Managed Care Law Manual

Managed Care Law Manual is a unique legal guide specific to managed care filled with the facts health care attorneys, managed care organizations, and health care administrators need to make informed choices. This legal guide will help you know not only your legal obligations, but also those of your contracting partners, employers, third-party payers, physicians, and others so you can form the joint alliances that will be essential in the health care reform days ahead. This manual is always current with twice a year updates. Managed Care Law Manual has been updated to include: - New information on CMS's proposed rule on the Medicare shared savings program for accountable care organizations
- Up-to-date material on civil monetary penalty sanctions under the Health Insurance Portability and Accountability Act
- Information on states that require coverage for autism treatment
- Updated material on states that require health plans to cover patient care costs in clinical trials
- Case law regarding unreasonable restraint of trade
- New material on state external review laws
- Recent ERISA case law addressing claims based on denial of coverage
- Seff v. Broward County, a recent case dealing with voluntary wellness programs and the Americans with Disabilities Act (ADA)
- New case law addressing false claims and credentialing
- Recent OIG advisory opinions regarding the Anti-Kickback statute
- Up-to-date material regarding state false claims acts
- Information on the recently released IRS/Treasury Priority Guidance Plan
- New CMS guidance regarding Medicare Advantage (MA) marketing and enrollment
- Recent case law regarding mental health coverage