News & Analysis as of

Accountable Care Organizations

Integrating MassHealth Long-Term Services and Supports: Considerations for ACOs and MCOs

I. INTRODUCTION AND CONTEXT - MassHealth, Massachusetts’ Medicaid program, is the largest payer of long-term services and supports (LTSS) in the Commonwealth and administers a number of LTSS programs, some in conjunction...more

Chronic Care Legislation Approved by Senate

by Reed Smith on

The U.S. Senate has unanimously approved S. 870, the Creating High-Quality Results and Outcomes Necessary to Improve Chronic (CHRONIC) Care Act of 2017 (as amended). The bill is intended to improve care for the chronically...more

CMMI Requests Ideas to Spur Innovation and Reduce Burden

by Polsinelli on

The Center for Medicare & Medicaid Innovation (CMMI) is seeking ideas on how to better drive change and reduce regulatory burden. CMMI solicited ideas to shape the agency’s future activities through a September 2017 “request...more

OIG: “High-Performing” ACOs Point the Way for Medicare Shared Savings Program Savings

by Reed Smith on

The OIG has examined the results of the first three years of the Medicare Shared Savings Program, under which accountable care organizations (ACOs) coordinate care to reduce Medicare costs and improve quality of care. The OIG...more

Massachusetts Senators Hold Healthcare Roundtable Discussions

by Mintz Levin on

This past August, the Massachusetts Senate and the Millbank Memorial Fund Healthcare Working Group held three roundtable discussions geared towards finding solutions to rising healthcare costs and providing patients with more...more

International News: Focus on Health Care - Fall 2017

by McDermott Will & Emery on

Nationalism and Cross-Border M&A: Navigating Populist Politics in Deal Making - More than half of the G20 countries voted-in campaigns that focused on harming foreign, outside interests as a means to strengthen domestic...more

Payment Reform: Moving at the Speed of Trust

by Epstein Becker & Green on

An August 14 meta-analysis of payment reform evaluations by Len Nichols and others offers health care investors a sobering appraisal of the success to-date of a range of payment reforms initiated by the Centers for Medicare &...more

MACRA Physician Payment Reform: Time to Take Stock of What Is Working and What Changes Are Needed

by Epstein Becker & Green on

In April 2015, Congress established a new framework for Medicare Part B physician payments through the passage of the Medicare Access and CHIP Reauthorization Act of 2015 (“MACRA”), which the Centers for Medicare & Medicaid...more

CMMI Focuses on Behavioral Health

by Pierce Atwood LLP on

CMS recently announced that the Center for Medicare and Medicaid Innovation (CMMI) is interested in lowering the cost of care for Medicare and Medicaid beneficiaries with behavioral health conditions while improving the...more

OIG Unveils New Work Plan Process: Assessing the Impact on Compliance Risk Assessment

by Baker Ober Health Law on

On June and July 17, 2017, the Department of Health and Human Services, Office of Inspector General (OIG) released new Work Plan initiatives and, in doing so, announced its intent to update its Work Plan monthly, in lieu of a...more

Washington, D.C. Update – June 2017

by Baker Donelson on

Having returned from its Memorial Day recess, Congress now enters one of the longest continuous work periods of the year and – with the exception of the week of the Fourth of July – will likely be in session until the end of...more

Round Two: Significant Telehealth Expansion Re-Proposed in Bipartisan Senate Bill

by McDermott Will & Emery on

On May 3, 2017, the Creating Opportunities Now for Necessary and Effective Care Technologies for Health Act of 2017 (S. 1016) (CONNECT Act of 2017) was reintroduced by the same six senators who had initially introduced the...more

Senate Finance Committee Advances Bipartisan CHRONIC Care Act

by Baker Donelson on

On May 18, the Senate Finance Committee unanimously approved the Creating High-Quality Results and Outcomes Necessary to Improve Chronic (CHRONIC) Care Act of 2017 (S. 870). The bipartisan bill aims to modernize care...more

Value-based health care: fraud & abuse laws

by Ropes & Gray LLP on

Michael Lampert, Ropes & Gray health care partner, discusses fraud and abuse law application to value-based health care arrangements. __ Much has been made about how the fraud and abuse laws, which were designed in order...more

Congressional Hearings, Markups Focus on Chronic Care, Drug Pricing, HHS Budget, Other Health Programs

by Reed Smith on

House and Senate committees have held a number of hearings recently to focus on health policy topics, including the following: - A Senate Health, Education, Labor & Pensions Committee hearing on “The Cost of Prescription...more

Proposed Telehealth Expansion of Medicare Reimbursement

by Baker Ober Health Law on

Telehealth continues to be a frontrunner on one strategy to achieve the triple aim, an effort to improve patient experience, population health and reduce per capita cost. To date, government reimbursement for telehealth...more

2017 Vermont Legislative Session | The Year in Review - DRM's Government & Public Affairs Team Final Analysis

by Downs Rachlin Martin PLLC on

A May 18th adjournment brought to a close the first half of the 74th biennial session of the Vermont General Assembly. Drama awaits as Gov. Phil Scott has threatened to veto H.518, the fiscal year 2018 budget, over an...more

CBO Greenlights Telehealth Provisions in Senate’s CHRONIC Care Act

Last week, the Congressional Budget Office (CBO) concluded that a key piece of telehealth legislation, the CHRONIC Care Act of 2017, would not, overall, increase or decrease Medicare spending. This score is significant as it...more

News From the Vermont Statehouse - An Analysis from DRM’s Government & Public Affairs Team - April 2017 #3

by Downs Rachlin Martin PLLC on

Senate Committee Rejects Anti-Uber Amendment - The Senate Finance Committee on Friday afternoon unanimously rejected a proposal from the Senate Judiciary Committee to impose high automobile liability insurance limits on...more

The Financial Impact of MACRA – Uncertainty Reigns in a Recent Rand Corporation Study

With all the talk of the Affordable Care Act’s uncertain future, it is easy to forget about the Medicare Access and CHIP Reauthorization Act (“MACRA”), a bipartisan law passed by Congress in 2015 to change the way physicians...more

Insiders Say New MACRA Rule Likely as Providers Look to Sec. Price to Ease Burden

The Trump administration is considering releasing a rule to ease the burden that small practices are facing in trying to comply with the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA), according to a recent...more

News from the Vermont Statehouse - An Analysis from DRM’s Government & Public Affairs Team - April 2017 #2

by Downs Rachlin Martin PLLC on

Senate Money Panel Passes Budget Bill - On a vote of 7-0, the Senate Appropriations Committee passed a $5.8 billion budget on Friday that closes a $72 million projected gap between revenues and expenditures in the 2018...more

Health Care Perspectives

With deep experience in the health care industry and a comprehensive understanding of its diverse participants, Katten attorneys serve as conference moderators and panelists, host accredited events, and produce webinars to...more

News From the Vermont Statehouse - An Analysis from DRM’s Government & Public Affairs Team - March 2017 #3

Paid Family Leave Could Be Costly - The House Committee on Ways and Means took up H.196, the Paid Family Leave bill this week after it passed out of the House Committee on General, Housing and Military Affairs over...more

News from the Vermont Statehouse An - Analysis from DRM’s Government & Public Affairs Team - March 2017 #2

by Downs Rachlin Martin PLLC on

The House Ways and Means Committee is considering a proposal from the Vermont Department of Taxes to reduce the amount of use tax a person can pay without providing records to prove his or her tax liability. The rate would...more

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