September 25, 2020

Volume X, Number 269

September 25, 2020

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September 24, 2020

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September 23, 2020

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Michael P. v. BCBS of Texas [PODCAST]

In this week’s episode, Gary Qualls discusses a recent case decided in the Western District of Louisiana, which highlights how the application of the arbitrary and capricious standard as applied to payor coverage determinations can, in some instances, favor the patient. Mr. Qualls discusses how this case was decided and what providers can learn from the court’s reasoning.

Copyright 2020 K & L GatesNational Law Review, Volume X, Number 218

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About this Author

Gary Qualls, KL Gates Law Firm, Healthcare Attorney

Mr. Qualls focuses his practice on representing health care clients. He litigates, arbitrates, and mediates healthcare disputes, including disputes involving the following issues: certificate of need; licensing and certification; payment and reimbursement; HIPAA; contracts of all types; medical staff privileges; EMTALA; and civil monetary penalties. He provides a broad range of legal services to the following types of providers: hospital systems; nursing facilities; adult care facilities; continuing care retirement facilities; home health and hospice agencies; dialysis...

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