News & Analysis as of

Federal Court Enjoins Part of ACA Final Non-Discrimination Rule

On December 31, 2016, the U.S. District Court for the Northern District of Texas issued a nationwide injunction in Franciscan Alliance, Inc. v. Burwell, N.D. Tex., No. 16-cv-108, holding that portions of the final rule issued...more

The Old and the New – Day 3 Notes from the JPMorgan Healthcare Conference

Day 3 of the JPMorgan healthcare conference was one of striking contrasts between the old and the new. (And, by the way, the rain finally stopped for a day, but it will be back tomorrow to finish off the last day of the...more

Looking Forward/Looking Backward – Day 1 Notes from the JPMorgan Healthcare Conference

A large amount of wind, much discussion about the U.S healthcare, and the public getting soaked again – if you were thinking about Washington, DC and the new Congress, you’re 3,000 miles away from the action. This is the week...more

Healthcare Provider Obligations For Individuals With Limited English Proficiency

This summer I wrote about the dangers of English-only policies in this age of multiculturalism. These policies tend to emerge more frequently in the healthcare workplace, the reason being – the provision of quality care is...more

Capitol Hill Healthcare Update

A growing number of moderate and conservative Republicans in Congress are voicing concerns about the party’s strategy to repeal the Affordable Care Act (Act) in February but then wait months – and possibly even into 2018 –...more

OIG Report Examines Minimum Loss Ratio Impact on South Carolina Medicaid Managed Care

OIG recently issued a report determining that South Carolina’s Medicaid Managed Care program would not have realized any savings if the state agency implemented a minimum Medical Loss Ratio (MLR) similar to the current...more

Researchers see ways Obamacare helped to cut costs, improve patient care

As the already known complications to its demise have increased by the minute, there may be some detectable pauses in the partisan zeal to give the Affordable Care Act, aka Obamacare, the bum’s rush. That’s because the...more

The New HHS: Tom Price and Value-Based Health Care - Part 1

What impact will the incoming Trump administration have on the 2017 health care and life sciences regulatory outlook? In this two-part podcast, The New HHS: Tom Price and Value-Based Health Care and The New FDA: Product...more

Federal Judge Blocks Transgender Protections

On Saturday, December 31, 2016, a federal judge in Texas entered a nationwide preliminary injunction barring the enforcement of antidiscrimination protections pertaining to transgender and abortion health services and...more

Federal Court Enjoins Enforcement of Section 1557’s Gender-Identity Protections in Healthcare

On New Year’s Eve, a federal court in the Northern District of Texas granted a nationwide preliminary injunction against two related HHS interpretations of the final Nondiscrimination rule issued under Section 1557 of the...more

Final Rule Implements Quality Payment Program under MACRA

If you are a physician, mid-level provider, or work with those providers, then you have been bombarded with new acronyms for new programs and promises to remove older acronyms from your Medicare vocabulary. Medicare...more

DOJ False Claims Act recoveries – implications for the health industry

The US Department of Justice Civil Division released its False Claims Act (FCA) recovery statistics for Fiscal Year 2016 on December 13, 2016, announcing that it had recovered $4.76 billion. This represents an increase of...more

21st Century Cures Act offers array of holiday gifts to healthcare providers

The 21st Century Cures Act, a rare beneficiary of broad bipartisan support, has been signed into law by President Barack Obama. The law has received much public acclaim for its $4.8 billion in new funding over the next...more

Providers Breathe Sigh of Relief with New Anti-Kickback Safe Harbors and CMP Exceptions

On December 7, 2016, the HHS Office of Inspector General (OIG) finalized a set of rules first proposed in 2014 adding new anti-kickback law safe harbors and protecting additional conduct from enforcement under the civil...more

CMS Issues Final ACA Benefit and Payment Policies for 2018; Questions Loom Over Implementation

On December 16, 2016, CMS released its Affordable Care Act (ACA) Notice of Benefit and Payment Parameters final rule and the final Annual Letter to Issuers for the 2018 plan year. Notably, the final rule revises the risk...more

OIG Revises and Adds Anti-Kickback Statute Safe Harbors and Civil Monetary Penalty Rules

In what may be one of the final federal health care revisions implemented during the Obama Administration, on December 7, 2016 the U.S. Department of Health and Human Services (“HHS”), Office of Inspector General (“OIG”),...more

Obama Signs 21st Century Cures Act, Adding $6.3 Billion For Medical Research

The Cures Act aims to increase the speed by which new drugs are brought to market by streamlining clinical trials, allowing the use of patient data in the regulatory review process, and modernizing U.S. Food and Drug...more

Cures Act Permits Small Employer Health Reimbursement Arrangements in 2017

President Obama has signed into law the 21st Century Cures Act (Cures Act), that expands funding for medical research. Hidden within the Cures Act is a provision entitled “Exception from Group Health Plan Requirements for...more

Up to 5800 Georgia Medicaid Providers Risk Year-End Terminations

To comply with the Affordable Care Act’s requirement to revalidate provider enrollment “at least every five (5) years,” beginning in April 2014 and continuing monthly thereafter, the Georgia Department of Community Health...more

2016 Health Care Year in Review

Since I began writing this year-end review in 2013, there have been some common themes – a shift to pay for quality and away from fee-for service, much of which has been brought about by the Affordable Care Act (ACA): efforts...more

Five Key Issues Impacting Health Care Employers

Employers in the health care industry are likely to face significant changes under President-elect Donald J. Trump’s administration and should expect a healthy dose of uncertainty for the next few months. During his campaign,...more

The Clock Is Ticking – ACA Nondiscrimination Rules Will Take Effect January 1

Earlier this year, the Department of Health and Human Services (HHS) and the Office of Civil Rights (OCR) published a final rule to implement Section 1557 of the Affordable Care Act (ACA). Most prominently, this rule...more

Capitol Hill Healthcare Update

After months of debate and partisan wrangling, the House on Wednesday voted 392-26 to pass the “21st Century Cures” bill designed to accelerate the development of new drugs and medical devices as well as increase federal...more

Health Law Insights: November Newsletter

ALERT: "No Contract" Disclaimer in Employee Handbook Upheld by Illinois CourtAuthor: Employee handbooks have long been a trap for the unwary employer that desires merely to establish a set of rules and policies without...more

10 Things You Need to Know About Health Care Bankruptcies in 2017

The coming year will likely continue to be a tumultuous year for health care providers, suppliers, and payers, as they adapt to meet new challenges and market forces, particularly in light of the open questions as to the...more

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