Providers

Navigating the Maze of Healthcare: Essential Insights on Administrative Law for Payers, Providers, and Patients

by

In Washington, D.C., the intricate landscape of administrative law plays a pivotal role in the health care sector, affecting payers, providers, and patients alike. As the regulatory environment evolves, understanding the implications of these laws becomes increasingly important for all stakeholders in medical care. Administrative law governs the actions of governmental agencies and is instrumental in how health care policies are formulated and enforced. This framework not only drives operational protocols within health care organizations but also significantly impacts the relationships among insurers, health care providers, and patients. As the industry grapples with new regulations … Read more

Legal Aid Sector on the Brink: Cyberattack Strikes Agency, Weighing Heavily on Vulnerable Clients and Providers

by

Bristol, England — A cyber attack targeting the Legal Aid Agency has wreaked havoc across the legal sector, significantly affecting legal aid firms that often struggle with limited financial resources. This disruption has raised immediate concerns over the ability of these firms to meet payroll and operational costs in the wake of such a crisis. Beverley Watkins, Managing Partner at Watkins Solicitors, spoke out about the dire situation on BBC Radio 4 and BBC Radio Bristol. With half of her firm’s work focused on legal aid, she described the ramifications of the assault as “devastating,” … Read more

Study Reveals Increased Demand and Emotional Strain on Gender-Affirming Care Providers Amid Legislative Changes

by

The landscape for gender-affirming care (GAC) in the United States is currently a patchwork of varied legislation, with a number of states imposing restrictions that complicate access, particularly for transgender minors. Meanwhile, providers in states without restrictive laws witness diverse repercussions, both professionally and personally. This scenario is highlighted in a recent survey which captures the experiences of GAC providers navigating through these tumultuous waters, amidst increasing legislative barriers in various regions. The survey, which gathered insights from 133 GAC providers, shows how this care landscape is changing. A majority of the respondents, who showcase … Read more

Texas’ Gold Card Experiment Stalls: Why Few Providers Win Exemption from Prior Authorizations

by

Austin, Texas — To streamline the medical preauthorization process for physicians, several states, including Texas, have introduced “gold card” laws aimed at exempting commonly approved procedures or prescriptions from repetitive checks. However, the anticipated simplification has not unfolded as expected, and the laws often fall short of their promise. Under the 2021 Texas gold card law, a health insurer or health maintenance organization (HMO) is required to waive preauthorization if a provider has had a 90% or higher approval rate during a six-month evaluation. This exemption, designed to be automatic, should relieve some of the … Read more