read
- PublicationsFederal Rule Broadens Association Health Plan Opportunities2 minute read
- PublicationsAssociation Health Plans: Federal Rule Broadens Opportunities, but Some States Clamp Down13 minute read
- Media CoverageHelaine Fingold Quoted in "Major Changes to EOC Distribution Will Reduce Plan Burden"3 minute read
- EventsHealth Plan Alliance: Final Call Letter - Take Aways for Medicare Advantage Health Plans1 minute read
- BlogsTri-Agencies Proposed Rule Alters Short-Term, Limited Duration Insurance Offering3 minute read
- BlogsCHRONIC Care Act, Title III of the Bipartisan Budget Act of 2018, Signals Meaningful Change for Medicare Advantage Plans and Telehealth Coverage7 minute read
- BlogsThey Giveth and They Taketh Away: CMS Policy Proposals on Supplemental Benefits under MA Plans4 minute read
- EventsHCCA: 101 Mental Health Parity - Managing Compliance Across Commercial, Medicaid, and Duals Products1 minute read
- PublicationsAssociation Health Plans: New Proposed Rule to Help Convert Small Businesses and Self-Employed Individuals into a Status Similar to Large Group for Access to Affordable Health Insurance13 minute read
- PublicationsSAMHSA Finalizes Additional Changes to the Confidentiality of Substance Use Disorder Patient Records Regulations20 minute read
- PublicationsComment Deadline Approaches for CMS's Proposed Changes to Medicare Advantage and Part D Programs for CY 2019 – Part 2: Beneficiary Cost, Access, and Protection21 minute read
- PublicationsComment Deadline Approaches for CMS's Proposed Changes to Medicare Advantage and Part D Programs for CY 2019 – Part 3: Part D Drug Management Programs Following Adoption of the Comprehensive Addiction and Recovery Act13 minute read
- PublicationsAssessing President Trump's "Executive Order Promoting Health Care Choice and Competition"13 minute read
- PublicationsThe October Deadline for Compliance with Medicaid Mental Health Parity Requirements2 minute read
- EventsAn Overview of MACRA and Its Intersection with Medicare Advantage and Other Medicare and Medicaid Managed Care Programs2 minute read
- Media CoverageHelaine Fingold Quoted in "NPS Is Viewed as Useful, but Not Best as Sole Satisfaction Measure for MA Plans"2 minute read
- PublicationsMACRA Physician Payment Reform: Time to Take Stock of What Is Working and What Changes Are Needed2 minute read
- PublicationsMaryland Is First to Ban "Price Gouging" on Generic Drugs, but Other State and Federal Initiatives May Soon Follow14 minute read
- PublicationsThe Trump Administration's First 100 Days: Impact on the Health Care Industry – a Work in Progress20 minute read
- EventsNational Medicare Advantage Summit1 minute read
- Media CoverageHelaine Fingold Quoted in "2016 Audit Notices Highlight Growing Misclassification Issue"2 minute read
- Media CoverageHelaine Fingold, Kevin Malone Quoted in "Behavioral Health Benefits Shift with GOP Plan"1 minute read
- EventsAdvanced Notice and Draft Call Letter: Changes, Proposals, & Priorities2 minute read
- PublicationsCMS Releases Proposed Rule for ACA Market Stabilization10 minute read
- Media CoverageHelaine Fingold, Adam Solander Quoted in "5 Key Takeaways from Trump's ACA Stabilizer Rule"2 minute read
- Media CoveragePresentations by Helaine Fingold, Thomas Hutchinson, Lynn Shapiro Snyder Featured in "Top Six Health Plan Alliance Presentations of 2016"2 minute read
- Media CoverageHelaine Fingold Quoted in "CMS's Large-Scale Appeals Monitoring Effort Could Have Sweeping Stars Impact"1 minute read
- PublicationsMedicare and Social Security Reform—Over 60 Million Beneficiaries Are Likely to Say "No"2 minute read
- BlogsWhat Does It Mean to Be a Recipient of Federal Financial Assistance for Purposes of Section 1557 Compliance?6 minute read
