Physicians, Affordable Care Act

Hospital-Physician Mergers: Practical Issues and Steps to Minimize Antitrust Risk

by William Berlin | Ober|Kaler on 4/26/2013

Recently, hospitals have been actively acquiring primary care and specialty physician groups, resulting in the employment of those physicians. This trend has occurred largely in response to reimbursement changes and other...more

Highlighting Transparency Through The Federal Sunshine Act Regulations

by Bruce D. Armon | Saul Ewing LLP on 4/9/2013

The final regulations implementing the Physician Payments Sunshine Act take effect April 9, 2013. Pharmaceutical manufacturers, group purchasing organizations, academic medical centers and physicians need to be ready to...more

Health Care Reform Update -- April 2, 2013

by Joseph P. Hammang, Alexander Hecht, Kevin M. Kappel, Tom Koutsoumpas, Jeremy Rabinovitz, Robert C. Skinner | Mintz Levin - Health Law on 4/3/2013

In This Issue: Implementation of the Affordable Care Act (ACA); Other HHS and Federal Regulatory Initiatives; Other Congressional and State Initiatives; Other Health Care News; and Hearings and Mark-Ups...more

Ordering/Referring Phase 2 Begins May 1st - Claims Will Be Denied

by Donna Senft | Ober|Kaler on 3/30/2013

In an April 24, 2009 transmittal, CMS announced a two-phase claims editing expansion designed to allow verification that the physician or non-physician practitioner (NPP) listed as the ordering/referring provider on a...more

Getting Ready For The Physician Payment ‘Sunshine’ Rule

by Kathleen Howard, Joel R. Levin, Charles Mulaney, Jerica L. Peters | Perkins Coie on 3/22/2013

Originally Published in BNA Bloomberg, Medical Devices Law & Industry Report on March 20, 2013. On February 1, 2013, the Centers for Medicare and Medicaid Services (CMS) published the long-awaited final regulations for...more

Here Comes the Sun: What You Need to Know about the Sunshine Act and Its Implementing Rules

by Edward Buthusiem, Cheray Lynch Sieminski | Berkeley Research Group, LLC on 3/20/2013

After years of deliberation, the Center for Medicare & Medicaid Services (CMS) published its long-awaited regulations to implement the specific requirements of the Physician Payment Sunshine Act (Sunshine) on February 1,...more

ProPublica's "Dollars for Docs": Will The Physician Payments Sunshine Provisions Clear The Haze?

by Robert Radick | Morvillo Abramowitz Grand Iason & Anello P.C.... on 3/20/2013

On February 1, 2013, the Centers for Medicare and Medicaid Services (CMS) published the long-delayed final rule that is intended to implement the Physician Payments Sunshine provisions that were included in the Patient...more

CMS Issues Rules On Physician Payments Sunshine Act

by Michael Volkov on 3/15/2013

People like to think they have it the hardest in life. I call it the competition among victims. If you are in the healthcare industry and fall under the Physician Payments regulations, then I think you are on your way to...more

Final Sunshine Act Arrives: Now the Hard Part

by Michele L. Buenafe, Jonathan Havens, Kathleen McDermott, Rebecca Osowski, Albert Shay | Morgan Lewis on 3/8/2013

The Centers for Medicare and Medicaid Services (CMS) issued the final regulations on the U.S. Sunshine Act on February 8, 2013. Transparency Reports and Reporting of Physician Ownership or Investment Interests, 78 Fed. Reg....more

Just How Much Integration Is Enough: FTC Advisory Opinion Finally Provides Guidance For Competitors Seeking To Collaborate Or...

by Barak Bassman, Daniel Boland, Deirdre McInerney, Barbara Sicalides | Pepper Hamilton LLP on 3/7/2013

The Federal Trade Commission (FTC) recently issued its first advisory opinion addressing clinical integration programs since the enactment of the Affordable Care Act (ACA). Without a doubt the advisory opinion is useful for...more

Physician Payment Sunshine Act Final Rule Released

by Thomas Donohoe, Lauren Groebe, Lindsay Kessler, Matthew Murer | Polsinelli on 3/7/2013

In This Issue: - Interpretation and Clarification of Key Definitions ..Applicable Manufacturers ..Applicable GPOs ..Covered Drug, Device, Biological or Medical Supply ..Covered Recipients ...more

The Sunshine Physician Payment Final Rule Overview and Analysis

by Nancy Bonifant, Elizabeth Carder-Thompson, Katie Pawlitz | Reed Smith on 3/6/2013

