bhoffman | August 25, 2010
Coordination of Benefits Handbook
In a case that does not involve a health plan subject to ERISA, a Florida appellate court ruled that a health plan’s reimbursement from the proceeds of a settlement of a medical malpractice case was limited to the amount paid by the plan less its pro-rata share of attorney’s fees incurred by [...]
Adam V. Russo | June 28, 2010
Florida. The state legislature is ready to cut Medicaid funding for nursing homes and is considering cuts to numerous other health programs to balance the budget. The proposed 7% cut to Medicaid payments rates for nursing homes totals approximately $200 million. Nursing homes likely would be able to offset at least part of the $200 [...]
Adam V. Russo | June 28, 2010
Twenty states so far have rejected federal funds to administer a high-risk insurance pool, as designed by the Patient Protection and Affordable Care Act. The high-risk pool would extend coverage to state residents unable to purchase insurance because of preexisting medical conditions. In these states, the federal government will be responsible for creating and running [...]
Adam V. Russo | June 28, 2010
NASP, www.subrogation.org
Florida attorneys and recovery specialists should be aware that the Florida Bar Association Board of Governors is looking to adopt a rule change to the fee limits that are placed on contingency fees that will allow attorneys who fight against subrogation liens to charge a fee separate from or in excess of the contingency [...]
Adam V. Russo | February 23, 2010
Florida. To avoid a legislative mandate on the issue, major health insurers in the state have agreed to pay for care for members diagnosed with cancer who participate in clinical trials. The “Clinical Trials Compact” ensures that cancer patients will receive continued benefits while being treated with experimental drugs and other therapies. Participating insurers are: [...]
Adam V. Russo | February 4, 2009
Forty-seven states ban in-network providers from billing insured patients more than their required copayment or deductible and federal law prohibits providers from billing Medicare beneficiaries for unpaid balances. Some states also ban additional charges for insured patients who seek care from out-of-network providers and emergency departments. While national statistics on the practice are unavailable, economists [...]
Adam V. Russo | October 16, 2008
The legislature has passed a health package that would allow insurers to offer “no-frills” coverage to the state’s 3.8 million uninsured residents. Under the plan, residents ages 19 to 64 could purchase limited health coverage for as little as $150 per month. Insurers offering such coverage would be exempt from mandates. Policies can cover preventive [...]