- PublicationsFive Key Issues Impacting Health Care Employers36 minute read
- Events3rd Annual Payer's Behavioral Health Management Summit: 42 CFR Part 2 - Change Is in the Air, Will It Be Enough to Allow Integrated Care?1 minute read
- Firm AnnouncementsEpstein Becker Green Introduces New Video Series: Thought Leaders in Health Law3 minute read
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Trends in Navigating CMS: Thought Leaders in Health Law Video Series
- PublicationsNondiscrimination Standards Under ACA Section 1557: Now Is the Time to Act25 minute read
- Media CoverageHelaine Fingold Quoted in "On Heels of Secret Shopping Success, CMS May Turn Elsewhere to Find Deficiencies"2 minute read
- Media CoverageHelaine Fingold Quoted in "First Broad-Based Study on MA Networks Highlights Inconsistencies"1 minute read
- PublicationsThe Road to Physician Payment Reform: Key Considerations for MIPS and APM Participation2 minute read
- Media CoverageHelaine Fingold Quoted in “New Marketing Guidelines Contain More Tweaks than Major Changes”1 minute read
- BlogsDistrict Court Invalidates Payment of Cost-Sharing Subsidies, Setting Up Additional Legal Tests for the Affordable Care Act4 minute read
- PublicationsMACRA Proposed Rule: CMS Provides Details on Implementing Medicare's New Quality Payment Program2 minute read
- EventsOverview of Value-Based Payments Efforts Under Medicare - Value-Based Payments Crash Course Webinar Series2 minute read
- PublicationsMental Health Parity Final Rule for Medicaid and CHIP: Few Changes from the Proposed Version32 minute read
- EventsOverview of CMS Star Ratings Program and Its Impact on Medicare Advantage Payment2 minute read
- Media CoverageHelaine Fingold Quoted in "Freezing Insurance Fee Won't Chill Rate-Hike Drivers for 2017"1 minute read
- Media CoverageHelaine Fingold Quoted in "As CMS Rolls Out $9.6M in CMPs, 2015 Audits Show Part D Compliance Defects"2 minute read
- PublicationsDoing the Cha-Cha on Exchange Rules: CMS Moves Forward on Standardized Plan Offerings but Steps Back from Instituting Minimum Network Adequacy Standards39 minute read
- EventsCMS Advance Notice and Draft Call Letter Proposals1 minute read
- PublicationsCMS Proposes Modest Increases to Medicare Advantage and Part D Plan Payment Rates Accompanied by Significant Revisions to Risk Adjustment Methodologies and Employer/Union-Only Group Welfare Plan Bids27 minute read
- Media CoverageHelaine Fingold and Brian Hall Quoted in "CMS Compliance Report Tells Plans to Improve Before 2016 Enforcement"2 minute read
- BlogsNetwork Adequacy: A Multimarket Recap of 2015 and Looking Ahead5 minute read
- PublicationsCMS Continues to Strengthen Federal-Level Requirements for Qualified Health Plans21 minute read
- PublicationsNational Association of Insurance Commissioners Updates Model Network Adequacy Law to Address Narrow Networks and Surprise Bills7 minute read
- PublicationsThe Three Trends That Will Carry Into Next Year2 minute read
- EventsOut-of-Network Billing: The Impact of Consumer Protection Measures on Health Plans and Providers2 minute read
- Media CoverageHelaine Fingold Discusses Health Insurance Coverage Under the Affordable Care Act with Modern Healthcare1 minute read
- PublicationsHHS Releases Far-Reaching Proposed Rule to Prohibit Discrimination by “Covered Entities” Pursuant to Section 1557 of the Affordable Care Act10 minute read
- Media CoverageHelaine Fingold Quoted in "VBID Model Could Boost Quality Metrics for MA Plans, Industry Observers Tell AIS Newsletter"2 minute read
- PublicationsNew Value-Based Insurance Design Model for Medicare Advantage Plans Is the First of Multiple Medicare Plan Innovations Anticipated from CMS9 minute read
