Barry Senterfitt is a partner in the insurance industry practice of Akin Gump Strauss Hauer & Feld LLP in the firm's Austin, Texas, office.
Review health risk assessment use under new GINA rules
Financial incentives and penalties are no longer permitted when genetic information is requested on health risk assessments
Political maneuvering misses the point on rising costs
Few are paying attention to the cost curve and the potential for state to enact their own reform measures
Silent PPOs under scrutiny
Model legislation adopted by NCOIL provides that the third party accessing the contract must comply with contacting terms
Employer-mandated spending requirement challenged
The Golden Gate Restaurant Association argues that contributions to San Francisco's Health Access Program under a 2006 ordinance are preempted by ERISA
Economy causes greater scrutiny of insurers
In the midst of current financial turmoil, the industry entrusted with the greatest accumulation of funds is the insurance industry. MCOs and HMOs should expect greater scrutiny of their finances.
Proposed HIPSA Legislation Intends to Tighten Privacy Rules
Sens. Leahy and Kennedy have introduced the Health Information Privacy and Security Act of 2007 (HIPSA), which if enacted into law, would require HHS to revise HIPAA.
Understand choice, implications of law principles
Choice of law issues arising from coverage disputes of both individual and group insurance policies many times determine which party will prevail on the merits of a particular case. Also, in today's mobile economy, insurance transactions frequently cross state boundaries.
Corporate practice of medicine seen as ancient approach
The Illinois Supreme Court recently confirmed that the corporate practice of medicine doctrine is still alive and well in the state of Illinois. In Vine Street Clinic, et al. v. HealthLink Inc., the court concluded that percentage-based fees charged by the owner of a healthcare provider network were illegal under the state's medical practices act.
False Claims Act proves difficult to fight
The federal False Claims Act (FCA) is the government's primary weapon to combat fraud. It empowers the federal government to file actions against those alleged to have knowingly submitted false or fraudulent claims to the government. Since 1986, the Department of Justice has recovered more than $15 billion under the law.
Anticompetitive activities may not give rise to antitrust claim
The Supreme Court has referred to U.S. antitrust laws as the Magna Carta of free enterprise-a set of laws as important to the preservation of economic freedom as the Bill of Rights is to the protection of personal freedoms. While these laws are typically enforced by state and federal governments, i.e., the Department of Justice and state attorneys general, they also provide for a private right of action enforceable by persons who have been injured by activities that are forbidden by the antitrust laws.
Solvency regulation helps minimize economic failures
Health insurance is one of the most regulated industries in the world. Within its comprehensive regulatory scheme, there are several laws that are designed to assure the solvency of health insurance companies and HMOs. These laws limit and restrict the types of investments that these companies may own, dictate the level of capitalization they must maintain, and establish other solvency measures.
Non-profit insurers follow the conversion trend
For the past several years, non-profit health plans and insurers have been converting to for-profit corporations (or have been acquired by for-profit enterprises) in an effort to gain access to capital markets, to expand their service area, and/or to add to their product lines. In most states, the Blue Cross Blue Shield plans are no longer non-profit.
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