Becky Kirby

So-called “ghost networks” have emerged as a significant problem in today’s health insurance landscape, particularly in the area of mental health and substance use disorder treatment. A ghost network exists when a health plan’s provider directory lists health professionals who are unavailable, not accepting new patients, no longer in network, or otherwise inaccessible in practice. […]

CMS is scheduled to award grants to states under the Rural Health Transformation Program on or before December 31, 2025. Although the award of half of the funds was specified by Congress, Congress provided CMS with significant discretion over the remainder – discretion that CMS is using to reward states whose current or future policies

A United States District Court judge for the District of Columbia has granted summary judgment to the government, finding that the Secretary of the Department of Health and Human Services had the discretion to reject Johnson & Johnson’s program to offer rebates instead of discounts to 340B covered entities. In reaching his conclusion, Judge Rudolph

In a victory for providers, the Fifth Circuit Court of Appeals has affirmed the District Court opinion striking down the rules governing how payments for out-of-network payments should be determined in arbitrations under the No Surprises Act. Congress passed the No Surprises Act to prevent patients from being surprised by bills for out-of-network cost sharing

Last Friday, the American Hospital Association released a 9-page report detailing the increasing financial pressures the nation’s hospitals are facing due to rising reimbursement denials and delays from payers, including Medicare Advantage and commercial plans. Among other things, the report — which analyzed data from 1,300 hospitals across the country — found that the median

Former U.S. District Judge U.W. Clemon writes at AL.com that the Supreme Court must be expanded to preserve opportunity for disadvantaged groups. Judge Clemon, a good friend of Whatley Kallas and our frequent co-counsel, movingly describes his own experience: the University of Alabama barred its doors to him as an undergraduate and a law student