News & Analysis as of

Health Care Providers Patient Protection and Affordable Care Act (PPACA)

2017 Nevada Legislative Session – Potential for Additional Anesthesiology Practice Opportunities in Nevada

by Snell & Wilmer on

On February 27, 2017, Senate Bill 210 (“S.B. 210”) was introduced into the Nevada Legislature, which paves the way for expanded anesthesiology practice and patient care opportunities in the State of Nevada....more

How Will the Trump Administration Impact Healthcare Litigation?

Editor's Note: In a dramatic conclusion to the heated debate surrounding the American Health Care Act (AHCA), the bill was withdrawn after it became clear that House leadership did not have enough votes to pass it. There is...more

Proving Utility, Demonstrating Value: How to Align the Moving Parts in Personalized Medicine Reimbursement

by Foley & Lardner LLP on

Of the many business, operational, legal, regulatory and clinical obstacles standing in the way of widespread delivery of personalized medicine, the single greatest challenge may lie in solving the reimbursement puzzle....more

HHS Finalizes Rule Aimed at Stabilizing ACA Individual Marketplace

by Baker Ober Health Law on

On Thursday, April 13, the Department of Health and Human Services finalized a long-awaited regulation intended to stabilize the Affordable Care Act (ACA) individual health insurance marketplace. The final rule tracks closely...more

New OIG Rules Change Patient Incentive Program Landscape: Where Are the Limits Now?

by McDermott Will & Emery on

With health care becoming more consumer-driven, health care providers and health plans are wrestling with how to incentivize patients to participate in health promotion programs and treatment plans. As payments are...more

Legislative Solutions: 2017 Virginia Legislative Recap

by Williams Mullen on

The following is a summary of key legislation impacting the health care industry in Virginia. Reforming or Repealing Virginia’s Certificate of Public Need Program - The study of the COPN process continues -...more

Does Defensive Medicine Impact the Cost of Healthcare?

by Snell & Wilmer on

Healthcare in the United States costs at least two to three times as much as healthcare in other developed countries. One of the reasons usually given is defensive medicine – doctors who order unnecessary tests and procedures...more

Deaf Individuals Sue Health System for Discrimination Under Section 1557 of the ACA

by Arnall Golden Gregory LLP on

This month, twelve deaf individuals filed a federal suit against Banner Health in Arizona alleging discrimination under Section 1557 of the ACA because of an alleged failure to provide effective auxiliary aids. Specifically,...more

Third-Party Payment of Premiums: Controversy and HHS Guidance

Since the passage of the Affordable Care Act (ACA), the payment of healthcare premiums by third parties has been the subject of controversy. As Congress develops its plan to repeal and replace the ACA, it is uncertain how...more

States May See Earliest Opportunities to Alter Health Care Landscape

by Epstein Becker & Green on

While the titans on Capitol Hill clash over the best answer to the Affordable Care Act (ACA), the Trump administration is promoting action at the state level that could produce meaningful impact soon. Health industry...more

Provider Payments Under a Medicaid Per Capita Cap

In a February 24th blog post, we described Medicaid block grants and per capita caps in terms of A x B = C to demonstrate how those payment policies work. ‘A’ is the amount a state is paid per beneficiary, ‘B’ is the number...more

Capitol Hill Healthcare Update

by BakerHostetler on

Republican leaders on Capitol Hill face growing cross pressures from different factions of GOP lawmakers over their emerging legislation to replace the Affordable Care Act (ACA). Conservatives in the House and Senate...more

Repealing the Medicaid Expansion: Implications for Montana

Congress is currently debating whether and how to repeal and replace the Affordable Care Act (ACA). This report provides an analysis of the potential impact to the State of Montana of a possible repeal of one portion of the...more

New OIG Exclusion Authority Rule Set To Go Into Effect on March 21, 2017

On January 12, 2017, just a week prior to President Trump’s Inauguration, the Department of Health and Human Service (HHS) Office of Inspector General (OIG) published a final Rule (Rule) regarding one of its most important...more

2017 Washington, D.C. Preview

by Baker Donelson on

With President Donald Trump in the White House and Republican majorities in both the House and Senate, 2017 will see Republicans looking to undo much of President Obama's legacy and advance longstanding policy priorities....more

New OIG Exclusion Regulations About to Go into Effect

by McDermott Will & Emery on

The Office of Inspector General (OIG) recently published a final rule regarding its exclusion authorities. The final rule goes into effect March 21, 2017, and expands OIG’s authority to exclude certain individuals and...more

Entitlement Reform – Medicaid

by Baker Donelson on

Of particular focus in the coming year will be Medicaid, the federal/state health care program for low-income Americans. The program, which cost the federal government $334 billion in FY15, is a frequent target of...more

Capitol Hill Healthcare Update

by BakerHostetler on

Trump’s speech: Clarity on ACA next steps? President Trump will address a joint session of Congress on Tuesday, and the expectation is that he will use the primetime moment to outline – at least in broad strokes – his...more

News from the Vermont State House - An analysis from DRM's Government & Public Affairs Team - February 2017 #3

by Downs Rachlin Martin PLLC on

Act 188 Plans On Hold as New Chemical Bill is Introduced - Nearly three years after the legislature passed a law to regulate children’s products containing chemicals of high concern, a web site intended to inform the...more

Capitol Hill Healthcare Update

by BakerHostetler on

Meeting privately with Senate Republicans to discuss next steps on the ACA was among the first actions taken last week by the new Secretary of the U.S. Department of Health and Human Services Tom Price. But GOP senators left...more

OIG Finalizes Expanded Exclusion Authorities under ACA (Updated)

by Reed Smith on

On January 12, 2017, the Office of Inspector General (OIG) of the Department of Health and Human Services issued the final rule implementing its statutory authority under the Affordable Care Act (ACA) to expand the exclusion...more

One In – Two Out and Healthcare Regulation

by Dorsey & Whitney LLP on

President Trump signed an executive order (the “Order”) on January 30th, 2017 aiming to reduce bureaucracy by requiring agencies to remove two regulations for every one new regulation they implement. The cost of any new...more

News from the Vermont State House - An analysis from DRM's Government & Public Affairs Team - February 2017 #2

by Downs Rachlin Martin PLLC on

Governor’s $35 Million Housing Bond Discussed in Ways and Means Committee - Executive Director Gus Selig of the Vermont Housing and Conservation Board revealed some of the details this week behind the $35 million bond...more

Stretching the Rules: HHS-OIG Expands its Exclusionary Authority

by Arnall Golden Gregory LLP on

On January 12, 2017, the Department of Health and Human Services’ Office of Inspector General (OIG) published a final rule expanding its authority to exclude providers from participation in federal healthcare programs. This...more

Capitol Hill Healthcare Update

by BakerHostetler on

Three weeks into President Trump’s administration, the Senate on Friday narrowly approved Tom Price as Secretary of the U.S. Department of Health and Human Services (HHS), elevating the former orthopedic surgeon as Trump’s...more

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