Healthcare Providers

News & Analysis as of

GAO Assesses Considerations for Expansion of the Medicare Appropriate Use Criteria Program

On September 30, 2015, the Government Accountability Office (GAO) released a report entitled “Medicare: Considerations for Expansion of the Appropriate Use Criteria Program.” In addition to describing CMS’s plans for...more

GAO Report Calls for Enhanced Medicare Advantage Network Oversight

On September 28, 2015, the Government Accountability Office (GAO) released a report regarding CMS controls of provider adequacy in Medicare Advantage Organization (MAO) networks. The GAO pursued its review because many MAOs...more

Also In The News - Health Headlines - October 2015 #2

HHS Publishes Final Federal Health IT Strategic Plan 2015-2020 – On September 21, 2015, the Office of the National Coordinator for Health Information Technology (ONC) of HHS laid out the federal government’s final version of...more

Coming Soon to a Hospital near You: Mandatory Bundled Payments for Common Surgeries

Recent action by the Centers for Medicare and Medicaid Services (CMS) announces significant change in reimbursement methodology for high volume orthopedic surgical procedures in many markets nationwide. Affected stakeholders...more

The Proposed 340B Guidance:  Who is the Biggest Loser?

We have now had more than 30 days to digest HRSA’s proposed 340B Drug Pricing Program Omnibus Guidance (“Proposed Guidance”), intended to clarify expectations and provide guidance on key issues in the 340B Program. There are...more

ONC Releases Final Health IT Strategic Plan, Draft Interoperability Standards Advisory

The Office of the National Coordinator for Health Information Technology (ONC) has released its final Federal Health IT Strategic Plan for 2015-2020. The 50-page document details how the federal government intends to...more

Health Alert (Australia) - October 5, 2015

In This Issue: - Judgments; Legislation; and Reports. - Excerpt from Judgments: Victoria. Epichealth Pty Ltd v Yang [2015] VSC 516 The Supreme Court has granted an interlocutory...more

OIG Flags $171 Million in Potentially Questionable Billing for Medicare Ophthalmology Services

The OIG has issued a report entitled “Questionable Billing for Medicare Ophthalmology Services.” The OIG concludes that most Medicare providers billing for ophthalmology services in 2012 did not demonstrate what the OIG...more

Manatt on Health Reform: Weekly Highlights - October 2015

Congress passes a bill to give states greater flexibility in defining “small businesses”; South Dakota seeks to offset Medicaid expansion costs in part with increased use of the fully federally-funded Indian Health Service;...more

Market Allocation = Antitrust Consequences

The U.S. Department of Justice and the State of Michigan recently initiated a civil antitrust action to enjoin certain marketing agreements between four south-central Michigan hospital systems alleging that the agreements...more

Arkansas Medical Board Proposes to Relax State Telemedicine Laws

Last month, the Arkansas State Medical Board’s Telemedicine Advisory Committee indicated that it was in the process of drafting a rule that would allow establishment of a physician-patient relationship through the use of...more

CMS Implements Changes to Prospective Payment System for Long-Term Care Hospitals

The Centers for Medicare & Medicaid Services (CMS) has implemented a revised payment system for Long-Term Care Hospitals (LTCHs). The changes, which became effective on October 1, define two separate payment categories for...more

Health care consolidations: Complex maneuvers in a high-stakes environment

In today’s shifting health care landscape, providers are consolidating and forming strategic partnerships that position them to offer comprehensive, high-quality services at reasonable costs....more

Fast Alert: OIG Calls For Reevaluation Of Medicare Therapy Billing

On September 30, 2015, the Office of Inspector General (OIG) published a report titled, "The Medicare System For Skilled Nursing Facilities Needs To Be Evaluated" in response to growing concerns over Medicare's payment system...more

Telehealth and Consumer Subscription Models

Telehealth opportunities continue to grow at an exponential rate, aligning with the concurrent growth of retail and consumer-focused medicine. Capturing the retail sentiment, companies are looking to offer subscription-based...more

Also In the News - Data, Privacy, & Security Practice Report - October 2015

HHS Publishes Final Federal Health IT Strategic Plan 2015-2020 – On September 21, 2015, the Office of the National Coordinator for Health Information Technology (“ONC”) of HHS laid out the federal government’s final version...more

CMS to Host Call on Implementation of the IMPACT Act

On October 21, 2015, CMS is hosting a provider call to discuss the Improving Medicare Post-Acute Care Transformation (IMPACT) Act of 2014. The call will cover...more

Payment Innovation: 30 Day Window to Provide CMS Comments on Physician Payment Changes Under MACRA Begins

On September 28, 2015, the Centers for Medicare & Medicaid Services (CMS) published a Request for Information (RFI) seeking stakeholder comments related to innovative physician payment models required by the Medicare Access...more

Highlights from the Tenth CEO/Innovators Roundtable: June 4 – 5, 2015

This past June, leaders from health systems, outpatient services companies, health insurers, IT and equipment suppliers, health retailers, home care providers, pharmaceutical companies, and investors gathered in Chicago for...more

Take Steps Now to Prepare for eDiscovery to Save Money Later

eDiscovery lawyers like to say that a company’s first significant ediscovery matter will be their most expensive one. That’s because most companies don’t take the proactive steps that can minimize their exposure to ediscovery...more

Texas Surgical Centers: Aetna Improperly Denies or Underpays Out-of-Network Claims

Aetna is now facing another set of claims calling into question its determination and payment methodology for out-of-network reimbursement. On September 4, 2015, six surgical centers in Texas (Allied Center for Special...more

Florida Non-Competes: Physicians, Attorneys, Quarterbacks, Oh My…

Regular readers of this blog know that Florida law allows “valid restraints of trade,” under certain circumstances. Those restrictions apply to the employer-employee relationship when written and duly executed in accordance...more

FCC’s New Order Provides Some Guidance for Imaging Centers Placing Autodialed Calls to Patients

The Telephone Consumer Protection Act (“TCPA”) protects consumers from unwanted telephone calls and text messages by requiring a business to obtain prior express consent before placing autodialed or prerecorded voice calls to...more

Kentucky Supreme Court Compares Giving Up Jury Trial To Giving Up Parental Rights; Refuses To Enforce Arbitration

Nursing home arbitration agreements are among the most unpopular arbitration agreements around.  Last week, Kentucky’s Supreme Court issued a lengthy, but fractured, opinion, finding three arbitration agreements were never...more

U.S. to China Health Care Arrangements: New Rules for Medical Institution and Service Advertisements

As U.S. hospitals and health care providers continue to explore China’s market for international health care business opportunities, including telemedicine, they often consider providing services or products to consumers...more

273 Results
View per page
Page: of 11

"My best business intelligence, in one easy email…"

Your first step to building a free, personalized, morning email brief covering pertinent authors and topics on JD Supra:

Sign up to create your digest using LinkedIn*

*By using the service, you signify your acceptance of JD Supra's Privacy Policy.
*With LinkedIn, you don't need to create a separate login to manage your free JD Supra account, and we can make suggestions based on your needs and interests. We will not post anything on LinkedIn in your name. Or, sign up using your email address.