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Alston & Bird

Health Care Week in Review: CMS Releases Final Medicare Prescription Payment Plan Part 2 Guidance

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Below is Alston & Bird’s Health Care Week in Review, which provides a synopsis of the latest news in health care regulations, notices, and guidance; federal legislation and congressional committee action; reports, studies,...more

ArentFox Schiff

Fast Five: Important Law and Policy Updates for US Health Care Transactions

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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

Akerman LLP - Health Law Rx

Did You Know Medicare Implemented New Provider and Supplier Enrollment Requirements?

The Centers for Medicare & Medicaid Services (CMS) has revised certain payment policies under the Medicare physician fee schedule, and updated provider and supplier enrollment regulations. CMS recently published a final rule...more

Epstein Becker & Green

California Finalizes SB 184 Pre-Transaction Notice Requirements for “Material Change” Health Care Transactions

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On December 18, 2023, the California Office of Administrative Law approved the emergency regulations promulgated by the Office of Health Care Affordability (OHCA) that set forth the procedural framework for (i) the...more

Nelson Mullins Riley & Scarborough LLP

Breaking Down the Impact of CMS's 2024 Medicare Physician Fee Schedule Final Rule

The Centers for Medicare & Medicaid Services (CMS) has finalized the calendar year 2024 Medicare Physician Fee Schedule (PFS) final rule, introducing policies to bolster primary care, advance health equity, support family...more

Butler Snow LLP

Prior Authorization Reform in Healthcare: Winds of Change?

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Bob Dylan, winner of the Nobel Prize in Literature and one of the greatest American songwriters of all time, has effectively used wind as a metaphor in a number of songs he has written, each with its own distinct message....more

Quarles & Brady LLP

Oklahoma Patient's Right to Pharmacy Choice Act Preempted by ERISA

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On August 15, 2023, the U.S. Court of Appeals for the Tenth Circuit issued an opinion in Pharmaceutical Care Management Association v. Glen Mulready, in his official capacity as Insurance Commissioner of Oklahoma, Oklahoma...more

Foley Hoag LLP

CMS Proposes Updates to Medicare Dental Coverage Pathway

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On July 13, 2023, the Centers for Medicare and Medicaid Services (CMS) released the CY2024 Physician Fee Schedule (PFS) proposed rule. This rule addresses changes in Medicare payment policies for physician services. Over the...more

Epstein Becker & Green

Physicians Beware! Groups Providing DME, Prosthetic Devices, and Other Medical Supplies to Their Medicare Patients Risk Violating...

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When the COVID-19 Public Health Emergency (“PHE”) ended on May 11, 2023, many physician groups furnishing certain medical equipment, devices, and/or supplies to their Medicare patients became in violation of the federal...more

Manatt, Phelps & Phillips, LLP

Proposed CY 2024 Medicare Physician Fee Schedule Extends Many Telehealth Flexibilities Through 2024

On July 13, the Centers for Medicare & Medicaid Services (CMS) released its annual proposed rule updating the Medicare Physician Fee Schedule (MPFS) for calendar year (CY) 2024, which includes various proposed changes related...more

Manatt, Phelps & Phillips, LLP

California Assembly Acts to Streamline Physician Credentialing Process

The California Legislature is considering a bill to simplify the process by which health insurers and plans credential providers. Currently, providers must satisfy the proprietary “credentialing” requirements of individual...more

McDermott Will & Emery

Top Takeaways | Employer Market Perspective

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In this session, McDermott Will & Emery Partner Patrick Healy moderated a panel that examined the expansion of value-based care in the employer market. We summarize the panel’s insights on how stakeholders can successfully...more

McDermott Will & Emery

PPM ASC Symposium 2023 | Trends in Value-Based Care Models

In this session, McDermott Will & Emery Partner Matthew Perreault moderated a panel that collected insights on how the value-based care market has shifted, how investors and other stakeholders can partner on value-based care...more

Rivkin Radler LLP

NY Enacts Scaled-Back Version of Hochul’s Health Care Transactions Proposal

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Following extended New York State budget negotiations, lawmakers have enacted a significantly modified version of Governor Hochul’s proposed health care transaction review bill. The bill, as originally proposed, included a...more

Health Care Compliance Association (HCCA)

Privacy Briefs: April 2023

Personal information from federal lawmakers and congressional staff members was available on the dark web following a breach of DC Health Link, the health insurance marketplace for Washington, D.C. In an internal memo sent to...more

Sands Anderson PC

Metrics in the ER: Impact on Healthcare Delivery and the Law

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Metrics. What are they? And, in the world of litigation, are they good, bad, or ugly? For my fellow Gen-X’ers, the word “metric” calls to mind an ambitious, but unsuccessful, national effort that included cartoons and...more

The Volkov Law Group

Modernizing Medicine Settles False Claims Act Violations for $45 Million

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The Justice Department continues to pile up healthcare enforcement actions — false claims, anti-kickback, and fraud.  DOJ is on its way to a record year....more

Wilson Sonsini Goodrich & Rosati

CMS Releases 2023 Proposed Medicare Physician Fee Schedule (PFS) Rule Announcing and Soliciting Comments on Planned Payment and...

On July 7, 2022, the Centers for Medicare & Medicaid Services (CMS) issued the 2023 Physician Fee Schedule (PFS) Proposed Rule. CMS publishes the PFS annually, informing healthcare providers about federal reimbursement and...more

Burr & Forman

Legal Issues to Keep in Mind Before Making the Switch to Concierge Medicine

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Getting in to see your doctor is not always as easy as picking up the phone. Often, there is a several-week-long wait for an opening, and the doctor your insurer covered last year may no longer be in-network this year. That...more

Epstein Becker & Green

CMS Framework for Health Equity: An Opportunity for Client Advocacy

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The Centers for Medicare & Medicaid Services (CMS) Office of Minority Health has published its comprehensive CMS Framework for Health Equity 2022–2032 (Framework). CMS’s Framework arose in response to the Biden...more

Shumaker, Loop & Kendrick, LLP

Client Alert: No Surprises Act: Good Faith Estimate Requirements

The No Surprises Act (NSA) imposes numerous requirements on health care facilities and other providers regarding protections against surprise billings. The requirements include posting and delivering notices regarding the...more

Epstein Becker & Green

The $2 Trillion Build Back Better Act Passes the House, Bringing the Potential for a Significant Health Care Expansion

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On November 19, 2021, the U.S. House of Representatives (“the House”) narrowly passed the Build Back Better Act (H.R. 5376, or “the Act”), a spending bill appropriating nearly $2 trillion for measures to expand the country’s...more

Sands Anderson PC

Fourth Circuit Holds that Federal Rights Cannot Be Waived Ex Ante

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A recent ruling by the United States Court of Appeals for the Fourth Circuit serves as a warning to healthcare providers against entering into service contracts that attempt to avoid being sued under 42 U.S.C. § 1983....more

Cranfill Sumner LLP

Updates to Medical Malpractice Legal Procedures in North Carolina

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On June 18, 2021, Governor Roy Cooper signed Senate Bill 255 into law.  The law contains two significant changes to the legal procedures in medical malpractice actions in North Carolina....more

Epstein Becker & Green

Ohio’s Medical Practitioner Conscience Clause Becomes Effective

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Ohio’s two-year state operating budget, which passed in June, enacted Revised Code 4743.10, which established a general medical conscience clause in Ohio law. Under the new law, which became effective September 30, 2021, “a...more

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