Healthcare

News & Analysis as of

President Signs MACRA: Permanently Reforms Medicare Physician Reimbursement Framework, Includes Other Medicare Payment, Program...

On April 16, 2015” (MACRA), which reforms Medicare payment policy for physician services and adopts a series of policy changes affecting a wide range of providers and suppliers. Most notably, MACRA permanently repeals...more

CMS’s Proposes Rule On Mental Health Parity to Strengthen Access to Medicaid and CHIP Plans

On April 6, 2015, CMS announced a proposed rule intended to align mental health and substance use disorder benefits for low-income Americans with benefits required of private health plans and insurance. The proposed rule...more

States Expanding Medicaid See Significant Budget Savings and Revenue Gains

In a report prepared for the State Health Reform Assistance Network, Manatt highlights key ways in which eight states—Arkansas, Colorado, Kentucky, Michigan, New Mexico, Oregon, Washington and West Virginia—were able to...more

Legal and Regulatory Landscape for Mobile Health Technologies

Mobile health (mHealth) technologies continue to expand in application and implementation. Over the past decade, the breadth of these technologies has grown from the creation of healthcare-directed websites (think WebMD) to...more

The Supreme Court Holds That Medicaid Providers Cannot Sue To Enforce Federal Reimbursement Rate Standards

On March 31, 2015, the U.S. Supreme Court issued its decision in Armstrong v. Exceptional Child Center, Inc., holding that Medicaid providers cannot sue to enforce reimbursement standards set forth in federal Medicaid law....more

Physician Non-Compete Agreements and Antitrust

Antitrust claims based on employee non-compete agreements generally fail because the plaintiff cannot establish antitrust standing. In the Eleventh Circuit, the test for antitrust standing requires the plaintiff show (1)...more

Do electronic records pose a risk to patient safety?

The Affordable Care Act has changed many facets of health care for Illinois residents. Not all of these changes are necessarily beneficial. In 2009, the new law offered incentives for doctors who began using electronic health...more

Telemedicine Providers Need to Keep Up with State Laws

Tech-savvy health care providers and tech-savvy patients in California can be grateful for California’s policies regarding telehealth practices. Consider the turmoil in Texas: telehealth practitioners who want to treat...more

Look Out for Meaningful Use Audits by the Office of Inspector General

The Medicare and Medicaid Electronic Health Care Record (“EHR”) Incentive Program (commonly referred to as “Meaningful Use”) provides incentive payments to eligible physicians and hospitals for adopting, implementing,...more

CMS Provides Guidance to States on Managed Care Contract Review

As states attempt to control increasing healthcare costs, many Medicaid programs are seeking approval from the Centers for Medicare & Medicaid Services (CMS) to implement Medicaid managed care programs. In 2013, nearly 68...more

CMS Issues Guidance on Reimbursement for Biosimilars under Medicare and Medicaid

Biosimilars Are Generally Treated as Single Source Drugs - On March 30, 2015, in the wake of the first biosimilar product licensed by the Food and Drug Administration (FDA), the Centers for Medicare & Medicaid Services...more

Healthcare News Alert: Congress Passes Repeal of Sustainable Growth Rate

In a 92-8 vote on Tuesday, the Senate passed a bipartisan measure to repeal the Medicare payment formula known as the Sustainable Growth Rate. This bill was part of a deal negotiated in the House between House Speaker John...more

Senate Approves Medicare “Doc Fix” Legislation

We wrote in late March about the U.S. House of Representatives passing SGR legislation intended to be a permanent cure to Medicare’s “doc fix” legislation. ...more

Health Law Wire: $1.2 Billion CRFP Grant Deadline Now May 6, 2015 – Applications To Be Re-Submitted Under New Standards (4/15)

In the recently enacted 2015-2016 State Budget, the “Capital Restructuring Financing Program” (CFRP), which provides up to $1.2 billion in capital funding to support DSRIP project goals, was significantly amended to require...more

Congress Repeals Medicare Sustainable Growth Rate (SGR)

MGMA has published the following alert: Congress repeals SGR! In a significant victory for physician group practices and MGMA, late last night the Senate voted (92-8) to approve the Medicare Access and CHIP...more

CMS Clarifies Survey Requirements for Off-Premises Activities of Outpatient Physical Therapy Providers

On April 3, 2015, CMS issued letter guidance and an update to the State Operations Manual (SOM), which will be of interest to outpatient therapy (OPT) providers. Medicare issued new clarifications on the survey requirements...more

The Many Levels of Supervision

Non-physician practitioners or physician extenders, as they are often called, are now common place in physicians' offices and have been for some time. They are an integral part of the private practice of medicine for the...more

Significant Guidance Released Regarding HIPAA Compliance

The Office of the National Coordinator for Health IT (ONC) released an updated version of the 2011 Guide to Privacy and Security of Electronic Health Information (Guide). The 62-page Guide provides significant guidance to...more

PilotFish Announces MedDevice Connection App

Applied PilotFish Healthcare Integration, Inc. (APHII) recently announced a new application called HealthConnect. APHII is the healthcare division of PilotFish Technology, a provider of middleware solutions for the...more

CMS Issues Proposed Modifications to Meaningful Use Rule

On Friday, April 10, 2015, CMS issued a proposed rule containing several important modifications to the Medicare and Medicaid EHR Incentive Programs. Among the most notable proposals is to move eligible hospitals from a...more

Federal Trade Commission and Department of Justice Hold Joint Workshop on Payment Models and Competition Within the Health Care...

On February 24-25, 2015, the Federal Trade Commission (“FTC”) and Antitrust Division of the Department of Justice (“DOJ”) co-hosted a second public workshop as part of the “Examining Health Care Competition” series to study...more

Around the Virtual World: April 6 – 10, 2015

A weekly wrap up of interesting news about virtual worlds, virtual goods, and other social media. In This Issue: - Will Doctors Soon Prescribe Video Games? - 5 ways the Postal Service could save money...more

Beyond HIPAA: Connected Health Care and the Internet of Things

The U.S. Federal Trade Commission (FTC) Staff Report titled "Internet of Things: Privacy & Security in a Connected World," released in January 2015, continues to generate interest and questions about the regulation of health...more

Five Key Elements of Transitional Care Management

Similar to rules providing billing opportunities for chronic care management, relatively new Medicare funds for Transitional Care Management (“TCM”) provide a new path for providers to supplement their Medicare practice with...more

Washington Healthcare Update

This Week: Montana Legislature Reverses Course, Endorses Medicaid Expansion... Final 2016 Medicare Advantage and Part D Rate Announcement and Call Letter... Upcoming: Energy and Commerce Subcommittee Hearing on Post-Acute...more

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