Blog: Healthcare Lawyers, Attorneys, Consultants, Firm

A Medi-Spa Practitioner’s Refresher on Medical Necessity and Cosmetic Treatments

A Medi-Spa Practitioner’s Refresher on Medical Necessity and Cosmetic Treatments

In Illinois, almost all health insurance companies and HMOs pay claims based on medical necessity. If a treatment is deemed to be medically necessary, an insurance company or HMO will likely pay the claim on that treatment. However, if a treatment is deemed to be purely cosmetic and not medically necessary, then an insurance company...

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Is Obamacare here to stay?: 3 Things to Expect in 2018

Is Obamacare here to stay?: 3 Things to Expect in 2018

Despite their efforts and actions to repeal Obamacare, the GOP did not have the sweeping success they had anticipated for 2017. As the new year begins, let’s take a look at the current state of the Affordable Care Act and how it will affect patients and providers in 2018.

With the 2018 midterm elections rapidly approaching, change may be this year’s only...

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3 Reasons Healthcare Providers Should Oppose Medicaid Work Requirements

3 Reasons Healthcare Providers Should Oppose Medicaid Work Requirements

Healthcare providers accepting Medicaid may see their patient volume decrease in coming months, the result of a plan recently approved by the federal government to grant states the authority to impose work requirements on Medicaid...

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3 Things to Know about Concierge Medicine

3 Things to Know about Concierge Medicine

Hate watching your afternoon tick by on a waiting room clock? Disgusted by Susie Sniffles lobbing definitely-contagious sneezes in your direction? Already caught up on your entertainment news? If this describes you (or your patients!), you may be ready to jump on the concierge medicine...

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How to Shop for Health Insurance {Deadline: December 15!}

How to Shop for Health Insurance {Deadline: December 15!}

It's time to purchase health insurance for 2018. As President Trump's first year in office winds down, the health insurance market is experiencing astounding turbulence. We answer your top 3 questions to help you cruise through Open Enrollment season without losing your...

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What you need to know about preexisting conditions

What you need to know about preexisting conditions

As Republicans work to make good on their campaign promises to repeal the ACA, coverage for those with preexisting conditions hangs in the balance. If the GOP can successfully repeal the insurance protections extended by the ACA to those with preexisting conditions, about 130 million Americans may see their healthcare costs...

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Life insurance company settles HIPAA breach for $2,200,000​​​​​​​

Life insurance company settles HIPAA breach for $2,200,000​​​​​​​

The U.S. Department of Health and Human Services announced a HIPAA settlement after MAPFRE Life Insurance Company of Puerto Rico disclosed unsecured electronic protected health information...

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How to Integrate the End of Medicare’s “Failure to Improve” Standard into Your Clinical Practices

How to Integrate the End of Medicare’s “Failure to Improve” Standard into Your Clinical Practices

If a Medicare patient has achieved their maximum level of recovery, and additional therapy would not help them improve beyond that point, then additional treatment isn’t warranted or medically necessary. Plus, Medicare surely won’t foot the bill.  You, their PT, think that additional therapy would help them from getting worse, but that’s not the standard. It’s time to discharge them,...

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Legal update: Insurance coverage for telehealth

Legal update: Insurance coverage for telehealth

Where I live in Chicago, the population density is about 10,000 people per square mile.  Generally, if an area has less than 1,000 people per square mile, it’s considered to be a “rural area.”  Before this spring, private insurance plans in Arizona were only required to cover telehealth services rendered to those living in rural areas.  But as of May 17th, they’re required to cover telehealth services...

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How to Avoid Being Surprised by a Medical Malpractice Lawsuit

How to Avoid Being Surprised by a Medical Malpractice Lawsuit

The provider-patient dynamic has long been plagued by paternalistic decision-making, timid patients, and communication failures.  I believe that the system is the problem, not thepeople who comprise it.  And the system is inextricably linked to the insurance companies, the business of hospital management, and the exhausting balancing of practice profits against patient...

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