Legal Solutions  Blog

Payment for Durable Medical Equipment (DME) has become one of the “hot points” for control of Medicare program expenses, bringing attorneys into struggles over regulations and their fact-intensive applications.  There are many seniors and disabled individuals for whom power wheelchairs and scooters are essential to normal daily living activities.  Such DME is often billed to Medicare. [...]

Many retirees expect to receive continuing health care benefits for their lifetimes.  However, these expectations are often being dashed as employers respond to financial pressures by reducing these benefits. Two current cases point out the legal struggles that may result, and the issues on which debates over retiree health benefits may turn. In the Witmer v. Acument Global [...]

The “premium subsidy program” under the Affordable Care Act (ACA) is intended to make it feasible for limited-income individuals to purchase individual health insurance coverage.  But patients are going to need extensive attorney help to cope with program requirements. The new individual mandate requires coverage, and the concept is to “ease” this demand with partial premium support, [...]

“Medical coding” sounds like a “back-office” aspect of health care that is not really of everyday interest to most attorneys, but the reality is very different.  Efforts are being made to computerize the practice of medicine, and all patients will be directly affected.  New regulations have recently been released to move forward this vision of “categorized care” [...]

The Department of Health and Human Services (HHS) is moving ahead with a Medicare Shared Savings Program that is intended to change physician behavior. Physicians are being placed in the position balancing off patient wishes and needs—on one side—against an opportunity to receive bonus payments for reducing services on the other side. The result will be conflict [...]

 (Editor’s Note:  This is part four of a four-part installment on “How the New Health Care Plan Has Been Misunderstood, Misrepresented, and Mismanaged.”)   The Affordable Care Act has now been ruled constitutional by the U.S. Supreme Court, except for a section of the Act that could be used to penalize states for not expanding their Medicaid [...]

(Editor’s Note: This is part three of a four-part installment on “How the New Health Care Plan Has Been Misunderstood, Misrepresented, and Mismanaged”.) Critics have painted a negative picture of the new Plan as reducing choice by forcing individuals to purchase insurance.  However, it may realistically be argued that the individual mandate ultimately results in expanding choice by [...]

(Editor’s Note: This is part two of a four-part installment on “How the New Health Care Plan Has Been Misunderstood, Misrepresented, and Mismanaged”.) In order to understand what has been happening in the debate over health care during the past two years, it is helpful to examine how the U.S. Health Care System is structured. The fundamental structure [...]

(Editor’s Note: This is part one of a four-part installment on ” How the New Health Care Plan Has Been  Misunderstood, Misrepresented, and Mismanaged”.) Americans place significant value on the diversity of options in the health care system. This includes variety among providers as well as among insurers and other payment options. The New Health Care Plan has been painted [...]

The new Health Plan is producing widespread conflict among individuals and organizations affected by the ongoing redesign of the Health Care System (as discussed in Legal Practice Implications of the New U.S. National Health Care Plan, 2011-2012 Edition , by Mitchell and Mitchell, published by Thomson Reuters/Westlaw). As a result of distractions over the past year due to the [...]

Based on the three days of oral arguments before the Supreme Court, the ruling to be made regarding the new national Health Care Plan (the Affordable Care Act) appears to be impossible to predict —options range from finding the law fully constitutional to fully unconstitutional, and include a range of in-between rulings that could discard parts of [...]