The budget reconciliation bill passed the House of Representatives by a one-vote margin, 215 to 214, and soon will be considered by Senate committees. The day before the House vote, the Rules Committee...
State regulations on housing discrimination protect individuals even when they are not otherwise included under federal law. Explore this U.S. 50 state, District of Columbia, and U.S. territories law survey...
Artificial intelligence (AI) is no longer a future consideration—it’s a core component of how businesses operate today. From automating workflows to powering proprietary tools, AI is reshaping...
This checklist covers the applicability of artificial intelligence (AI) in areas critical to life sciences and healthcare companies, including data privacy, intellectual property, and research and development...
Do you need to understand key labor and employment considerations for companies and their legal counsel navigating mergers and acquisitions and other business transactions? Review our recently published...
* The views expressed in externally authored materials linked or published on this site do not necessarily reflect the views of LexisNexis Legal & Professional.
Learn about external review of adverse determinations involving claims for payment for healthcare services under commercial health insurance policies. Gain insights on the mechanism that must be in place to allow for review of denied healthcare claims. Understand how the National Association of Insurance Commissioners (NAIC) Uniform Health Carrier External Review Model Act (Model Act) serves as the foundation for federal and state external review requirements. Assess the interaction between the Model Act and the Patient Protection and Affordable Care Act (ACA), the latter of which requires insurers to provide an external review opportunity. Consult this practice note for guidance on issues including providing notice of external appeal rights and insurer policies and procedures.
Read now »
Related Content
Legal Developments
Practical Guidance Updates Featuring the latest updates from your Practical Guidance account.
Experience results today with practical guidance, legal research, and data-driven insights—all in one place.Experience Lexis+