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How to Assess and Improve Your Corporate Cyber Security Infrastructure

It's no secret that data breach is becoming more and more common as sophisticated hackers penetrate corporate and governmental networks at what seems to be a breakneck pace. No business or institution with an internet...more

Proposed 2016 Physician Fee Schedule Would Impact Medicare Shared Savings Program

The proposed Physician Fee Schedule for 2016 [PDF] contains several provisions that are likely to have an impact on the Medicare Shared Savings Program (MSSP). These provisions focus in large part on quality measures and the...more

What Should Be in Your Physician Shareholder Agreement?

Prior to partnering with one or more physicians, doctors should consider drafting a shareholder agreement that outlines the terms of the relationship, as well as the goals of the corporation. Shareholder agreements anticipate...more

Do I need an expert witness in my case? [Video]

Phoenix business law firm Jaburg Wilk partner Matt Anderson discusses when an expert witness is needed in a case and provides examples of when an expert witness should be utilized. For more information visit...more

Healthcare Law Update

Governing boards of health care organizations can greatly benefit from reading a recently released educational document that presents practical tips for board members responsible for overseeing their organizations’ compliance...more

CMS Announces Modifications to ACO Investment Model

On June 25, 2015, CMS announced modifications to the Accountable Care Organization (ACO) Investment Model. These modifications are aimed at helping rural areas and small group practices participate in the Medicare Shared...more

Final Rule Will Give ACOs Participating in MSSP Access to More Data for More Beneficiaries

This is the third post in Health Care Law Today’s series on the final rule. This post addresses changes to sharing of beneficiary identifiable data. In its December 8, 2014 proposed rule revising the Medicare Shared...more

Acelity Reported to Plan $1 Billion IPO

San Antonio, Texas based medical device company Acelity LP Inc. is reported to be considering an initial public offering that could raise up to $1 billion, according to the Wall Street Journal. Acelity has reportedly...more

MSSP Final Rule ACO Eligibility Requirements, Application and Renewal Process

This is the second post in Health Care Law Today’s series on the final rule. This post addresses Eligibility Requirements, and the Application and the Renewal Process. ACO Eligibility Requirements - Under the...more

Real Guidance (Finally) On the Compliance Oversight Role of Boards

New guidance for boards of directors on what it means to have “reasonable oversight” for the implementation and effectiveness of corporate compliance programs could signal the beginning of a global trend towards more—and more...more

Will Personalized Medicine Survive Alternative Payment Models?

There is no doubt that health care costs in the United States are rising. According to a recent study published by the U.S. Department of Health and Human Services, personal health care expenditures in the United States...more

OIG Releases New Compliance Oversight Guidance for Health Care Governing Boards

On April 20, 2015, the U.S. Department of Health and Human Services Office of Inspector General (OIG), in conjunction with the American Health Lawyers Association (AHLA), the Association of Healthcare Internal Auditors (AHIA)...more

Medicare Shared Savings Program - 2015: What's Changed, What's New, and What's to Come?

The most recent Shared Savings Program final rule, published in the Federal Register on June 9, 2015, finalizes a number of the revisions to the original November 2011 final rule that CMS proposed on December 8, 2014. In...more

Not Much New … But a Good Reminder for Medical Director Relationships

After a significant number of settlement agreements between the U.S. Department of Health and Human Services Office of Inspector General (OIG), OIG decided to release a Fraud Alert reminding physicians, practices and...more

CMS Releases Final Rule on Medicare Shared Savings Program

This is the first post in Health Care Law Today’s Series on the final rule. The Centers for Medicare and Medicaid Services (“CMS”) released a final rule, on June 4, 2015, addressing changes to its Medicare Shared Savings...more

What Changes Are In Store With The New CMS Proposed Rule For Medicaid Managed Care?

On June 1, 2015 the Centers for Medicare & Medicaid Services (“CMS”) issued a proposed rule, revising the provisions of the Medicaid managed care (“MMC”) program for the first time in over twelve years. The effects of these...more

CMS Seeks to Boost ACO Participation Through New Final Rule for MSSP

In line with its earlier announcement to tie increasing percentages of Medicare payments to quality and value through alternative payment models by 2018, the Centers for Medicare and Medicaid (CMS) released its final rule...more

CMS Issues Final ACO Rules: Key Legal Implications for Hospital & Health System ACOs

On June 4, 2015, the Centers for Medicare & Medicaid Services (CMS) released a final rule (Final Rule) containing changes to its Medicare Shared Savings Program (MSSP). Some of the changes codify informal guidance that the...more

Kentucky Federal Court Sustains Hospital Insurer’s Denial of Claim Due to Untimely Notice, Declines to Require Insurer Show...

The U.S. District Court for the Eastern District of Kentucky recently held that an insurer properly denied coverage to a hospital because the hospital gave untimely notice of the claim. In Ashland Hospital Corporation v. RLI...more

CMS’ Long Awaited Final ACO Regulations for 2016 and Beyond: Major New Options and Plenty of Fine Tuning

Today, the Centers for Medicare and Medicaid Services (“CMS”) will publish final regulations (“Final Rule”) for its flagship pay-for-performance program, the Medicare Shared Savings Program, in the Federal Register. The Final...more

Health Law Wire: FTC Objects to Legislative Antitrust Immunity in New York (6/15)

The FTC is urging the NY Legislature to withdraw a bill which would grant broad antitrust immunity to the Westchester and Erie County health care public benefit corporations. There is continuing scrutiny of state-sponsored...more

Unfair Business Practices – Hospital’s “Facility Fee” Billed To New Patients

Justin Nolte et al., v. Cedars Sinai Medical Center - Court of Appeal, Second Appellate District (May 21, 2015) - Generally, a business practice is unfair if it violates established public policy or if it is...more

ACO Model Expansion Hinges on Increasing Medicare Program Flexibility

Earlier this month, HHS Secretary Silvia Burwell made a game-changing announcement about the Obama Administration’s most significant alternative payment model (APM). The Pioneer Accountable Care Organization (Pioneer ACO)...more

OIG issues additional guidance to healthcare boards regarding compliance efforts and oversight

The Office of the Inspector General (OIG) of the U.S. Department of Health and Human Services, together with leading legal, audit and compliance collaborators, recently issued the fourth in a series of publications providing...more

Healthcare & Life Sciences Private Equity Deal Tracker: Shockwave Medical Secures $40 Million in Financing

Shockwave Medical, based in Fremont, Calif., develops technology for the treatment of peripheral and coronary vascular disease and aortic stenosis. It is the developer of Lithoplasty balloon catheters....more

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