The mask itself didn’t raise any suspicions. After all, the man wearing it—Richard Toussaint--was an anesthesiologist. But like so many other masked men, he turned out to be a thief. That’s why on March 4 he was convicted in a Texas federal court on seven counts of health care fraud totaling about $10 …
Battle Over Cost of Drugs Ratchets Up
May 30, 2014 Leave a Comment
The battle over the rising costs of drugs, fueled by Gilead's Hepatitis C drug Sovaldi that costs $84,000 for a 12 week treatment regimen, intensified this week. Critics of the cost have taken to referring to the drug as the "1,000-a-day" pill. Earlier this week, the National Coalition on Health Care launched its …
Minnesota Health Insurance Exchange Coming Soon
March 25, 2013 Leave a Comment
Minnesota is on the brink of passing a law that would establish a Minnesota health insurance exchange. The "Minnesota Insurance Marketplace Act" passed the Minnesota legislature and is on its way to Governor Dayton's desk for signature. He is expected to sign the bill. Minnesota is one of only 18 states that have …
Effective Date of Summary of Benefits and Coverage Delayed
November 21, 2011 Leave a Comment
On November 17, the DOL issued its FAQs About Affordable Care Act Implementation Part VII and Mental Health Parity Act. These FAQs clarify the effective date of the Summary of Benefits and Coverage ("SBC") required under section 2715 of the Public Health Services Act, as amended by PPACA. The DOL previously …
Essential Health Benefits and Minimum Essential Coverage
November 16, 2010 1 Comment
Essential health benefits and minimum essential coverage are two phrases used throughout the health care reform law and although they sound similar, each has very different meanings and implications under health reform. A common assumption is minimum essential coverage is required to cover essential health …
Just Released: HHS Application Procedure for Annual Dollar Limit Waivers
September 8, 2010 Leave a Comment
In an earlier post, we discussed the interim final regulations issued relating to the prohibition of annual dollar limits on essential health benefits. Those regulations also provided that these restricted annual limits could be waived by the Secretary of HHS if compliance with the regulations would result in a …