A final rule published on January 18 implements the first major revisions to the federal regulations governing the confidentiality of substance-use disorder patient records (Part 2) since 1987. It finalizes a proposal from...more
1/31/2017
/ Confidential Information ,
Consent ,
Electronic Protected Health Information (ePHI) ,
Final Rules ,
Health Care Providers ,
Health Insurance Portability and Accountability Act (HIPAA) ,
Medical Records ,
Mental Health ,
Patient Privacy Rights ,
SAMHSA ,
Scientific Research ,
Substance Abuse
Just in time for the New Year, the Office of Inspector General (OIG) of the U.S. Department of Health and Human Services issued final regulations (Final Regulations) that revised two existing Anti-Kickback Statute safe...more
1/19/2017
/ Advertising ,
Ambulance Providers ,
Anti-Kickback Statute ,
Cost-Sharing ,
Department of Health and Human Services (HHS) ,
Discounts ,
FQHC ,
Free Health-Related Services ,
Health Care Providers ,
Medicare Advantage ,
Medicare Coverage Gap Discount Program ,
OIG ,
Pharmacies ,
Safe Harbors ,
Waivers
Governor Brown approved a new law last Friday that limits patient exposure to so-called surprise medical bills. AB 72 caps the cost-sharing obligations of patients who unexpectedly receive care from non-contracted providers...more
9/29/2016
/ Cost-Sharing ,
Employee Retirement Income Security Act (ERISA) ,
Governor Brown ,
Health Insurance ,
Managed Care Contracts ,
Medi-Cal ,
Medicare ,
New Legislation ,
Out of Network Provider ,
Patient Rights ,
Surprise Medical Bills
The Centers for Medicare & Medicaid Services (“CMS”) has released the final version of its much anticipated revisions to the regulations governing Medicaid managed care (the “Final Rule”). First proposed in May 2015, the...more
5/5/2016
/ Beneficiaries ,
Centers for Medicare & Medicaid Services (CMS) ,
Fee-for-Service ,
Final Rules ,
Health Care Providers ,
Managed Care Contracts ,
Medicaid ,
Mental Health ,
Prescription Drug Coverage ,
Quality of Care Standards ,
Reporting Requirements ,
Section 340B ,
State Medicaid Programs ,
Subcontractors ,
Value-Based Purchasing
On February 9, 2016, almost thirty years after the last substantive change to the federal regulations governing the confidentiality of alcohol and drug abuse patient records, the Substance Abuse and Mental Health Services...more
New guidance from Centers for Medicare & Medicaid Services (CMS) places the spotlight on the ability of states to seek approval of “State Innovation Waivers” to test new approaches for delivering health insurance reform....more
A federal court vacated the Department of Health and Human Services’ (HHS) Orphan Drug Rule that had allowed certain 340B Drug Pricing Program (340B Program) hospital covered entities to receive discounted prices when...more
10/20/2015
/ Abuse of Discretion ,
Administrative Procedure Act ,
Arbitrary and Capricious ,
Comment Period ,
Covered Entities ,
Department of Health and Human Services (HHS) ,
Drug Pricing ,
Final Rules ,
Hospitals ,
HRSA ,
Interpretive Rule ,
Omnibus Guidance ,
Orphan Drugs ,
Pharmaceutical Industry ,
PHRMA ,
Section 340B ,
Vacated
This is the third post in Health Care Law Today’s series on the final rule. This post addresses changes to sharing of beneficiary identifiable data.
In its December 8, 2014 proposed rule revising the Medicare Shared...more
The Centers for Medicare and Medicaid Services (“CMS”) released, on May 26, 2015, the a far-ranging proposal for revising the Medicaid managed care regulations (“Proposed Rule”). The number of individuals enrolled in Medicaid...more
In This Issue:
- Executive Summary
- Improving Care by Tapping Into the Data Goldmine
- Big Opportunities Available in Big Data
- Government Programs Supporting the Use of Big Data
-...more
The Centers for Medicare and Medicaid Services (CMS) has extended the deadline for eligible professionals to attest to meaningful use for the Medicare Electronic Health Record (EHR) Incentive Program 2014 reporting year. The...more
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