Starting January 1, 2022, it will be illegal for providers to bill patients for more than the in-network cost-sharing due under patients’ insurance in almost all scenarios where surprise out-of-network bills arise, with the notable exception of ground ambulance transport. Health plans must treat these out-of-network services as if they were in-network when calculating patient cost-sharing. The legislation also creates a new final-offer arbitration process to determine how much insurers must pay out-of-network providers. If an out-of-network provider is dissatisfied with a health plan’s payment, it can initiate arbitration. The arbitrator must select between the final offers submitted by each party, taking into consideration several factors including the health plan’s historical median in-network rate for similar services.
Read moreHuawei agreeing to ‘mediation’ with Verizon a positive gesture?
Chinese telecom giant Huawei Technologies has reportedly agreed to “private mediation” in one of the two lawsuits it brought against US carrier Verizon over patent royalties, in what could be a positive development in the Chinese firm’s troubled standing in the US.
Read moreArbitration clauses and class actions: the cross-border dialogue continues in light of recent SCC and SCOTUS jurisprudence
The policy rationales that underpin enforcing arbitration agreements may potentially be at odds with those underpinning the class actions regime (see our previous posts here and here). These policy rationales collide when confronting the question of whether plaintiffs can waive their right to participate in a class action through a mandatory arbitration clause and, if so, when this is permissible. Canada and the United States continue to have different approaches to the question of who decides whether a dispute is arbitrable – the arbitrator or the court? With respect to enforcement in the class action context, courts in the United States tend to enforce arbitration clauses such that class actions are precluded. However, in Canada an arbitration clause that acts as a barrier to dispute resolution may be unenforceable and precluded by certain legislation.
Read moreIn brief: selecting mediators in USA
Is there a professional body for mediators, and is it necessary to be accredited to describe oneself as a ‘mediator’? What are the key requirements to gain accreditation? Is continuing professional development compulsory, and what requirements are laid down?
Read moreThe Benefits Of More Alternative Dispute Resolution At GAO
In late December, the U.S. Government Accountability Office issued its highly anticipated Bid Protest Annual Report to Congress.[1] The statutorily mandated report contains an array of information about the GAO's bid protest forum over the prior fiscal year, including the most prevalent reasons the GAO sustained protests along with a variety of statistical data.
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