Wolfe | Pincavage

Claim denials are a persistent and growing crisis for revenue cycle leaders nationwide. The impact is far-reaching, including financial strain and workforce burnout for providers and patient anxiety due to treatment delays. A recent survey of revenue cycle operators from HealthLeaders underscores the severity: - 77% say payer policy changes are occurring more frequently; - 73% say claim denials are increasing; and - 67% say reimbursement time frames are being prolonged.

Big News: Wolfe Pincavage is pleased to announce its expansion into New York! Partners Becky Greenfield, JD, MPH and Danya Pincavage will lead the new office, bringing our specialized provider-centric expertise to the Empire State. We are excited to contribute to the vibrant New York healthcare ecosystem. Law360 with the full story:

?? It’s St. Patrick’s Day ?? and we're celebrating with corned beef and cabbage. May your day be filled with good cheer, great company, and plenty of green! Doug Wolfe Kristen Dagher Erika De Leon

Is the $2.8 billion Blues settlement the best outcome for providers? Modern Healthcare spoke with our Managing Partner, Doug Wolfe, about the rising number of providers opting out. Doug notes, "The skepticism may send BCBS companies back to the drawing board. If more providers reject the 2024 deal than insurers anticipated, Blues companies may want to restructure the deal.” Learn how this settlement could affect your practice and understand the serious considerations for providers.

A recent American Medical Association survey reveals that physicians overwhelmingly experience prior authorization as a significant barrier to timely patient care, with care delays negatively impacting clinical outcomes. The use of AI by insurers further exacerbates these issues and is a top concern for providers.

Florida ranks second nationally for projected impact if ACA premium tax credits expire in 2025. The potential loss of subsidies would lead to significant coverage drops, directly impacting provider revenue and patient volume. Becker's Healthcare has the full report here.

This Women's History Month, Wolfe Pincavage celebrates the contributions of women in law. As a majority-women firm, we witness firsthand the power of diverse perspectives in driving innovation and achieving impactful results for our clients. We're committed to fostering an equitable environment, where women thrive as leaders and changemakers. Thank you to our exceptional team and all the women shaping the future of the legal profession! Danya Pincavage Becky Greenfield, JD, MPH Lindsay Burrows Kristen Dagher Beatriz Suzuki Raneem Shehadeh Gabriela M. Guzmán, JD, LLM Hana Aryan Jossie Viera Gaby Pavia Katherine Perdomo

Thank you, Gulf States Newsroom, for including us in your story about the state of healthcare and claim denials throughout the Gulf states. For the segment, which tells the story of a Mississippi family's struggles with coverage, Partner Becky Greenfield, JD, MPH offered insight into the latest reimbursement challenges and how "network inadequacies" affect access to critical care and worsen health outcomes.

Is your hospital prepared for the BCBS anti-trust settlement deadline? March 4th is the cutoff for opting out of the $2.8 billion agreement, and unless your organization affirmatively opts out by then, it will be included in the settlement class. Our Managing Partner, Doug Wolfe, advises hospitals to scrutinize the settlement's release language, citing potential ambiguities that could impact future claims. Read Healthcare Financial Management Association (HFMA)’s interview with Doug here:

The Kaufman Hall National Hospital Flash Report provides insights into the financial health of hospitals across the country. Though hospital operational performance stabilized in 2024, drug expenses saw a year-over-year increase, with the Great Plains region experiencing a particularly alarming 12% rise. Labor expenses also increased, with the West and South regions seeing a 6% jump. These rising costs are putting pressure on hospitals, particularly in light of other financial challenges such as supply chain fluctuations.