Medical Insurer Contract Violations

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Health insurers are abruptly terminating …

https://www.healthcarefinancenews.com/news/health-insurers-abruptly-terminating-physician-contracts

Proposed surprise medical bill legislation has coincided with a significant number of insurance contract terminations. Physician anesthesiologists are being forced out of network as insurance …

Breach of Contract - Stop Insurance Denial Law Firm

https://www.stopinsurancedenial.com/services/denials/breach-of-contract

Insurance is a legally binding contract between the insurer and the insured. If your claim for coverage is wrongfully denied, you can establish a case for breach of contract. This …

Provider Rights and Responsibilities - Department of …

https://www.dfs.ny.gov/consumers/health_insurance/rights_responsibilities

The Insurance Law and Public Health Law include important protections for health care providers with respect to network participation, provider contracting, claims processing, …

NASHP Model Act to Address Anticompetitive Terms in …

https://nashp.org/nashp-model-act-to-address-anticompetitive-terms-in-health-insurance-contracts/

[Commentary: Some states have a code section in their insurance or business codes defining unfair and deceptive acts or practices (UDAP) in the business of …

Compliance and Enforcement | CMS

https://www.cms.gov/CCIIO/Programs-and-Initiatives/Health-Insurance-Market-Reforms/compliance

In the event that a state notifies the Centers for Medicare & Medicaid Services (CMS) that it does not have statutory authority to enforce or that it is not …

Provider Contracts - The Source on HealthCare Price …

https://sourceonhealthcare.org/provider-contracts/

The settlement terms require Sutter Health to cease anticompetitive bundling of services, all-or-nothing contracting with must have facilities, and increase transparency in pricing. …

$91 million case against nation's largest insurer is …

https://www.cnn.com/2019/01/28/health/california-supreme-court-insurance-commissioner-decision/index.html

The California Supreme Court in early January decided to let stand a decision by an appeals court affirming $91 million in fines against UnitedHealthcare, the nation's largest insurance company ...

Negotiating Insurance Contracts: Tips for Providers

https://payrhealth.com/resources/blog/negotiating-insurance-contracts/

While healthcare contract management along with negotiating insurance contracts is widely regarded as a difficult and sometimes contentious process, it is also a necessary …

Anticompetitive Conduct by Commercial Health …

https://www.aha.org/guidesreports/2021-08-16-anticompetitive-conduct-commercial-health-insurance-companies

For decades, the commercial health insurance industry has largely escaped close scrutiny for conduct and practices that adversely impact both consumers and …

Insurance Company Bad Faith Tactics and Examples

https://www.findlaw.com/consumer/insurance/insurance-company-bad-faith-tactics-and-examples.html

It’s even worse when your insurance company doesn’t live up to their end of the contract. Your insurance company is required to investigate, negotiate, and settle …

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