The CMS Interoperability and Prior Authorization Rules
Podcast — Drug Pricing: How Are Payers Responding to the IRA?
Findings from Gibbins’ Annual Healthcare Bankruptcy Report
A Fond Farewell: Musings on the End of the Medicare Advantage Hospice Carve-In Demonstration
Video: Braidwood v. Becerra – Challenging the Affordable Care Act’s Preventive Services Coverage Provision – Thought Leaders in Health Law
Hospice and Home Health Survey Perspectives: A Conversation with Kim Skehan, VP of Accreditation at CHAP
Transparency and the Open Payments Program
Taking the Pulse, A Health Care and Life Sciences Video Podcast | Episode 173: Improving rural health care with Dr. Kevin Bennett, the Director of the Research Center for Transforming Health and the
Counsel That Cares - The Private Payer's Perspective on Value-Based Care
Podcast: Health Equity – Behind the Buzzwords – Diagnosing Health Care
A Very “Special” Episode: Amid Controversy, CMS Launches the Hospice Special Focus Program
Grace from CMS: Unexpected Good News on HIS and CAHPS Appeals
This Bandwagon Has a Broken Wheel: OIG Joins the Inconsistent Approach to Hospice GIP Claims
Behind the Curtain: Enhanced Provider Enrollment Oversight
Survey Woes: CMS Ramps Up Hospice Survey Program and Consequences
Inflation Reduction Act’s Drug Price Negotiation Provisions – What Now? – Diagnosing Health Care Podcast
A Glimpse Into the Other Side: Understanding the Perspective of Government Enforcers
I Understood There Would Be No Math: Audits, Extrapolations, and a New Set of Rules
Podcast: Inflation Reduction Act’s Drug Price Negotiation Provisions – What’s Next? - Diagnosing Health Care
Quick Takeaways From the 2024 Proposed Hospice Wage Index Rule
Background on Indiana’s “Baby HSR” Law - Indiana passed Senate Bill 9 in March 2024, which requires an Indiana healthcare entity involved in a merger or acquisition with another healthcare entity with a value of at least...more
Investment in the healthcare industry requires careful consideration, as it involves numerous distinct areas of the law. Venable's Private Equity Investment in Healthcare webinar series explores the unique issues and timely...more
With the end of the first quarter of 2024, we highlight five developments, changes, or challenges that health systems, hospitals, nursing homes, clinics, physician practices, health insurers, and other health care providers,...more
On March 5, 2024, the Federal Trade Commission (FTC) hosted “Private Capital, Public Impact: An FTC Workshop on Private Equity in Health Care” to examine the role of private equity investment in healthcare markets. The same...more
The top enforcers at the Federal Trade Commission (FTC) and Antitrust Division of the Department of Justice (DOJ) are sending strong signals that private equity (PE) firms are likely to be the next target in the Biden...more
ACI’s Advanced Forum on Managed Care Disputes and Litigation offers an unparalleled learning experience, specifically designed for the MCO legal community. Attend and develop winning legal strategies and business best...more
The Centers for Medicare & Medicaid Services (“CMS”) has finalized 2024 home health rules to include application of the home health “36-month rule” to hospice providers. The revised rule will forbid any change in majority...more
News Briefs - States Investigate Nonprofit Hospitals' Lack of Charity Care - More than a dozen states have considered or passed legislation to better define charity care, to increase transparency about the benefits hospitals...more
MedPAC recommends no additional increase in payments for dialysis in 2024 - MedPAC’s report on outpatient dialysis services recommends Congress not increase Medicare payments for dialysis services next year beyond the...more
Since the private equity issue was last addressed in the Bulletin in the Summer of 2022, the volume of healthcare private equity deals has subsided somewhat, according to statistics presented at the March 2023 Pennsylvania...more
On April 20, 2023, HHS announced that it is releasing ownership data for all Medicare-certified hospice and home health agencies not previously available to the public in this way. There are more than 6,000 hospices and...more
On March 15, the Centers for Medicare and Medicaid Services (CMS) released guidance on the drug price negotiations provisions of the Inflation Reduction Act (IRA). The guidance contains CMS’s interpretations for a range of...more
Post-acute and long term care providers have endured a state of distress since March 2020, not only from the challenges created by the COVID-19 virus, but also from ever-increasing regulatory compliance burdens, changes in...more
Co-authored by: Garrett Reinhart, Law Clerk As 2023 begins, we are tracking several key legal and regulatory issues that are sure to impact the health care industry in North and South Carolina in the coming year....more
Here are this week’s curated AG and federal regulatory news stories highlighting key areas in which state and federal regulators’ decisions are having an impact across the US: •AG Frosh Announces Settlement with Alleged...more
Court Square Capital acquisition of West Coast Dental could fuel M&A in Calif. and neighboring states - The acquisition was reportedly valued around $250 million and plans for the acquisition include accelerating new de...more
Benesch: SCOTUS decisions on COVID-19 vaccine mandates have repercussions for employers, healthcare facilities The Supreme Court decided two cases relating to COVID-19 vaccination mandates. In the first case, SCOTUS ruled...more
Can’t attend the conference in-person? The virtual Managed Care Compliance Conference, February 8–9, allows you to hear from industry professionals just like you—all from the comfort of your home or office. Geared towards...more
Attend our annual event for those who manage compliance at health plan providers. Explore topics and issues that are pertinent to industry professionals like you. Learn the latest practices, share strategies, and connect with...more
AMA report suggests Medicare spending fell 19% YoY during first half of 2020; reduction in nephrology much smaller The report from the American Medical Association (AMA) found Medicare payments to physicians the first six...more
IRC completes acquisition of kidney care provider ARA - In Oct., it was revealed that Franklin, Tenn.-based Innovative Renal Care (IRC), an affiliate of equity firm Nautic Partners, would purchase American Renal...more
CMS to reprocess excepted off-campus provider-based outpatient claims following court ruling - CMS says it’ll begin reprocessing claims for outpatient clinic visit services provided at excepted off-campus provider-based...more
Proposed class action alleges DaVita subsidiaries withheld wage premium during declared COVID health emergency - According to a proposed class action filed in Washington state, an employee at Total Renal Care contends the...more
Businesses are starting to reopen as stay-at-home orders and business closures resulting from the novel coronavirus (COVID-19) begin to ease. Unfortunately, reopening likely will not be an immediate return to business as...more
We are excited to bring the healthcare compliance sessions and updates to you as an interactive, online experience. Watch, listen, and ask questions. Each hour, attendees will be able to select from four concurrent sessions....more