David Ault at Faegre Drinker Biddle & Reath LLP

The Affordable Care Act at Risk: American Health Policy at a Crossroads

We are at a major crossroads in U.S. health policy. The direction for American health care in 2021 and beyond will depend in large part on events that are unfolding now, and that will come to fruition in the first half of...more

11/12/2020 / Affordable Care Act , Biden Administration , Constitutional Challenges , Health Insurance , Healthcare Reform , Individual Mandate , Trump Administration

Proposed CMS Regulation Pushes Alignment Between Medicare Coverage and FDA Breakthrough Device Approvals

On August 31, 2020, the Centers for Medicare & Medicaid Services (CMS) proposed a rule to align Medicare coverage decisions with breakthrough technologies approved by the Food and Drug Administration (FDA), thereby speeding...more

9/11/2020 / Centers for Medicare & Medicaid Services (CMS) , Food and Drug Administration (FDA) , Medical Devices , Medicare

Health Care Amid and After COVID-19: Public Policy Outlook

With the COVID-19 pandemic response and civil discourse on race and health disparities raising new questions about the future of U.S. health care policy, the winners of the 2020 federal elections will face a multitude of...more

8/7/2020 / Centers for Medicare & Medicaid Services (CMS) , Coronavirus/COVID-19 , Health Care Providers , Hospitals , Inpatient Prospective Payment System (IPPS) , Outpatient Prospective Payment System (OPPS) , Physician Fee Schedule , Physicians

Evolving Physician Arrangements in a Post-COVID-19 Environment

Like virtually every other sector of the economy, COVID-19 has presented novel challenges to health care providers. As the pandemic has forced physicians to adapt to changing patient care demands and a drop in...more

8/6/2020 / Anti-Kickback Statute , CARES Act , Centers for Medicare & Medicaid Services (CMS) , Coronavirus/COVID-19 , Health Care Providers , OIG , Physicians , Stark Law

FEMA Relief for Hospitals and Health Systems: What’s Covered and How to Apply

On March 13, 2020, President Donald Trump issued emergency declarations for all states, tribes, territories and the District of Columbia under the Stafford Act in response to the COVID-19 pandemic. This unprecedented...more

6/16/2020 / Centers for Disease Control and Prevention (CDC) , Coronavirus/COVID-19 , Department of Health and Human Services (HHS) , FEMA , Health Care Providers , Hospitals

CMS Innovation Center Announces Policies to Address COVID-19

On June 3, the Centers for Medicare & Medicaid Services’ (CMS) Center for Medicare and Medicaid Innovation (Innovation Center) announced long-awaited policies to address the impact of COVID-19 on its ongoing models, as well...more

6/8/2020 / Centers for Medicare & Medicaid Services (CMS) , Coronavirus/COVID-19 , Health Care Providers , Infectious Diseases

Centers for Medicare & Medicaid Services Issue Guidance Regarding EMTALA Requirements During COVID-19

In response to the COVID-19 pandemic, health care providers have been faced with numerous questions about how to effectively treat patients during the pandemic while still complying will all applicable laws. ...more

3/24/2020 / Centers for Medicare & Medicaid Services (CMS) , Coronavirus/COVID-19 , Emergency Rooms , EMTALA , Health Care Providers , Hospitals

Is There a ‘Z’ in SDOH? New Government Report on Social Determinants of Health

Over the last five years, clinicians, health plans and policymakers have ramped up their focus on the social determinants of health (SDOH). SDOH are non-medical factors (food security, housing security, reliable access to...more

1/29/2020 / Centers for Medicare & Medicaid Services (CMS) , Fee-for-Service , Health Care Providers , Medicare , Physicians

Increasing the Advantage of Medicare Advantage: Decoding President Trump’s Medicare Executive Order

On October 3, President Donald Trump signed an executive order (EO) focused on the Medicare program, titled, “Executive Order on Protecting and Improving Medicare for Our Nation’s Seniors.” The EO offers expected political...more

10/7/2019 / Executive Orders , Medicare , Medicare Advantage , Trump Administration

CMS Announces New Models for Kidney Care and Radiation Oncology

New payment models – both voluntary and mandatory – are on the way for Medicare-participating providers treating kidney disease and offering radiation oncology services. On July 10, the White House, in conjunction with the...more

7/15/2019 / Centers for Medicare & Medicaid Services (CMS) , Department of Health and Human Services (HHS) , Health Care Providers , Payment Methods

Executive Order on Health Care Prescribes Change Ahead for Providers and Insurers

President Trump signed an Executive Order (EO) aimed at improving health care price and quality transparency. While it requires few immediate changes, it foreshadows future requirements for health care providers and health...more

6/26/2019 / Department of Health and Human Services (HHS) , Executive Orders , Health Care Providers , Prescription Drugs , Trump Administration

The Pronounced Importance of an Unpronounceable Acronym: New Guidance on SSBCI in Medicare Advantage

On April 24, Centers for Medicare and Medicaid Services (CMS) issued a memo to Medicare Advantage (MA) plan sponsors detailing the scope of Special Supplemental Benefits for the Chronically Ill (SSBCI). Established by the...more

4/26/2019 / Centers for Medicare & Medicaid Services (CMS) , Health Care Providers , Medicare , Medicare Advantage

CMS Announces Primary Cares Initiative: New Direction or New Messaging?

On April 22, The Center for Medicare and Medicaid Innovation (the Innovation Center) at the Centers for Medicare and Medicaid Services (CMS) announced a new Primary Cares Initiative, with two new payment models aimed at...more

4/24/2019 / Alternative Payment Models (APM) , Centers for Medicare & Medicaid Services (CMS) , Health Care Providers , Value-Based Care

David Ault

Faegre Drinker Biddle & Reath LLP

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