Health Finance & Banking

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Annual Penny-Wise, Pound-Foolish Award Winner Announced

When it comes to the annual Penny-Wise, Pound-Foolish Award, don’t ever bet against the United States Congress. This year, Congress lay back in the weeds until the year was almost over before making its move for the trophy. ...more

CMS Proposes Financial Revisions to MSSP to Encourage Continued and Expanded Participation

Many critics have suggested that the November 11, 2011 final rule establishing the MSSP created a financial model that over time would not be sustainable. ACOs viewed the requirement to take risk after the initial three years...more

Healthcare & Life Sciences Private Equity Deal Tracker: CardioDx Secures $35 Million in Financing

CardioDx, headquartered in Redwood City, Calif., is a molecular diagnostics company specializing in cardiovascular genomics. Participants in this round of financing included Alberta Investment Management Corp. and the...more

North Carolina Legislative Report

The General Assembly adjourned “sine die” on Wednesday, August 20. During the interim, the MVA Public Affairs Legislative Report on North Carolina will be distributed biweekly to keep you up to date on the latest legislative...more

CFPB Addresses Medical Debt Collection, Requires Consumer Reporting Agencies To Provide Accuracy Reports

On December 11, the CFPB held a field hearing on medical debt collection and how it affects consumer credit reports. In his prepared remarks, Director Cordray announced the release of a white paper focused on the specific...more

Banking and Financial Services E- Note - December 2014

In This Issue: - Congress Move to Roll Back Bank 'Push-Out' Regulation Meets Anger - NCUA Calls for Retailers to Cover Data Breach Costs - Regulators Propose 8 Biggest Banks Increase Capital...more

Illinois Supreme Court Agrees to Decide Whether Pension Board's Disability Finding is Preclusive in Employee Benefits Act...

In the closing days of its November term, the Illinois Supreme Court agreed to decide whether a pension board’s finding that an officer is disabled for pension purposes is preclusive of the employer’s liability for health...more

CFPB requires credit bureaus to identify furnishers and industries with highest dispute rates and issues study of collections...

In conjunction with its field hearing today on medical debt collection, the CFPB released a study that “describes characteristics of the medical and non-medical collections tradelines on consumers’ credit reports and the...more

December 2014 Filing and Notice Deadlines for Qualified Retirement and Health and Welfare Plans

Employers and plan sponsors must comply with numerous filing and notice deadlines for their retirement and health and welfare plans. Failure to comply with these deadlines can result in costly penalties and excise taxes. To...more

The Unique Risks Of Investing In Out-Of-Network Providers

For several years, industry observers have been predicting the demise of out-of-network business models, yet they still survive. For some providers in certain specialties and certain geographies, a predominantly...more

Second Circuit Rejects Plan’s Claim For Reimbursement From Another Plan

Where an ERISA plan specifically sets forth in the plan document its rights to reimbursement/subrogation vis-à-vis a plan participant then there is no requirement that recovery be conditioned on the plan being able to trace...more

Monthly Benefits Update - November 2014

U.S. Supreme Court Grants Review of ACA Case Involving Premium Subsidies Offered Through Federally Facilitated Exchanges - The Supreme Court granted review in King v. Burwell, a Fourth Circuit case that upheld an IRS...more

OMB Releases Fall 2014 Regulatory Agenda

The White House Office of Management and Budget’s Office of Information and Regulatory Affairs has released its semi-annual Unified Regulatory Agenda and Regulatory Plan for Fall 2014, covering more than 60 Federal...more

View From McDermott: A New Type of ERISA-Based Hold-Up—The Rise of Out-of-Network Provider Suits Against Self-Funded Health Care...

Over the past decade, there has been a significant increase in the number of physicians who have dropped out of Preferred Provider Organization (‘‘PPO’’) and Health Maintenance Organization (‘‘HMO’’) networks and attempted to...more

Health Care: DSRIP Still a Moving Target as Application Deadline Nears - An Update on Key Developments (12/14)

As the date to submit final applications to participate in the Delivery System Reform Incentive Payment Program (DSRIP) approaches, the New York State Department of Health (DOH) continues to roll out new information, revised...more

CFPB to hold Dec.11th field hearing on medical debt collection

The CFPB has announced that it will hold a field hearing on medical debt collection in Oklahoma City, OK on December 11. The hearing will include remarks from Director Cordray and testimony from consumer groups, industry...more

California Healthcare Institute Releases 2015 California Biomedical Industry Report

The California Healthcare Institute and PricewaterhouseCoopers, LLP have released their 2015 California Biomedical Industry Report describing industry trends through 2014. The CHI report highlights the continued strength of...more

Administration Publishes Fall 2014 Unified Regulatory Agenda

We expect 2015 to be a very busy year for actions on new or proposed federal regulations in the absence of congressional legislation. That was confirmed on November 21, 2014, when the administration published its “Unified...more

Reimbursement Changes, Shift to Consumerism Discussed at Akerman Healthcare Briefing

Changing reimbursement models and a shift to consumerism were two of the hot topics discussed at Akerman LLP's recent Healthcare Briefing event titled "Financial and Corporate Implications of the Affordable Care Act: A Look...more

DOJ Announces Record Year of Over $5 billion in False Claims Act Recoveries

2014 was a banner year for federal recoveries under the False Claims Act (“FCA”). In a press release dated November 20, 2014, the DOJ announced that its total recoveries – including those from both settlements and judgments –...more

Ancillary Joint Ventures Involving Taxable and Tax-Exempt Health Care Entities: Addressing the Chilling Effect of IRS Inaction

Tax-exempt health care systems facing growing operating costs and falling revenues frequently explore creation of ancillary joint ventures (AJVs) as vehicles to raise capital, share risk, expand coverage, and provide care...more

Just In Time for the Holidays: More Security Requirements From NIST

National Institute of Standards and Technology (NIST) has published draft recommendations aimed at securing the confidentiality of sensitive federal information located within non-federal entities’ information technology...more

Health Care Reform Implementation Update

Over the past several days, the second open enrollment period through the Affordable Care Act’s (ACA’s) health insurance exchanges began; Republican lawmakers, now with majorities in both the House and the Senate, explored...more

Health Care Financing Trends: What Do They Foreshadow?

This article explores some current health care financing trends and speculates on what they may portend for work in a health care restructuring professional’s “pipeline.” While there are many kinds of health care enterprises...more

The ERISA Litigation Newsletter

Editor's Overview - As it is well known, in Cigna Corp. v. Amara, 131 S. Ct. 1866 (2011), the U.S. Supreme Court identified several forms of appropriate equitable relief that may be available under Section 502(a)(3) of...more

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