As part of the agreement, EmblemHealth will provide full restitution to members who paid out-of-pocket for gender reassignment surgical procedures after denial of coverage by EmblemHealth. For the full article please click here. … [Read more...] about NY Settlement with EmblemHealth Requires Insurance Company to Cover Gender Reassignment Surgery for Members
Cohen Howard Scores Another Big Win For Out-of-Network Provider Community
Law360 (December 11, 2018, 10:09 PM EST) has published an article covering another case in which Cohen Howard has successfully challenged the under-reimbursement of authorized medical services rendered by our client, an out-of-network provider. For … [Read more...] about Cohen Howard Scores Another Big Win For Out-of-Network Provider Community
NJ Surprise Bill Regulatory Alert — DOBI Publishes Implementation Bulletin
On November 20, 2018, The New Jersey Department of Banking and Insurance (“DOBI”) released Bulletin No. 18-14 (the “Bulletin”) relating to Implementation of P.L. 2018 C. 32 (N.J.S.A. 26:2SS-1 to -20) Out-of-Network Consumer Protection, Transparency, … [Read more...] about NJ Surprise Bill Regulatory Alert — DOBI Publishes Implementation Bulletin
Cohen Howard represents Out-of-Network Spinal Surgeon and prevails against BCBS of NJ
Out-Of-Network Health Care Provider Isn’t Seeking ERISA Benefits, Judge Says (Lexis Legal News) TRENTON, N.J. — An out-of-network provider is not a beneficiary of an Employee Retirement Income Security Act plan (ERISA), and because the plan … [Read more...] about Cohen Howard represents Out-of-Network Spinal Surgeon and prevails against BCBS of NJ
Cohen Howard Represents Out-Of-Network Provider and DEFEATS Aetna in motion to dismiss in Federal Court
Cohen Howard represents out-of-network orthopedic surgeon on September 25, 2018 in suit filed against Aetna. Federal Court denied motion to dismiss case, finding that State law claims were not preempted by ERISA. Please click link below for media … [Read more...] about Cohen Howard Represents Out-Of-Network Provider and DEFEATS Aetna in motion to dismiss in Federal Court
ALERT: DOBI Issues a “Synopsis of the Implementation” of the NJ Surprise Bill
On August 27, 2018, the Department of Banking and Insurance issued a "Synopsis of the Implementation of the Out-of-Network Consumer Protection, Transparency, Cost Containment and Accountability Act" (the "Synopsis"). The Synopsis is intended to … [Read more...] about ALERT: DOBI Issues a “Synopsis of the Implementation” of the NJ Surprise Bill
Anti-Assignment Clause Ruling Requires New Forms
In order to facilitate proper claim reimbursements and to file health benefit claims on behalf of your patients, your Assignment of Benefits and Designated Authorized Representative Form(s) must be updated to include a Limited Special Power of … [Read more...] about Anti-Assignment Clause Ruling Requires New Forms
Webinar: Conquering NJ’s Out-Of-Network Consumer Protection Act
On July 9th Leslie Howard hosted a live webinar and that outlined the impact of the NJ Surprise Bill for the OON provider community. In an effort to protect consumers from unexpected medical bills, the NJ law prohibits balance billing for "emergency … [Read more...] about Webinar: Conquering NJ’s Out-Of-Network Consumer Protection Act
Leslie Howard Speaks At The NJDPA Practice Enhancement Seminar
The conference room of the APA Hotel in Woodbridge was filled to capacity Monday, June 11, for the New Jersey Doctor-Patient Alliance Practice Enhancement Seminar focusing on what independent providers should do to prepare for the uncertainty coming … [Read more...] about Leslie Howard Speaks At The NJDPA Practice Enhancement Seminar
NJ Surprise Bill
On Monday, June 11, Leslie Howard shared her insights on the NJ Surprise Bill at the NJ Doctor-Patient Alliance (NJDPA) Meeting to a packed audience of 250 healthcare providers and professionals. She provided a comprehensive roadmap of the bill's … [Read more...] about NJ Surprise Bill