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Articles by Gregory Mitchell
LETTER: Utah's workforce needs seat at the table
To the editor, Utah’s greatest economic asset has never been a particular industry. It is the people who keep building the next one. From construction sites to technology companies, Utah has developed a workforce known for turning ideas into businesses and projects into reality. More than 11,000 electricians work across the state, alongside thousands of other skilled tradespeople whose expertise is increasingly needed as new industries take root.
Expectant mothers in rural Tanzania need a new maternity ward. Here’s how you can help
Help build a maternity ward for expectant mothers in rural Tanzania: LifeFunder (LifeSiteNews) — Sister Dr. Mpeli Jacob Mwakyelu is the OB/GYN physician at Mwambani Mission Hospital in the Southern Highlands of southwestern Tanzania. She describes her practice not in statistics, but in distance. “Sometimes we need to go far away more than 2 km to follow the woman for us to help their complications and solve their problem.” She is not describing an exceptional event.
Budget reconciliation’s effect on New York’s Medicaid and Essential Plan funding | JD Supra
The budget reconciliation process resulting in the One Big Beautiful Bill Act, which was enacted on July 4, 2025, contains many significant changes to the Medicaid program. Many of the changes, such as those related to work requirements, provider taxes, and state directed payments, will have nationwide implications.
New York Executive Budget Proposes Amendments to MCO Provider Tax | JD Supra
The New York State Executive Budget for Fiscal Year (FY) 2026 proposes significant updates to the managed care organization (MCO) provider tax, aiming to enhance Medicaid funding through innovative financial strategies. The budget proposes amendments to codify the tax structure and plan for spending over the next three years, with a projected $3.7 billion in savings to the state.
New York Executive Budget Proposes Patient Consent to Payment Law Updates | JD Supra
KEY UPDATE The recently released New York State Executive Budget for Fiscal Year 2026 contains proposed revisions to a recently enacted law impacting how healthcare providers obtain patients’ consent to payment. NY Public Health Law (PHL) § 18-c currently requires that patients provide consent for payment separate from consent to receive healthcare services. That consent to payment cannot be given before the provider discusses treatment costs with the patient and the patient receives services.
New York Governor Proposes Cost Market Impact Review, Expanded Disclosures for Material Transactions With Healthcare Entities | JD Supra
Overview On January 21, 2025, New York Governor Kathy Hochul released the FY 2026 New York State Executive Budget, which proposed to impose a “cost market impact review” (CMIR) for certain “material transactions” involving “health care entities” in New York. The New York State Assembly and Senate must now review the proposed legislation and may propose revisions to, or removal of, the proposal before approving the final FY 2026 state budget.
NY Providers Take Note: New Consent to Payment Laws Effective October 20 | JD Supra
KEY UPDATE On October 20, 2024, two new laws will take effect in New York that impact how healthcare providers obtain consent to payment and collect payments from patients. These laws will affect all providers, particularly those who maintain patients’ credit card information on file, including many digital health providers.
State Regulators Address Insurers’ Use of AI: 11 States Adopt NAIC Model Bulletin
In December 2023, the National Association of Insurance Commissioners (NAIC) adopted a Model Bulletin on the Use of Artificial Intelligence (AI) Systems by Insurers. The model bulletin reminds insurance carriers that they must comply with all applicable insurance laws and regulations (e.g., prohibitions against unfair trade practices) when making decisions that impact consumers, including when those decisions are made or supported by advanced technologies, such as AI systems.
State Regulators Address Insurer's Use of AI: 11 States Adopt NAIC Model Bulletin
In December 2023, the National Association of Insurance Commissioners (NAIC) adopted a Model Bulletin on the Use of Artificial Intelligence (AI) Systems by Insurers. The model bulletin reminds insurance carriers that they must comply with all applicable insurance laws and regulations (e.g., prohibitions against unfair trade practices) when making decisions that impact consumers, including when those decisions are made or supported by advanced technologies, such as AI systems.
