Healthcare

News & Analysis as of

Healthcare Regulatory Diligence: “What Does it Mean to Financial Underwriting?”

It’s deal time! The 2016 JP Morgan Healthcare Conference has set the tone for another successful year for healthcare investing. A company’s financial health is a key factor in the underwriting process for any type of loan...more

U.S. Departments of Education and Health and Human Services Issues Joint Policy Letter On Improving School-Based Health

The United States Departments of Education and Health and Human Services (the “Departments”) recently issued a joint policy letter emphasizing the importance of improving school-based health through the use of partnerships...more

Antitrust: “Doctor, Doctor, Give Me the News”* Court gives Teladoc some good news in its antitrust challenge to Texas Medical...

Back in April 2015, Teladoc, Inc., which provides U.S. board-certified doctors for consults via phone or online video, filed an antitrust challenge to stop a new Texas Medical Board (TMB) rule from taking effect that requires...more

FDA Not Sure About Essure

Medical doctors have a great deal of responsibility placed upon them. After years of training and practice, they are expected to have the skill and ability to identify symptoms and translate that into a diagnosis. That...more

CMS Issues Final Rule Implementing Mandatory Bundled Payment Program for Lower Extremity Joint Procedures

The Centers for Medicare & Medicaid Services (CMS) recently issued a final rule (Final Rule) that implements the Comprehensive Care for Joint Replacement model (CJR Model), a new bundled payment program covering certain...more

HHS issues new guidance on individual access to PHI under HIPAA

On January 7, 2015, HHS issued new guidance (Guidance) regarding an individual’s right to access his or her health information under HIPAA’s Privacy Rule. The Guidance emphasizes that HIPAA, while protecting the privacy and...more

Review of the 2015 Global IPO Market

According to Renaissance Capital’s 2015 Annual Review of the Global IPO Market, a total of 310 IPOs were completed in 2015 raising $156.5 billion in proceeds. This is a 35% decrease from 2014’s figures, yet remains higher...more

Recent Changes to the Stark Law Provide Added Flexibility

The 2016 Medicare Physician Fee Schedule Final Rule ("Final Rule") contains recent changes to the Federal Stark Law, the majority of which took effect on January 1, 2016. The issuance of the Final Rule on November 16, 2015...more

Infrastructure Deals Dominate Digital Health Investment in 2015

Among its list of defining quotes of 2015, Rock Health included one from a physician who was frustrated with the fact that, as she put it, “In my hospital there are 19 software systems across departments – few of which...more

Health Law Pulse - January 2016

CHANGES TO STARK LAW, NEW ADVANCE CARE PAYMENTS INCLUDED IN 2016 PHYSICIAN FEE SCHEDULE - The Centers for Medicare & Medicaid Services (CMS) recently published a final rule (Final Rule) regarding physician payment...more

Deadlines Extended on Cadillac Tax and ACA Forms 1095 and 1094 Reporting

In a recent Omnibus appropriations package, Congress extended the effective date for the Affordable Care Act (ACA) "Cadillac Tax" by two years, from plan years beginning on or after January 1, 2018, to plan years beginning on...more

Record Mega-Settlements May Attract More Whistleblowers

September was a record-setting month for the United States Department of Justice, which entered into major health care fraud settlements with two large Floridabased hospital systems. The settlements were made in the face of...more

The Managed Care Industry – 2015 Year in Review

As we start a new year, let’s take a look back at a few hot topics that emerged in the managed care industry in 2015 and will likely be drivers of developments in 2016. Industry Consolidation – The Changing Landscape...more

Could Your Medical Device Be a Hacker’s Gateway into a Hospital Network?

This has been a big year for health care data breaches. In January, the data of 80 million Anthem members was compromised; in March, a cyberattack exposed the data of 11.2 million Premera BlueCross BlueShield members and...more

Avoiding the Bull’s-Eye

The federal government collected over $200 million from three settlements based on health care fraud and abuse allegations this past September. This staggering amount excludes fees paid to attorneys, consultants and expert...more

Texas Medical Board Loses Bid for State Action Immunity

The Teladoc decision reinforces that state boards that are composed of market participants need to reassess how they are supervised if they seek shelter from antitrust scrutiny under the state action doctrine....more

CMS Updates Two-Midnight Rule

The Centers for Medicare and Medicaid Services (CMS) has revised the two-midnight rule to create an exception that will allow payment under Medicare Part A for certain medically necessary hospital stays that do not extend...more

IRS Extends 2015 Affordable Care Act Information Reporting Deadlines

In a welcome development for employers and health coverage providers, the IRS has extended the Affordable Care Act information reporting deadlines. Unlike the prior transition relief in which the IRS delayed the information...more

Digital health funding hits $4.3 billion in 2015

A new report from Rock Health states that digital health funding in 2015 reached $4.3 billion from 180 merger and acquisition deals in the past year, primarily with IPOs in the first half of 2015. This represents 7 percent of...more

Quest Defeats Claims that It Conspired with Health Insurers

On November 25, District Court Judge William Orrick (N.D. Cal.) dismissed all claims in Eastman v. Quest Diagnostics, finding that the plaintiffs, a class of Northern California consumers who had utilized Quest's services,...more

Telehealth

We previously reported on the case between Teladoc, Inc. and the Texas Medical Board (Board). The medical board issued regulations requiring doctors to see patients in person before prescribing medication. Teladoc sued the...more

Regulations Limiting Executive Compensation and Administrative Costs of State-Funded Providers Upheld by Appellate Division,...

On December 30, 2015, the New York State Appellate Division, Second Department issued a decision in Agencies for Children’s Therapy Servs., Inc. v. N.Y. St. Dep’t of Health, upholding the regulations promulgated by the...more

Employee Benefits Developments - December 2015

ALERT: IRS Extends ACA Reporting Deadlines. With only a few days remaining in 2015, the IRS provided some welcome relief for employers subject to certain Affordable Care Act reporting requirements. Under IRS Notice 2016-4,...more

Happy New Year from the IRS

Yet another end-of-year brings another late-breaking IRS notice. The IRS has extended the deadlines that apply to employers and coverage providers for reporting health coverage through the 2015 Forms 1094/1095. ...more

The Netherlands Publishes Report on Nanotechnologies in Medical Devices

The Netherlands National Institute for Public Health and the Environment (RIVM) posted on December 17, 2015, a report entitled Nanotechnologies in medical devices. RIVM conducted an investigation to provide insights into and...more

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