News & Analysis as of

Health Care E-Note - March 26, 2014

In This Issue: - Hospital CEO Turnover Rate Reached Record 20 Percent in 2013 - States Take on Authority of Doctors vs. Advanced Practice Nurses - HHS Urges Hospitals to be More Prepared for Emergencies -...more

Judge’s Order to Unwind Hospital’s Acquisition of Physician Group Tests Boundaries of Antitrust Laws and the Affordable Care Act

A federal judge’s recent order to unwind the acquisition of Saltzer Medical Group, an independent physicians group, by St. Luke’s Health System, Ltd., a hospital system with its own staff of physicians, presents challenges...more

Polsinelli Podcast - Health Care Payment Changes: From Service to Value [Video]

Healthcare is changing for consumers and providers under the Affordable Care Act. Less publicized is the way providers are now being paid and the way they will work together. In this week's Polsinelli "Inside Law," podcast,...more

HHS Allows Third-Party Premium Payments By Tribes And Non-Profits

We previously reported that the U.S. Department of Health and Human Services ("HHS") has discouraged hospitals and other third parties from paying patients' premiums or cost-sharing. HHS stated in its November 4, 2013 FAQ...more

Health Reform + Related Health Policy News - January 2014, Issue 1

In This Issue: - Top News ..Congress Approves Budget Deal with Short-Term ‘Doc Fix' ..CMS “Two-Midnight” Rule delayed until March 31, 2014 ..Individuals with Canceled Insurance Policies May Apply for...more

Also in the News

President Obama Signs Pathway for SGR Reform Act of 2013 – On December 26, 2013, President Obama signed the Pathway for SGR Reform Act of 2013 (the “Act”), preventing the scheduled payment reduction for...more

CMS Reports Hospital Readmission Rates Declining Under Affordable Care Act

A recent CMS news release reported that Affordable Care Act reforms are leading to lower hospital readmission rates for Medicare beneficiaries. Hospital readmission can be an indicator of poor care coordination or low-quality...more

2013 – The Health Law Year in Review

As 2013 draws to a close, we are pleased to look back on the year that was and highlight some of the key developments in the ever-changing field of health law. While a great deal of attention was focused on the implementation...more

CMS Releases CY 2014 Hospital OPPS and ASC Final Rule

CMS has published its Calendar Year (CY) 2014 Final Rule for Medicare policy and payment rates for hospital outpatient prospective payment systems (OPPS) and Ambulatory Surgical Center (ASC) services. This final rule with...more

Why Are We Not Surprised? Hospital Charges Are The Largest Driver Of Medical Cost Inflation

In a recent front page report, The New York Times provided multiple examples of outrageously high hospital charges and pointed the finger at hospitals for being one of the principal drivers of rapidly increasing healthcare...more

HHS: Providers May Be Able to Subsidize Premiums For Uninsured in Marketplace Plans

An announcement October 30 from Health and Human Services Secretary Kathleen Sebelius could remove the first hurdle for providers wishing to offer premium support for individuals eligible for health insurance on the Health...more

Health Care E-Note - September 19, 2013

In This Issue: - Many States Want More Oversight of Health Insurance Navigators - Insurers, Hospitals Argue Over Who Pays When Enrollees Default - ACA Increases Scrutiny of Doctors' Gifts, Payments - States...more

340B Drug Pricing Program Update: Hospital Recertification and Recent Audit Activity

As part of its expanded authority resulting from the Patient Protection and Affordable Care Act (PPACA), the Health Resources and Services Administration (HRSA) is continuing its efforts to ensure compliance with 340B Drug...more

2014 Physician Fee Schedule: Cuts and Quality and Data! Oh My!

The Centers for Medicare and Medicaid Services (CMS) recently released the calendar year 2014 Physician Fee Schedule Proposed Rule (Proposed Rule)....more

CMS Releases FY 2014 Hospital IPPS Final Rule

On August 2, 2013, CMS released the annual Hospital Inpatient Prospective Payment System Final Rule for FY 2014 (the “Final Rule”), effective for discharges occurring on or after October 1, 2013....more

Client News Alert: Regarding Physician Payments Sunshine Act

On August 1, 2013 a new reporting obligation under the federal Physician Payments Sunshine Act (“Sunshine Act”) takes effect. The Sunshine Act was originally signed into law on March 23, 2010, as part of the Patient...more

HRSA Clarifies 340B Orphan Drug Exception But 340B Audit Enforcement Remains Murky

Recently, HRSA publicly announced the issuance of a final rule clarifying when 340B covered entities can purchase and distribute orphan drugs through the 340B Drug Pricing Program. Separately, HRSA quietly posted a report on...more

Health Care Reform Implementation Update - June 27, 2013

The countdown is on now. Less than 100 days until the Affordable Care Act’s (ACA) main provisions go into effect, and Organizing for Action and Enroll America kicked outreach efforts to the uninsured into high gear last week....more

Health Care E-Note - June 19,2013

In This Issue: - FTC Hospital Merger Investigation Highlights Cost of Health Care - Survey Finds Doctors Warming to Health Information Exchanges - Health Insurance Markets Seeing More Competition from New...more

Medicare Trustees Project Longer Solvency Period for Hospital Trust Fund

A May 31, 2013 report from the Trustees of the Federal Hospital Insurance and Federal Supplementary Medical Insurance Trust Funds projects that the Medicare Hospital Insurance Trust Fund will remain solvent through FY 2026,...more

Florida Legislative Session 2013: Healthcare Summary

The 2013 Florida Legislative Session concluded on May 3, 2013. The following is a partial summary of healthcare-related bills that may impact your business or practice. Note that some of these bills have become law, but...more

Bringing Sunlight to Healthcare Pricing: The CMS Release of Hospital Charge Data

Former U.S. Supreme Court Justice Louis D. Brandeis once said that "Sunlight is the best disinfectant." The release of charges billed by some 3,337 Medicare hospitals for 100 of the most common inpatient diagnosis related...more

Strategic Implementation of Employer Shared Responsibility Rules & 2014 Planning Considerations

In This Presentation: •Welcome •Overview of the Employer Shared Responsibility Rules - Impact on Corporate Structure - Time Line Examples to Demonstrate Application of Measurement, Administrative & Stability...more

IRS Proposes Regulations Regarding Community Health Needs Assessments for Charitable Hospitals

The IRS has released its proposed regulations [PDF] detailing the requirements for conducting and reporting Community Health Needs Assessments (CHNAs) under section 501(r)(3) of the Internal Revenue Code, which were...more

CMS Releases Proposed Inpatient Payment Regulation

On April 26, 2013, CMS released the proposed 2014 payment schedule for inpatient stays at general acute care and long-term care hospitals. In addition to the annual adjustment to payment rates, the proposed rule also reduces...more

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