The No Surprises Act (NSA) has been in effect since January 2022, and has faced litigation ever since from healthcare providers. States and federal agencies are also examining surprise billing and consumer protection laws...more
On July 7, 2023, the Centers for Medicare and Medicaid Services (CMS) released the proposed rule, Hospital Outpatient Prospective Payment System: Remedy for 340B-Acquired Drugs Purchased for Calendar Years 2018–2022, to...more
The Health Resources and Services Administration (HRSA) reminded providers through a program update on Monday, June 5, 2023, that the Provider Relief Fund (PRF) and COVID-19 Uninsured Program (UIP) Terms and Conditions...more
6/29/2023
/ Audits ,
Coronavirus/COVID-19 ,
Department of Health and Human Services (HHS) ,
Department of Justice (DOJ) ,
Health Care Providers ,
Hospitals ,
HRSA ,
OIG ,
Provider Relief Fund ,
Qui Tam ,
Relief Measures
The US Health Resources and Services Administration (HRSA) announced on Monday, June 5, 2023, that it has stopped payments to healthcare providers under the Provider Relief Fund (PRF) and COVID-19 Uninsured Program (UIP)....more
On April 27, 2023, The Departments of Health and Human Services (HHS), Labor, and the Treasury (the Departments) released a status update on the Federal Independent Dispute Resolution (IDR) Process, which covers the period...more
On December 2, 2022, the US Department of Health and Human Services (HHS) issued an FAQ announcing that it will not enforce the requirement for convening providers and convening facilities to include expected charges for...more
12/22/2022
/ Consolidated Appropriations Act (CAA) ,
Department of Health and Human Services (HHS) ,
Enforcement ,
Good Faith ,
Health Care Providers ,
Healthcare Facilities ,
Information Technology ,
No Surprises Act (NSA) ,
Proposed Regulation ,
Rulemaking Process ,
Surprise Medical Bills
Provider Relief Fund (PRF) Period 3 reports and the first independent audits (e.g., Single and Financial Audits) were due September 30. Recovery actions and enforcement activity are likely to follow and may be informed by...more
On August 19, 2022, the US Departments of Health and Human Services (HHS), Labor and Treasury posted a final rule revising portions of the federal No Surprises Act (NSA). Generally, the rule finalizes three aspects of the...more
By July 2022, the US Supreme Court is expected to release its opinion in American Hospital Association v. Becerra, a case that not only has significant ramifications for healthcare providers but may also impacts the deference...more
2/15/2022
/ American Hospital Association ,
Appeals ,
Centers for Medicare & Medicaid Services (CMS) ,
Chevron Deference ,
Department of Health and Human Services (HHS) ,
Health Care Providers ,
Medicaid Reimbursements ,
Medicare ,
Outpatient Prospective Payment System (OPPS) ,
SCOTUS ,
Section 340B
A flurry of litigation in federal district and appellate courts has led to an even split between states in which the COVID-19 vaccine mandate issued by the Centers for Medicare and Medicaid Services may be implemented and...more
As we continue our three-part webinar series, McDermott’s litigation and healthcare lawyers will focus on how payors can actively prepare for possible enforcement and litigation stemming from recent and potential changes to...more
4/29/2021
/ Affordable Care Act ,
Anti-Discrimination Policies ,
Commercial Litigation ,
Continuing Legal Education ,
Department of Health and Human Services (HHS) ,
Enforcement ,
Health Care Providers ,
Health Insurance ,
Health Plan Sponsors ,
Payor Contracts ,
Reimbursements ,
Rulemaking Process ,
Section 1557 ,
Webinars
A revitalized focus on antitrust in healthcare has increased healthcare companies’ concerns about their compliance status. On this episode of In the Trenches, Brian Stimson, McDermott partner and former Acting General Counsel...more
Telehealth has become an integral part of care delivery, particularly in light of the waivers instituted during COVID-19. However, these flexibilities remain in flux and at the same time, government scrutiny and enforcement...more
4/19/2021
/ Compliance ,
Continuing Legal Education ,
Coronavirus/COVID-19 ,
Criminal Prosecution ,
Enforcement Actions ,
Health Care Providers ,
Health Technology ,
Healthcare Facilities ,
Hospitals ,
Patients ,
Physicians ,
Public Health Emergency ,
Regulatory Oversight ,
Risk Mitigation ,
Telehealth ,
Telemedicine ,
Waivers ,
Webinars
The large volume of relief funding distributed by the government in connection with the COVID-19 pandemic will be the source of enforcement and regulatory scrutiny for years to come. During this webinar – the first in a...more
4/1/2021
/ Biden Administration ,
Continuing Legal Education ,
Coronavirus/COVID-19 ,
Department of Justice (DOJ) ,
Dismissals ,
Enforcement Actions ,
False Claims Act (FCA) ,
Health Care Providers ,
Healthcare Fraud ,
Materiality ,
Objective Falsity ,
Provider Relief Fund ,
Relief Measures ,
Telehealth ,
Webinars
For healthcare and life sciences companies, regulatory disputes with the U.S. Department of Health and Human Services (HHS) and its operating divisions can present significant economic costs and reputational risks. Efficient...more
3/16/2021
/ Administrative Procedure Act ,
Best Practices ,
Biden Administration ,
Department of Health and Human Services (HHS) ,
Dispute Resolution ,
Food and Drug Administration (FDA) ,
Health Care Providers ,
Life Sciences ,
Litigation Strategies ,
Negotiations ,
Physicians ,
Regulatory Violations ,
Risk Mitigation ,
Webinars
This must-attend webinar will give 340B covered entities and their partners up-to-the-minute insights into the most pressing issues affecting their business today and the trends that will shape the market tomorrow.
Our...more
3/16/2021
/ Biden Administration ,
Billing ,
Covered Entities ,
Dispute Resolution ,
Drug Pricing ,
Health Care Providers ,
Legislative Agendas ,
Manufacturers ,
Medicaid ,
Pharmaceutical Industry ,
Pharmacies ,
Physicians ,
Prescription Drugs ,
Section 340B ,
Webinars
Over the past year, we saw significant developments in managed care regulation at the federal and state levels, and we anticipate the rapid pace of change to continue in 2021. In this webinar, attendees will hear an analysis...more
1/12/2021
/ Biden Administration ,
Drug Pricing ,
Health Care Providers ,
Health Insurance ,
Health Plan Sponsors ,
Managed Care Contracts ,
Medicare Advantage ,
Pharmaceutical Industry ,
Pharmacy Benefit Manager (PBM) ,
Physicians ,
Prescription Drugs ,
Price Transparency ,
Surprise Medical Bills ,
Webinars