Elizabeth Halpern

2 months ago | jdsupra.com | Brian Carey |Elizabeth Halpern |James Huang

BackgroundMedicare generally only covers or items that are “reasonable and necessary” for the diagnosis or treatment of illness or injury or to improve the functioning of a malformed body member. When CMS issues an NCD establishing whether an item or service is covered by Medicare, it must evaluate clinical, medical, technical, and scientific evidence to determine if the item or service satisfies this reasonable and necessary standard.

Jul 3, 2024 | jdsupra.com | Elizabeth Halpern |James Huang |Stuart Langbein

July 3, 2024 Elizabeth Halpern, James Huang, Stuart Langbein, Rianna Modi, Beth Roberts, Victoria Wallace Hogan Lovells + Follow x Following x Following - Unfollow Contact To embed, copy and paste the code into your website or blog: On June 27, 2024, the Ensuring Access to Breakthrough Products Act of 2024 (H.R. 1691) was marked up and reported out of the House Ways and Means Committee.

Aug 1, 2023 | jdsupra.com | Elizabeth Halpern |Jessica Robinson Hanna |Lindsey Johnson

Declaring that “too often” health plans and health insurance issuers are not complying with the Mental Health Parity and Addiction Equity Act of 2008 (“MHPAEA”), the U.S. Departments of Labor (“DOL”), Health and Human Services, and Treasury (the “Departments”) on July 25 jointly proposed regulations (“Proposed Rule”) that would impose significant obligations on health plans and issuers.

Jul 31, 2023 | lexology.com | Craig Smith |Elizabeth Halpern |Jessica Robinson Hanna |Lindsey Johnson |Abdie Santiago

Declaring that “too often” health plans and health insurance issuers are not complying with the Mental Health Parity and Addiction Equity Act of 2008 (“MHPAEA”), the U.S. Departments of Labor (“DOL”), Health and Human Services, and Treasury (the “Departments”) on July 25 jointly proposed regulations (“Proposed Rule”) that would impose significant obligations on health plans and issuers.

Jun 28, 2023 | jdsupra.com | Elizabeth Halpern |Stuart Langbein |Beth Roberts

Stakeholders may submit comments to the Notice during the comment period, which will end on August 28, 2023. According to a CMS Fact Sheet on TCET, CMS will respond to comments in a final notice. Eligibility to participate in TCETAs proposed, the TCET pathway would facilitate coverage only for devices that have Breakthrough designation from the FDA.