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Elevate Healthcare - fastest growing outpatient mental health hospital has chosen to leave AmeriGroup's network


Elevate Healthcare
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DALLAS, July 26, 2021 /PRNewswire/ Elevate Healthcare has terminated their network agreement amid a dispute over denial of medical necessity authorizations, outstanding reimbursements since 2019 and poor active provider list. The two have been engaged in contract negotiations since 2019 and were unable to reach an agreement on May 14, 2021. Elevate Healthcare fees are less than most outpatient programs as we stand by the mental health parity act affordability and accessibility removing barriers to obtain mental health care has been our priority since opening our first location.
Elevate Healthcare s priority is to provide quality client care and service excellence through evidence base. Our programming offers a full wrap around and always welcomes back our clients in our alumni program. Life happens we will be here when you need us. ....

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Tennessee Supreme Court Holds Contractor Potentially Liable For $300-Per-Day Penalty


Tennessee Supreme Court Holds Contractor Potentially Liable For $300-Per-Day Penalty
Wednesday, June 30, 2021
The Tennessee Supreme Court on Wednesday held that a general contractor may be required to pay a $300-per-day penalty under Tennessee law for its failure to pay a subcontractor for work completed on a Nashville construction project. Applying Tennessee’s Prompt Pay Act, the Court reversed the trial court’s decision that the subcontractor’s claim was filed too late; it held the general contractor could be liable for the penalty for the year before the subcontractor filed its lawsuit.
In 2013, general contractor Holladay Construction Group, LLC hired subcontractor Snake Steel, Inc. ....

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Singapore and Thailand link up cross-border fast payments in a world first


The PayNow-PromptPay linkage will allow customers of participating banks to transfer funds of up to $1,000 or 25,000 baht (S$1,060) daily across the two countries. - BANGKOKBANK.COM
SINGAPORE (The Straits Times/ANN): The local PayNow system that lets individuals transfer money using just a mobile number will be linked to Thailand s PromptPay version on Thursday (April 29), the Monetary Authority of Singapore (MAS) and Bank of Thailand (BOT) said in a joint statement.
The linkage between the two countries national fast payment systems is the first of its kind in the world, they said.
Three of Singapore’s 12 PayNow banks are participating in the scheme DBS Bank, OCBC Bank and UOB together with four banks in Thailand Bangkok Bank, Kasikorn Bank, Krung Thai Bank and Siam Commercial Bank. ....

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New York State Department of Financial Services Summarizes Changes Relating to Administrative Denials, Prior Authorizations, and Claims Payment | Epstein Becker & Green


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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. More specifically, the Circular Letter summarizes a host of important statutory changes relating to common managed care issues, including administrative denials, utilization review, coding, and denials of pre-authorized services. In addition to covering statutory changes, the Circular Letter clarifies the DFS’s positions on when down-coding requires a utilization review determination and on the subsequent denial of a claim that had received pre-authorization. These changes relate to commercial and Medicaid products in New York; they do ....

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Prompt Pay Act Lessons from The Arizona Court of Appeals | Snell & Wilmer


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Last November, Arizona’s Court of Appeals issued a memorandum decision analyzing Arizona’s Prompt Pay Act. Though the decision was not published and is not binding authority, it does guide the construction industry and practitioners as to how this court analyzed Prompt Pay Act enforcement.
To set the table,
was limited to a payment dispute between the general contractor Shea Connelly, and its subcontractor, Revive. The project owners effectively had no role in the dispute.
Critically for Shea Connelly’s arguments, Revive was hired to provide framing work on two separate Arizona projects, one in Glendale, and one in Fountain Hills called Park Place. The Glendale subcontract included a cross-default term providing that if Revive defaulted on any subcontract with Shea Connelly, it would be deemed to have defaulted on all of its subcontracts with Shea Connelly. ....

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