State Regulators Address Insurers’ Use of AI: 11 States Adopt NAIC Model Bulletin | JD Supra
In December 2023, the National Association of Insurance Commissioners (NAIC) adopted a Model Bulletin on the Use of Artificial Intelligence (AI) Systems by Insurers. The model bulletin reminds insurance carriers that they must comply with all applicable insurance laws and regulations (e.g., prohibitions against unfair trade practices) when making decisions that impact consumers, including when those decisions are made or supported by advanced technologies, such as AI systems.
Model Bulletin on the Use of Artificial Intelligence (AI) Systems by Insurers
In December 2023, the National Association of Insurance Commissioners (NAIC) adopted a . The model bulletin reminds insurance carriers that they must comply with all applicable insurance laws and regulations (e.g., prohibitions against unfair trade practices) when making decisions that impact consumers, including when those decisions are made or supported by advanced technologies, such as AI systems.
New York Institutes New Tax on Health Plans for Insurers, Managed
The New York State fiscal year 2024 – 2025 budget was signed on April 20, 2024, instituting, among many other provisions, a new tax on health plans, including insurers and managed care organizations. This tax has been garnering attention for its promise to yield $4 billion for New York State.
New York State Budget Institutes Revenue-Neutral Health Plan Tax | JD Supra
The New York State fiscal year 2024 – 2025 budget was signed on April 20, 2024, instituting, among many other provisions, a new tax on health plans, including insurers and managed care organizations. This tax has been garnering attention for its promise to yield $4 billion for New York State.
New York State Budget Institutes Revenue-Neutral Health Plan Tax
The New York State fiscal year 2024 – 2025 budget was signed on April 20, 2024, instituting, among many other provisions, a new tax on health plans, including insurers and managed care organizations. This tax has been garnering attention for its promise to yield $4 billion for New York State.
New York Withdraws Proposed Market Conduct Regulations for PBMs, Adopts Licensure Rules | JD Supra
OVERVIEW On October 31, 2023, the New York State Department of Financial Services (DFS) released a notice withdrawing its proposed market conduct rules for pharmacy benefit managers (PBMs). The proposed rules, announced August 16, 2023, would have significantly increased the state’s oversight of PBMs. At the same time, DFS finalized licensure rules for PBMs, to be effective November 15, 2023.
CMS Announces New Guide Model for People Living with Dementia and Their Caregivers
Skip to main content October 31, 2023 Volume XIII, Number 304 Legal Analysis. Expertly Written. Quickly Found. Trending News CMS Announces New Guide Model for People Living with Dementia and Their Caregivers Print Mail Download i The US Centers for Medicare & Medicaid Services (CMS) recently announced a new, voluntary and nationwide test model designed to support two rapidly growing demographic groups: people living with dementia, and their unpaid caregivers.
New York Proposes Regulations Expanding State’s Ability to Regulate Pbms
Friday, September 8, 2023 The New York State Department of Financial Services (DFS) recently announced the publication of proposed regulations that would increase the state’s oversight of pharmacy benefit managers (PBMs). According to DFS, the proposed regulations would be “the most comprehensive set of market conduct rules for pharmacy benefit managers in the country.” If enacted, the regulations would govern a wide range of PBM activities.
Bankruptcy Schedules: Schedule A/B | JD Supra
This will be the first in a series of blog posts that will focus on completing bankruptcy schedules. We'll start in this blog with the first schedule - Schedule A/B. Bankruptcy can be a complex and overwhelming process, but it's important to accurately complete the required forms and schedules to ensure that your case proceeds smoothly.
Fraudulent Transfers | Badges of Fraud | JD Supra
After a break for the holidays, this is the third of an expected five-part series on fraudulent transfers. In my first blog , I laid out the basic statutory framework, as well as a described generally the difference between actual and constructively fraudulent transfer.
Pro-life initiative in Africa saves lives of mothers, children while sharing the Christian faith
(Lepanto Institute) — Caritas Veritate Missions, in partnership with Father Stephen Imbarrato, director of Life Ministries USA, and the Catholic Archdiocese of Mbeya’s Mwanbani Mission Hospital, is launching an initiative to save the lives of unborn babies, at-risk mothers, and children by building a maternity waiting home (MWH) in Mwanbani, Tanzania.
