Hospitals Patient Protection and Affordable Care Act (PPACA)

News & Analysis as of

Anatomy of a Provider-Merger Antitrust Challenge (Part 6)

This is the concluding installment of a six-part series discussing the Federal Trade Commission's challenges to provider mergers. Following the initial Introduction and Background (Part 1), the series discusses The Need for...more

Manatt on Health Reform: Weekly Highlights - May 2015

This week Montana became the 30th state to expand Medicaid, and the battle over Medicaid expansion and uncompensated care reached a breaking point in Florida. Meanwhile, as the King v Burwell decision looms, Congress and...more

ABA Antitrust Spring Meeting Highlight: “Antitrust & Health Care: Square Peg in a Round Hole?”

In this month’s American Bar Association (ABA) Section of Antitrust Law Spring Meeting, the program “Antitrust & Health Care: Square Peg in a Round Hole?” featured debate and discussion about antitrust law treatment of health...more

Challenge to DSH Adjustment Estimates Barred by Statute

In a decision issued on March 31, the United States District Court for the District of Columbia dismissed a challenge by Florida Health Sciences Center, Inc., also known as Tampa General Hospital, to the calculation of its...more

Health Care Enforcement: The Impact on Private Equity Investments [Video]

Brian Platton provides an overview of enforcement trends that private equity investors should be aware of before entering into the health care space....more

Washington Healthcare Update

This Week: Energy and Commerce Health Subcommittee Explores Post-Acute Bundling…CMS Releases First-ever Hospital Compare Star Ratings…Fiscal Year 2016 Proposed Inpatient and Long-term Care Hospital Policy and Payment Changes....more

SGR Law Brings Changes to CMP Prohibition on Gainsharing

On April 16, President Barack Obama signed into law the “Medicare Access and CHIP Reauthorization Act of 2015,” ending a perennial struggle over the Medicare reimbursement formula for physicians. Although the law is most...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

Health Care: New IRS Requirements For Charitable Hospitals (4/15)

The IRS published its long awaited final rule December 31, 2014 to implement certain requirements of the Affordable Care Act (the ACA). The ACA added a new provision in Section 501(r) of the Tax Code, which creates additional...more

[Webinar] Health Care Antitrust Trends In 2015: What Is the Government Really Up To? - April 23rd, 12 pm

The Federal Trade Commission and the Department of Justice Antitrust Division continue to stake out an aggressive health care antitrust agenda — and they have “the wind at their backs.” In important recent decisions, two...more

Hospital Wins First Round Against Largest Rival in Antitrust Suit Alleging Illegal Exclusive Dealing Agreements with Insurers

The waves of change affecting health care providers include reimbursement and funding developments, the impact of the Affordable Care Act, technological and medical advances, provider network design transformations imposed by...more

Nonprofit Hospitals Face Additional Regulatory Burdens in Financial Assistance and Debt Collection

Roughly 60 percent of hospitals nationwide either have received or are seeking tax-exempt status under the United States Treasury Department (Treasury) and Internal Revenue Service (IRS) rules and regulations. With new final...more

New IRS Revenue Procedure Finalizes Guidance Regarding Correction and Disclosure of Charitable Hospitals’ Failures to Meet the...

On March 10, 2015, the Internal Revenue Service (IRS) issued Revenue Procedure 2015-21, which provides guidance regarding correction and disclosure procedures applicable to certain failures by charitable hospitals to meet the...more

Charitable Hospitals: Financial Assistance Policies

The Internal Revenue Service (IRS) has issued the final section 501(r) regulations, implementing the amendments to the Internal Revenue Code under the Affordable Care Act and providing regulatory guidance for tax-exempt...more

IRS Lessens Reporting Burden on Charitable Hospitals

This week, the IRS issued new guidance for charitable hospitals that are required to disclose the failure to meet the requirements imposed by the Affordable Care Act. This new guidance is meant to lessen the burden on such...more

Charitable Hospital Organizations and the Affordable Care Act

The IRS has issued final regulations providing guidance on certain complex requirements imposed on charitable hospital organizations added by the Patient Protection and Affordable Care Act of 2010. Specifically, the...more

The Unhappy Intersection of Hospital Mergers and Antitrust Laws

The rapidly-evolving field of health care has been moving lately towards a single-minded goal – coordination of patient care in the name of efficiency and efficacy. Hospital systems are more and more often merging with other...more

FTC and DOJ Host Workshop Examining Health Care Competition - Updated 2015

The Federal Trade Commission (FTC) and the Antitrust Division of the U.S. Department of Justice (DOJ) held a public workshop on February 24–25, 2015, to examine recent trends and developments in health care provider...more

Ninth Circuit and Massachusetts Superior Court Release Important Antitrust Decisions

The Ninth Circuit Court of Appeals and a Massachusetts Superior Court each recently released decisions dealing with alleged violations of antitrust prohibitions that implicate a number of important issues surrounding health...more

In it Together -- Emerging Joint Venture Structures for Hospitals and Insurers

Locke Lord lawyers Jon Biasetti, Baird Allis and Benjamin Sykes provide a detailed look at recent efforts by hospitals, physician practice groups and health insurance and managed care companies to lower health care delivery...more

Health Care Update - February 2015 #3

In This Issue: - IRS in the ACA Spotlight - DOJ and FTC Examine Competition - Implementation of the Affordable Care Act - Other Federal Regulatory Initiatives - Congressional Initiatives - Other...more

Classic Antitrust Principles Apply to Health Care Mergers Even Post-ACA

The Ninth Circuit last week held that St. Luke’s Health System’s purchase of a physician practice group violated federal antitrust laws. In doing so, it upheld a district court’s order that the merger be dissolved. ...more

Implications of Final Regulations Under Internal Revenue Code Section 501(r)

The Internal Revenue Service replaced proposed regulations under Section 501(r) of the Internal Revenue Code (the “Code”) with final regulations in late 2014 (the “Final Regulations”). As enacted in the Patient Protection and...more

Ninth Circuit Upholds Ruling for FTC in Hospital Merger Challenge

The Ninth Circuit upheld a district court’s ruling ordering St. Luke’s Health System to unwind its purchase of the Saltzer Medical Group. The decision is another victory for the Federal Trade Commission (FTC) in its renewed...more

Washington Healthcare Update

This Week: President’s FY2016 Budget Request... FDA Commissioner Hamburg to step down... Tennessee Medicaid expansion plan rejected by legislature. 1. Congress House House Ways and Means Committee Hosts Hearing...more

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