On February 1, 2013, the Centers for Medicare & Medicaid Services (CMS) of the Department of Health and Human Services (HHS) released the long-awaited Final Rule (Rule) to implement the “Sunshine” provisions of the Affordable...more

Research-Related Payments and the Physician Payment Sunshine Act: How Reporting Works and What Applicable Manufacturers Should...

by Frederick Ball, Elinor Hart, Michael A. Swit | Duane Morris LLP on 3/6/2013

On February 1, 2013, the Centers for Medicare & Medicaid Services (CMS) published long-awaited rules (the "Rules") detailing manufacturers' and group purchasing organizations' reporting requirements under Section 6002 of the...more

CMS Publishes Physician Payment Sunshine Rules; Manufacturers and Group Purchasing Organizations Are Required to Submit Detailed...

by Frederick Ball, Elinor Hart | Duane Morris LLP on 2/25/2013

On February 1, 2013, the Centers for Medicare and Medicaid Services (CMS) published the long-awaited rules (the "Rules") detailing manufacturers' and group purchasing organizations' reporting requirements under Section 6002...more

FTC's Norman PHO Advisory Opinion - New Clinical Integration Guidance, Same Antitrust Analysis

by William Berlin | Ober|Kaler on 2/21/2013

The Federal Trade Commission (FTC) provided its first guidance for clinically integrated networks since passage of the Affordable Care Act (ACA) and the joint FTC/DOJ Accountable Care Organization (ACO) Antitrust Policy...more

FTC Issues Another Favorable Clinical Integration Program Advisory Opinion

by Ashley Fischer | McDermott Will & Emery on 2/20/2013

In a February 13, 2013, advisory opinion, the Federal Trade Commission (FTC) Bureau of Competition stated that it has no present intention to recommend that the FTC challenge a clinical integration program (CIP) proposed by...more

FTC Issues First Clinical Integration Advisory Opinion Post-ACA

by Michael Denniston, Jay Hardcastle, Jay L. Levine | Bradley Arant Boult Cummings LLP on 2/20/2013

FTC staff advisory opinions are not issued all that frequently and advisory opinions regarding clinical integration are issued even less frequently. The latest advisory opinion, issued last week, is therefore noteworthy, not...more

CMS Issues Final Rule for Implementing Sunshine Act

by Wilson Sonsini Goodrich & Rosati on 2/14/2013

On February 8, 2013, 16 months after the statutory deadline, the Centers for Medicare & Medicaid Services (CMS) published in the Federal Register the final regulation implementing the physician payment transparency...more

The Physician Payment Sunshine Act Final Rule A Summary Of Key Provisions

by Pat A. Cerundolo, Igor Gorlach, Tad Heuer, Colin J. Zick | Foley Hoag LLP on 2/8/2013

On February 1, 2013, Centers for Medicare and Medicaid Services (CMS) published the long-awaited Physician Payment Sunshine Act (Sunshine Act) Final Rule, implementing Section 1128G of the Social Security Act. The...more

CMS Shines Light on Financial Relationships with Final Physician Payment Sunshine Act Rule

by Matthew Arend, Jennifer Mitchell | Dinsmore & Shohl LLP on 2/7/2013

On February 8, 2013, the final Physician Payment Sunshine Act (“Sunshine Act”) rule, issued by the Centers for Medicare and Medicaid Services (“CMS”) will be published. The arrival of this final rule has been much anticipated...more

Effective January 2013: Ordering- and Referring-Only Providers Must Enroll in Texas Medicaid

by Carla Cox | Jackson Walker on 1/11/2013

Texas Medicaid providers that receive referrals from non-participating physicians or other health care providers need to beaware that beginning January 1, 2013, individual providers who arenot currently enrolled in Texas...more

Health Law Alert: Special Focus: Antitrust: Renown Health-FTC Antitrust Agreement: Guidance for Hospitals Acquiring and Employing...

by Ober|Kaler on 9/17/2012

Renown was represented in the agencies' investigation and the ensuing settlement negotiations by Ober/Kaler principal Bill Berlin, a member of the firm's Antitrust and Competition Group. On August 6, 2012, Renown...more

How Physician Practices and Physicians Can Take Advantage of the Supreme Court's ACA Ruling

by Saul Ewing LLP on 9/11/2012

The June 28th Supreme Court ruling to uphold the Patient Protection and Affordable Care Act ("ACA") removed some of the uncertainty surrounding the immediate short-term prospects for health care reform. Now that the debate...more

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Physicians › Patient Protection and Affordable Care Act (PPACA)