Are Progressives in Denial About Progress? Yes, but So Is Almost Everyone Else
Abstract Scott Lilienfeld warned that psychology’s ideological uniformity would lead to premature closure on sensitive topics. He encouraged psychologists to question politically convenient results and did so himself in numerous areas. We follow Lilienfeld’s example and examine the empirical foundation beneath claims that positive illusions about societal change sustain inequalities by inducing apathy and opposition to reform.
Are Progressives in Denial About Progress? Yes, but So Is Almost Everyone Else
Abstract Scott Lilienfeld warned that psychology’s ideological uniformity would lead to premature closure on sensitive topics. He encouraged psychologists to question politically convenient results and did so himself in numerous areas. We follow Lilienfeld’s example and examine the empirical foundation beneath claims that positive illusions about societal change sustain inequalities by inducing apathy and opposition to reform.
Obtaining Extension to Make §754 Election | JD Supra
Private Letter Ruling 202244002, November 4, 2022 In a recent Private Letter Ruling, the Internal Revenue Service granted a partnership 120 days from the date of the letter to make an election under §754 of the Internal Revenue Code based on a finding that it acted reasonably and in good faith, and that granting relief would not prejudice the government’s interests. The requesting partnership intended to make a §754 election for its most recent taxable year.
Can Trustees Avoid Transfers Made Pursuant to Divorce Decrees or Other Agreements Incident to Divorce? | JD Supra
This issue arose in a case I am currently working on, and the short answer is yes, and divorce lawyers would be served well by becoming familiar with this possibility. Situations where this might arise can vary substantially. The most obvious scenario involves a sham divorce that is specifically intended to hinder, delay, or defraud a creditor.
New York State Department of Financial Services Summarizes Changes Relating to Administrative Denials, Prior Authorizations, and Claims Payment | JD Supra
On March 10, 2021, the New York State Department of Financial Services (“DFS”) issued Insurance Circular Letter No. 4 (“Circular Letter”),[1] which both explains modifications to the Insurance Law and the Public Health Law brought about by statutory changes in 2021 and sets forth two policy statements by DFS.
New Health Care Transparency Requirements: Will They Lower Cost and Improve Quality? | JD Supra
On November 12, 2020, the Trump administration published its final rule on price transparency (the “Final Rule”) requiring affected entities to publicly release personalized information on out-of-pocket costs as well as certain negotiated rates, stating that transparency in health coverage requirements will improve competition and “strengthen America’s health care system by giving health care consumers, researchers, regulators, lawmakers, health innovators, and other health care stakeholders...
CARES Act Temporarily Suspends Sequestration: How Will It Affect Provider Reimbursement? | JD Supra
Updated: May 25, 2018: JD Supra is a legal publishing service that connects experts and their content with broader audiences of professionals, journalists and associations.
Post-Acute Care and “COVID-19 Centers of Excellence” | JD Supra
Updated: May 25, 2018: JD Supra is a legal publishing service that connects experts and their content with broader audiences of professionals, journalists and associations.
Value-Based Payment Arrangements During the COVID-19 Pandemic | JD Supra
Updated: May 25, 2018: JD Supra is a legal publishing service that connects experts and their content with broader audiences of professionals, journalists and associations.
Value-Based Payment Arrangements During the COVID-19 Pandemic
The ongoing pandemic caused by the novel coronavirus has upended the American health care system in many ways. One of the many effects of COVID-19 will likely be substantial disruption in value-based payment arrangements between health plans and providers. Though this is an issue that is not on the top of providers or payors minds as the health care system prepares to respond to the crisis, there are some simple steps that providers can take now to avoid issues in the future.
Families First Coronavirus Response Act: Guidance for Health Care Providers and Plans Regarding COVID-19 | JD Supra
Updated: May 25, 2018: JD Supra is a legal publishing service that connects experts and their content with broader audiences of professionals, journalists and associations.
