by Gustavo Matheus | Jun 13, 2022 | Insurance Coverage Disputes
On April 27, 2022, the Office of the Inspector General for the U.S. Department of Health and Human Services (“OIG”) released a report finding that Medicare Advantage Organizations (“MAOs”) are issuing unnecessary denials resulting in delayed care for patients and...
by Hailey Groover | Mar 2, 2022 | Insurance Coverage Disputes
By: Hailey Groover, Legal Assistant Conflicts in Coordination of Benefits Under Maryland Insurance Article § 15-1008 Healthcare providers occasionally run into situations where a patient will have coverage under two health plans. Ironically, because of...
by Admin Anderson Quinn | Aug 4, 2021 | Healthcare Reimbursement, Healthcare Updates, Managed Care - General, Managed Care Reimbursement
Why Insurance Article § 15-1009 Should be Applicable to Managed Care Organizations This is the second of two articles regarding Maryland laws in need of updating. By: Jason C. Anderson and Gustavo Matheus In our last article, found here, we discussed the need for...
by Admin Anderson Quinn | Jun 3, 2021 | Healthcare Reimbursement, Healthcare Updates, Managed Care - General, Managed Care Reimbursement
Why Healthcare Providers Should Insist on Laws Requiring Payment of Services Denied for Lack of Authorization: A Maryland MCO Case Study. This is the first of two articles regarding Maryland laws in need of updating. By: Robert P. Scanlon and Gustavo Matheus Two of...
by Christopher Oram | Nov 12, 2020 | Appeals and Denials, COVID-19 Updates
You might think that a health insurance company would not possibly contest the hospital treatment of an insured patient severely ill with COVID-19. Think again. COVID-19, also known as coronavirus, has created a global pandemic. More than 230,000 Americans have died...
by Jason Anderson | Jul 21, 2020 | Denied Claim Appeals, Denied Claims Litigation, General Litigation, Healthcare Reimbursement, Hospital Reimbursement, Managed Care - General, Managed Care Reimbursement, Medicaid Reimbursement
Why litigation may be the best option in Maryland to recover denied claims Since its inception in 1997, Maryland’s HealthChoice program has expanded to provide healthcare coverage to a majority of Maryland’s Medical Assistance (“Medicaid) recipients. Through its...
