Healthcare

News & Analysis as of

CMS Issues Rewards and Incentive Guidance to MA Plans

On December 4, 2014, CMS issued additional guidance regarding rewards and incentives programs (“RI Programs”). This guidance elaborates on whether an RI Program can target members with specific diseases, whether rewards can...more

Beneficiary Assignment in the Proposed Revised Medicare Shared Savings Program Regulations

This post addresses the changes that the rule would make to how CMS assigns beneficiaries to an ACO participating in the MSSP. The Proposed Rule places a renewed emphasis on primary care for beneficiary assignment. Section...more

Health Care Update - December 2014 #4

Let’s Get to Work: OIG Releases 2015 Work Plan, Focusing on Long-Term Care and Health Reform - The U.S. Department of Health and Human Services (HHS)--Office of Inspector General (OIG) released its 2015 Work Plan (Work...more

Registration Begins for American Telemedicine Association’s New Accreditation of Online Medical Services

The American Telemedicine Association (ATA) is now accepting limited registrations for organizations that wish to gain ATA’s seal of approval for online medical services. Registration for the new Accreditation Program for...more

California’s Insurance Fraud Prevention Act: 3 unsettled issues the health sector should understand

California’s Insurance Frauds Prevention Act, Ins. Code §§ 1871 et seq. (IFPA), is an unusual false claims statute. It allows “interested persons” (aka whistleblowers or relators) to file false claims lawsuits based on the...more

CMS Proposes Posting Overall Star Rating for HHAs on Home Health Compare Website in 2015

On December 11, 2014, CMS issued a fact sheet detailing its proposal for assigning an overall star rating for each home health agency (HHA) on the Home Health Compare website starting in 2015. An HHA’s star rating would be...more

Recent Changes to Stark Law's Whole Hospital Exception

The federal physician self-referral law, or Stark Law, provides a number of exceptions to the law's prohibition of physician referrals of designated health services to an entity in which the physician has an ownership or...more

CMS Proposes Sharing More Data With ACOs Participating in the Medicare Shared Savings Program

CMS may be ready to ramp up the data it is willing to share with Accountable Care Organizations (“ACOs”) that participate in the Medicare Shared Savings Program (“MSSP”). CMS explained in the November 2011 final rule...more

Changing Basic Rules of the Game: CMS Proposed Rule Relating to ACO Governance and Contracting

The Centers for Medicare and Medicaid Services released a new proposed rule for Accountable Care Organizations (ACOs) participating in the Medicare Shared Savings Program (MSSP). This advisory expands upon our initial...more

Advertising Law - December 2014 #3

FCC Proposes Online Disclosures for Broadcast Contests - The Federal Communications Commission has proposed a rule change that would allow broadcast stations to disclose on the Internet the material terms for contests...more

ACA Outlook: What Will 2015 Hold for the Affordable Care Act and Employers?

For many employers, the effective date of the Affordable Care Act's "play-or-pay" mandate is only weeks away. The impending deadline comes amid questions about the future—and perhaps viability—of the law itself. Entering...more

Blog: No More Paper PIs? FDA Issues Proposed Rule on Electronic Distribution of Prescribing Information

Yesterday, the U.S. Food and Drug Administration (FDA) announced a proposed rule to require electronic distribution of the prescribing information intended for health care professionals (often called the “PI”) for human...more

CMS Announces Next Phase in Medicare DMEPOS Competitive Bidding Program

On December 11, 2014, CMS announced the bidding timeline for the Medicare Durable Medical Equipment, Prosthetics, Orthotics and Supplies (DMEPOS) Competitive Bidding Program Round 2 Recompete and National Mail-Order...more

Manatt on Health Reform: Weekly Highlights: December 2014 #3

Enrollment numbers and Medicaid reform top the news this week. Federal officials report 1.4 million consumers have selected plans on healthcare.gov. And in the states, Michigan and New Hampshire announce Medicaid expansion...more

The M&A Outlook in the Middle East: A Look Back at 2014 and Beyond

The Megatrends in Mergers & Acquisitions conference held in October 2014 focused on the evolving M&A landscape, promoting inbound and outbound M&A in the Middle East, and general industry trends. Among the speakers at the...more

Health Care Update - December 2014 #3

In This Issue: - Congress passes CROmnibus - Implementation of the Affordable Care Act - Other Federal Regulatory Initiatives - Congressional Initiatives - Ongoing Ebola Response -...more

MSSP Proposed Rule Seeks to Enhance ACO Transparency and Patient Engagement

Under the Medicare Shared Savings Program (“MSSP”) ACO proposed rule, CMS has proposed additional program requirements, beneficiary protections and participation agreement procedures to enhance ACO transparency and improve...more

Highlights of the 2015 Home Health Prospective Payment Rule

On November 6, 2014, CMS published its final Medicare home health prospective payment system (HH PPS) rule for calendar year (CY) 2015. As highlighted below, notable changes in the HH PPS final rule [PDF] include: (1) a...more

FDA Issues Guidance on “Patient Counseling Information”

The Food and Drug Administration (FDA) has released new Guidance to assist in developing the “Patient Counseling Information” section of labeling required under § 201.57(c)(18) of the “Physician Labeling Rule.” See 21 C.F.R....more

Health Care Update - December 2014 #2

In This Issue: - SGR Replacement Odds Not Likely to Increase Ahead of Upcoming Deadline - Implementation of the Affordable Care Act - Other Federal Regulatory Initiatives - Congressional...more

The Beat Goes On: Antitrust Enforcement and Healthcare*

In one form or another, the Federal Trade Commission (FTC) has been banging the drum that there is no inconsistency between antitrust enforcement and healthcare. The latest to pick-up the drumbeat is the chair of the FTC...more

OIG Report: MCOs Cause Limited Access to Primary Care for Medicaid Enrollees!

With flu season well under way, access to care to primary care physicians for Medicaid recipients is (as it is always) extremely important. During flu season, in particular, emergency rooms (ERs) are full of people suffering...more

Conspiracy? Ohio Federal Court Says No; Holds That Health System Joint Venture Is a Single Entity Incapable of Conspiring in...

When competing health care providers affiliate by contract, rather than by merger or acquisition, they often face the challenge of structuring their joint activities to avoid liability under § 1 of the Sherman Act, which...more

Health Alert (Australia) - December 15, 2014

In This Issue: Judgements; Legislation; and Reports. Excerpt from Legislation: Commonwealth - Aged Care and Other Legislation Amendment Act 2014 - C2014A00126 • Act No. 126 of 2014 as made -...more

Oklahoma Legislature significantly expands peer review privilege

Oklahoma’s peer review statute provides that peer review information is private, confidential, and privileged. It encourages health care professionals to police themselves by evaluating their peers. It also promotes the...more

3,307 Results
|
View per page
Page: of 133