News & Analysis as of

Health Insurance Dept. of Health and Human Services Medicare

HHS Cannot Pause United’s Challenge to the Medicare C/D Overpayment Rule

by King & Spalding on

As previously reported, UnitedHealthcare Insurance Company (United) is challenging CMS’s Medicare C/D Overpayment Rule as it applies to Medicare Advantage (MA) organizations. HHS sought to stay United’s lawsuit while it...more

Privacy Tip #92 – Finally, HHS is Removing SSNs From Medicare Cards

For those of you who know me, you know that I have been very frustrated with the federal and state governments for continuing to use Social Security numbers for eligibility, enrollment and participating in Medicare and...more

FY 2018 President’s Budget May Signal Challenges for Health Programs on the Horizon

by McDermott Will & Emery on

Eric Zimmerman, along with McDermott+Consulting Vice Presidents Adaeze Enekwechi and Piper Su, wrote this +Insights publication detailing the possible effects of the Trump Administration's 2018 budget on health programs and...more

Update: HHS Decides Appeals Backlog Rule

by Polsinelli on

On January 17, 2017, HHS published a rule addressing public comments and finalizing changes to the Medicare benefit claim appeals processes that were proposed on July 5, 2016. Although there was initially some speculation...more

Trump Administration Takes First Steps to Support Exchanges, but Key Questions Remain

by McDermott Will & Emery on

In an effort to stabilize the Exchanges and encourage issuer participation, the Centers for Medicare & Medicaid Services (CMS) recently extended the federal Exchange application and rate filing deadlines and published a...more

Manatt on Health Reform: Weekly Highlights - February 2017 #2

Tom Price is confirmed as the new head of Health and Human Services; Georgia and Missouri legislatures call for new Medicaid waivers to implement capped funding; and the uninsurance rate hits a new low in 2016....more

Potential Implications to the ACA Under the Incoming Republican Administration – Part II: Physicians

In contemplating the ways in which physicians may be affected by the possible repeal of the Affordable Care Act (ACA)—and certain features of any legislation that may replace it—a good place to start is with the person...more

Texas Court Enjoins Enforcement of Regulation that Would Forbid Discrimination in Healthcare on the Basis of Gender Identity and...

by FordHarrison on

As LGBTQ rights have taken center stage in political and social issues, FordHarrison has been following ground-breaking litigation related to LGBTQ rights and providing updates. In the latest decision, a federal judge in...more

The New “Price” of U.S. Health Care: The Future of Value-based Reimbursement Under President-elect Trump and Tom Price

by Carlton Fields on

The total U.S. health care expenditure was $3.2 trillion in 2015, and is projected to grow to nearly $5.6 trillion by 2025. As our nation’s cost of care rises, both Democrats and Republicans recognize the overwhelming need to...more

2016 Health Care Year in Review

by Burr & Forman on

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

The Trump Administration: The Future of Health Care

The election of Donald J. Trump as the 45th President of the United States, along with the Republican control of the majority of both the House of Representatives and the Senate, will likely set in motion a major overhaul of...more

Repealing and Replacing the ACA: Five Developments Likely to Occur in the Years Ahead

by Proskauer Rose LLP on

On the back of the 2016 United States presidential election results, the health care industry ponders how a Republican president and Congress will transform the business environment. The health care industry has a number of...more

What Trump’s HHS Secretary Appointment Could Mean for Healthcare Providers

by Nilan Johnson Lewis PA on

President-elect Donald Trump announced on November 28, 2016, that current House Budget Chair Representative Tom Price is his choice for Health and Human Services (HHS) Secretary. Many providers are wondering what health care...more

The New Political Landscape’s Impact on Health Care Investing: 10 Takeaways from the Epstein Becker Green and Jefferies...

by Epstein Becker & Green on

The day after the 2016 U.S. presidential election, Epstein Becker Green, in conjunction with Jefferies LLC, hosted “The Ballots Are Counted: How the New Political Landscape Will Shape Health Care Investing.” The event was...more

HHS Final Rule Extends Anti-Discrimination Protection to Transgender Patients

This past May, the Department of Health and Human Services (HHS) issued a final rule implementing Section 1557 of the Affordable Care Act (ACA), which prohibits discrimination on the basis of race, color, national origin,...more

Health Update - July 2016

The Vulnerability of Healthcare Information - According to a report the Brookings Institute issued in May 2016, 23% of all data breaches occur in the healthcare industry. Nearly 90% of healthcare organizations had some...more

HHS Issues Final Rule on ACA Nondiscrimination in Health Programs and Activities

by Franczek Radelet P.C. on

On May 18, 2016, the Department of Health and Human Services (“HHS”) issued final regulations interpreting the nondiscrimination provisions of Section 1557 of the Affordable Care Act (“ACA”). The rule mainly impacts insurers...more

A&B Healthcare Week in Review

by Alston & Bird on

I. REGULATIONS, NOTICES, & GUIDANCE - On April 15, 2016, the Food and Drug Administration (FDA) issued a proposed rule entitled, “Applications for Approval and Combinations of Active Ingredients Under Consideration for...more

A&B Healthcare Week in Review

by Alston & Bird on

I. REGULATIONS, NOTICES, & GUIDANCE - On March 15, 2016, the Centers for Disease Control and Prevention (CDC) issued voluntary guidelines entitled, “CDC Guidelines for Prescribing Opioids for Chronic Pain — United...more

Washington Healthcare Update

by McGuireWoods LLP on

This Week: Congress unable to come to agreement on funding the government past Dec. 11 so a short-term funding bill was passed to give more time for negotiations... Tax extenders still being discussed as a vehicle for a...more

Millennium Health to Pay $256 million in False Claims Act Settlement

by Polsinelli on

Millennium Health, one of the nation’s largest urine drug testing laboratories, has agreed to pay the government $256 million to resolve claims that it violated the Federal False Claims Act (“FCA”). The Settlement...more

Health Care Update - October 2015

by Mintz Levin - ML Strategies on

Senate Working Group Pressing Forward on Telehealth - As Congress focuses on bigger picture policy decisions, including broad budget negotiations and raising the debt ceiling, there are some exciting developments on the...more

Washington Healthcare Update

by McGuireWoods LLP on

Bicameral Bill Introduced to Provide HHS Authority to Reject Proposed Insurance Rates - Before Congress left for its Columbus Day recess, Rep. Jan Schakowsky (D-IL) and Sen. Diane Feinstein (D-CA) introduced the Health...more

Clinical Laboratories: Proposed Rule Implements Requirements for Reporting and Payment Based on Private Payer Rates

by Foley & Lardner LLP on

As required by a 2014 statute, CMS has issued proposed regulations (Proposed Rule) implementing new requirements for laboratory reporting of, and eventually basing Medicare payment on, rates for clinical laboratory services...more

Manatt on Health Reform: Weekly Highlights - September 2015 #4

The Massachusetts Marketplace takes steps to ease consumer confusion by reducing choice among QHPs; North Carolina appears poised to pass Medicaid reform legislation; and bipartisan support is gaining for defining businesses...more

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