Despite Issuance of Final Rule on Price Transparency, Are Health Care Rates Too Complicated to Be “Consumer Friendly”? | JD Supra
The Centers for Medicare & Medicaid Services (“CMS”) recently issued a final rule requiring hospitals to publicly disclose their rates, including negotiated rates with third-party payors regardless of product line, by January 1, 2021 (“Final Rule”).[1] The Final Rule’s intent is to increase price transparency so that health care consumers can “shop” for health care services.
How Long Does It Take to Settle a Personal Injury Lawsuit?
Understanding why settling or winning a case takes so long requires understanding everything a personal injury lawsuit involves. No case plays out exactly the same. Especially with medical malpractice claims, the processes involved in collecting, analyzing, and (on the defense side) challenging evidence can take a very long time.
CMS’s Direct Contracting Model: What’s New from Next Gen? | JD Supra
Updated: May 25, 2018: JD Supra is a legal publishing service that connects experts and their content with broader audiences of professionals, journalists and associations.
Pharmacy Benefit Managers 101: Who They Are and What They Do
This on-demand program is designed to provide legal counsel and others with a basic understanding of pharmacy benefit managers (PBMs). Over the past 25 years, new medications and broader insurance coverages have led to a doubling of expenditures for outpatient prescription drugs. The growth in prescription drug coverage has led to increased complexity in the delivery and reimbursement of medications.
What Are Social Determinants of Health? | Lexology
Did you know that your zip code is a better predictor of your health than your genetic code? Public health experts – and your health insurance provider – have long known that the air you breath, the education you receive, your net worth, and even the music that you listen to are strong indicators of your overall health – and the possibility that you might need expensive medical procedures in the future.
Social Economic Environmental Factors and Overall Health
KATHLEEN M. PREMO is a Member of the Firm in the Health Care and Life Sciences practice, in the St. Petersburg office of Epstein Becker Green. For more than 20 years, she has served as a legal and strategic advisor for a diverse range of health care and business clients, including Fortune 500 companies, hospital and health systems, Medicare Advantage provider groups, and entrepreneurial privately held companies.
Association Health Plans: Federal Rule Broadens Opportunities, but Some States Clamp Down | JD Supra
JD Supra is a legal publishing service that connects experts and their content with broader audiences of professionals, journalists and associations. This Privacy Policy describes how JD Supra, LLC ("JD Supra" or "we," "us," or "our") collects, uses and shares personal data collected from visitors to our website (located at www.jdsupra.com) (our "Website") who view only publicly-available content as well as subscribers to our services (such as our email digests or author tools)(our "Services").
SAMHSA Finalizes Additional Changes to the Confidentiality of Substance Use Disorder Patient Records Regulations
On January 3, 2018, the Substance Abuse and Mental Health Services Administration (“SAMHSA”) published a final rule (“Final Rule”) to further update the Confidentiality of Substance Use Disorder Patient Records regulations (“Part 2 Regulations” or “Part 2”).[1] The Final Rule comes one year after SAMHSA’s publication of a prior final rule (“2017 Part 2 Rule”) that provided the first substantive update to the Part 2 Regulations since 1987.[2] The regulatory changes included in the 2017 Part 2...
New Audits and Penalties on Medicaid Plans and Providers Related to Encounter Data in Value-Based Payment Models
For value-based payments, encounter data[1] provides valuable information in much the same way that claims data does for fee-for-service arrangements. With the growing prevalence of value-based payments, especially in the Medicaid programs, the focus on encounter data is growing. The federal government and many states are currently tying the timely submission of complete and accurate encounter data to federal payments, and are requiring states to audit Medicaid managed care plans’ encounter data.
Assessing President Trump’s “Executive Order Promoting Health Care Choice and Competition”
On October 12, 2017, President Donald Trump signed an executive order (the “Order”) designed to “promote healthcare choice and competition across the United States,” which in effect will allow many Americans to sidestep protections under the Affordable Care Act (“ACA”).[1] The Order instructs various departments to consider regulations relating to three main areas: (1) association health plans (“AHPs”); (2) short-term, limited duration insurance products (“STLDI”); and (3) health...
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