- EventsDigesting the Details and Implications - The Medicaid Managed Care Proposed Rule, an MCOL Webinar1 minute read
- EventsManaging Enterprise Risk from the Board of Directors Down1 minute read
- PublicationsCMS Issues Broad-Reaching Proposals to Better Align Medicaid Managed Care with the Commercial and Medicare Markets36 minute read
- Events2015 CMS Audit Protocols - Are You Prepared?2 minute read
- PublicationsMental Health Parity Requirements and Medicaid Plans: CMS Seeks Comment on Proposed Rule29 minute read
- Media CoverageHelaine Fingold, Brian Hall Quoted in "CMS Audits of Qualified Health Plans to Focus on Broker Standards"2 minute read
- Media CoverageHelaine Fingold Featured in "Baltimore Senior Counsel Specializes in Health Care Policy"2 minute read
- PublicationsCMS Announces Key 2015 Compliance Priorities for Federally Facilitated Exchange Plans4 minute read
- EventsAn Update on Innovation and Regulation: Wireless Health Regulations and Medicare Advantage Requirements3 minute read
- PublicationsHigher Bar for “Good Faith Compliance” in Second Year of Exchange Operations1 minute read
- BlogsHigher Bar for "Good Faith Compliance" in Second Year of Exchange Operations2 minute read
- PublicationsCMS Releases Updates to Its Medicare Advantage and Part D Plan Audit Protocols and Processes5 minute read
- BlogsCMS Hosts MLN Connects National Provider Call to Review New CCM CPT Code4 minute read
- PublicationsObama Administration Seeks Comments on Proposed Changes to Summary of Benefits and Coverage Document and Requirements9 minute read
- PublicationsProposed Exemption of Limited Wraparound Coverage from Health Insurance Market Standards7 minute read
- PublicationsCMS Releases Key Proposals for the 2016 Qualified Health Plan Application Process22 minute read
- PublicationsComment Period on Proposed QHP Certification Guidance and Proposed Rule That May Impact Health Insurance Issuers’ Offering of Private Health Insurance Products1 minute read
- BlogsComment Period on Proposed QHP Certification Guidance and Proposed Rule That May Impact Health Insurance Issuers' Offering of Private Health Insurance Products2 minute read
- PublicationsCMS Seeks Comments on Proposed Enhancements and Modifications to the Star Ratings for Medicare Advantage and Part D Prescription Drug Plans15 minute read
- PublicationsHHS Broadens Federal Controls Over Private Health Insurance Benefits and Operations49 minute read
- EventsCompliance Auditing and Monitoring2 minute read
- EventsMedicare Advantage and Prescription Drug Plan Compliance and Oversight2 minute read
- PublicationsCMS Cost Sharing Reduction Reconciliation Reporting for QHPs4 minute read
- PublicationsCMS Requests Input on Health Plan Innovation Initiatives5 minute read
- Media CoverageEpstein Becker Green Client Alert "CMS Final Exchange and Insurance Market Standards" Featured in Express Script's Healthcare Reform Quarterly Update Newsletter2 minute read
- PublicationsHow Big Is Halbig? The Potential Effects of This Major Ruling Are Numerous and Significant13 minute read
- PublicationsCMS's Final Exchange and Insurance Market Standards Impact Qualified Health Plan Filings for 2015 and Beyond12 minute read
- PublicationsCMS Scaled Back Changes to the Medicare Part D Prescription Drug and Medicare Advantage Programs, but Some Important Revisions Remain11 minute read
- Firm AnnouncementsHelaine I. Fingold Rejoins Epstein Becker Green's Health Care and Life Sciences Practice3 minute read
- PublicationsCMS Identifies Key Priorities for 2014 Compliance Reviews of Qualified Health Plans in the Federally Facilitated Marketplace3 minute read