Healthcare

News & Analysis as of

Identifying the likely beneficiaries of an emerging biosimilars market

Financial analysts have predicted that over the next five years, biosimilars will be a $10 billion market, so it is understandable why considerable attention and investment is being made in this space. However, while there is...more

New Jersey Tax Court Eliminates Non-Profit Hospital’s Property Tax Exemption

On June 25, 2015, a New Jersey Tax Court issued a significant opinion in the case of AHS Hospital Corp. d/b/a Morristown Memorial Hospital v. Town of Morristown, upholding the Town of Morristown’s denial of Morristown...more

Health Alert (Australia) - August 3, 2015

In This Issue: - Judgments; Legislation; and Reports - Excerpt from Judgments: Victoria. 29 July 2015 - Inquest into the death of Jeffrey John McCarty The Victorian Coroner has investigated the death of...more

4 Ways Medicare and Medicaid Have Changed the Health Care Industry

It’s a bizarre program that is absolutely essential to American healthcare. That is the opinion of Theodore Marmor, professor of public policy at Yale and author of the book, The Politics of Medicare. Whether you agree with...more

Filer Beware! E-Filing Error Can Destroy Trade Secret Status

First rule of thumb in trade secrets litigation? A trade secret must be kept secret. It is painfully obvious, but modern practitioners must not grow complacent due to the convenience of electronic filing. Although trade...more

Final Rules for Preventive Services

The U.S. Departments of Treasury, Labor (DOL) and Health and Human Services (HHS) have issued interim final regulations and Frequently Asked Questions and Answers on the cost-free coverage of preventive services under the...more

The “Cross-Your-Fingers-And-Hope-It-Goes-Away” School of Statutory Interpretation”: Recent D.C. Circuit Opinion Orders HHS To...

On June 12, 2015, the U.S. Court of Appeals for the District of Columbia (the “Court”) issued an opinion questioning the Department of Health & Human Services’ (“HHS”) interpretation of congressional intent when it...more

NIST releases draft guide for use of mobile devices for medical providers

The National Institute of Standards and Technology (NIST) cybersecurity center released a draft guide last week for health IT professionals to use to bolster security for the use of mobile devices in the health care industry....more

Member information accessed through Healthfirst’s online portal during fraud scheme

On July 25, 2015, Healthfirst Inc. notified approximately 5,300 of its members that their information may have been compromised during a criminal fraud scheme perpetrated against it. The fraudulent scheme was discovered by...more

CMS Announces Hospices Invited to Participate in the Medicare Care Choices Model

On July 20, 2015, CMS announced the hospices invited to participate in the Medicare Care Choices Model. Under current Medicare rules, a Medicare beneficiary must forgo curative treatments to receive palliative care provided...more

CMS Issues CY 2016 Proposed Rule for OPPS, ASC Payment Systems and Quality Reporting

On July 8, 2015, CMS published in the Federal Register [PDF] its proposed changes and updates to the Medicare Hospital Outpatient Prospective Payment System (OPPS) and Ambulatory Surgical Center (ASC) Payment System policy...more

Anthem-Cigna Mega Merger Likely Problematic for Providers

Anthem announced on July 24, 2015 that it would purchase Cigna, just three weeks after Aetna agreed to buy Human for $37 billion. The deal is valued at $54.2 billion, and would create the United States’ largest health insurer...more

Defrauding Medicare — A Little Help from the Private Sector?

The headline on Medicare last week was astounding — $60 billion (not million) was lost each year to Medicare fraud, large numbers of fraudulent providers were providing fake or bad addresses – meaning locations including...more

Bio/Pharma IPR Challenges Nearly Double in 2015

Newly released statistics (2015-06-30 PTAB Statistics) from the USPTO reveal that the number of bio/pharma IPR challenges almost doubled in 2015, even though fiscal year 2015 still has three months to go. Last year, there...more

Getting More Personal: California Amends Data Security Law

California’s data security statute will get a little more “personal” as of January 1, thanks to a recently-passed amendment revising the definition of covered personal information. On July 14 California expanded the...more

MPT to Acquire GTCR-Backed Capella; Shows Value Added for PE in Hospital Space

MPT is a Birmingham, Ala.-based self-advised real estate investment trust. Capella is one of the largest for-profit hospital companies in the U.S. Based in Franklin, Tenn., Capella owns and/or operates seven hospitals across...more

“Everything Old is New Again” – Issues in Recent Cyber Insurance Litigation

Early days still for coverage litigation about cyber risks – whether under cyber insurance policies or other types of policies. This is not surprising given the relatively short history of cyber risks and even shorter history...more

Are Wellness Programs Worth It?

Please see Chart below....more

Affirming the Need to Fix the Medicare Appeals Backlog: The AFIRM Act of 2015

If you are one of the many health care providers wanting to appeal a Medicare contractor’s reimbursement decision, you may need to be prepared for a long wait. Over the last few years, the backlog of appeals to the...more

Health Care Update - July 2015 #3

ACA Repeal Votes Continue: As part of a rare Senate Sunday session to consider a bill to replenish the highway trust fund for six years, Majority Leader Mitch McConnell (R-KY) brought up an amendment to repeal the ACA—in...more

For-Profit PACE Programs: Harbinger of the Future?

The Program of All-Inclusive Care for the Elderly (PACE) is a benefit program provided by the federal government through the Centers for Medicare & Medicaid Services (CMS), geared toward the care of frail, elderly...more

CMS Call: Countdown to ICD-10 (Aug. 27)

On August 27, 2015, CMS is hosting a call to help health care providers prepare for ICD-10 implementation on October 1, 2015. CMS staff will be joined by representatives of the American Health Information Management...more

CMS Call on Proposed Reform of LTC Facility Requirements (Aug.11)

On August 11, 2015, CMS is hosting a provider call to discuss its proposed rule to reform the Medicare and Medicaid participation requirements for long-term care (LTC) facilities. A question and answer session will follow the...more

FCC Ruling Addresses Robocalls by Health Care Providers

Mintz Levin’s Communications Practice recently released a Communications Advisory discussing a Declaratory Ruling and Order released by the Federal Communications Commission (FCC). The ruling clarified and expanded the reach...more

Washington Healthcare Update

This Week: CMS Releases Guidance on Fast Track Process for 1115 Waivers for Medicaid and CHIP... Healthcare.gov CEO Sends Letter to State Insurance Commissioners Concerning 2016 Premium Decisions... Medicare Board of Trustees...more

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