On August 23, Johnson & Johnson (J&J) issued a written notice to disproportionate share hospitals that participate in the prescription drug discount program established under section 340B of the federal Public Health Service...more
On May 21, the U.S. Court of Appeals for the District of Columbia Circuit upheld the right of pharmaceutical manufacturers to place at least some restrictions on the shipment of 340B drugs to contract pharmacies of 340B...more
Editor’s Note: In a new white paper funded by Pfizer, Inc., Manatt Health discusses the current landscape of Medicaid and Children’s Health Insurance Program (CHIP) coverage and reimbursement for prenatal vaccines, informed...more
Prenatal vaccines—those administered during a pregnancy—provide crucial protections to pregnant women and/or newborns against communicable diseases such as whooping cough and influenza. Additional prenatal vaccines are in...more
5/17/2023
/ Affordable Care Act ,
Children's Health Insurance Program (CHIP) ,
Fee-for-Service ,
Food and Drug Administration (FDA) ,
Health Care Providers ,
Health Insurance ,
Healthcare ,
MCOs ,
Medicaid ,
Medicare ,
Patient Access
In the wake of the Supreme Court’s ruling in Dobbs v. Jackson Women’s Health Organization, the Department of Health and Human Services Office for Civil Rights (OCR) yesterday issued guidance addressing how the Health...more
6/30/2022
/ Abortion ,
Dobbs v. Jackson Women’s Health Organization ,
Equal Protection ,
First Amendment ,
Health Insurance Portability and Accountability Act (HIPAA) ,
Healthcare ,
HIPAA Privacy Rule ,
Human Rights ,
Medical Records ,
New Guidance ,
OCR ,
Patient Access ,
Patient Privacy Rights ,
PHI ,
Pregnancy ,
Reproductive Healthcare Issues ,
Roe v Wade ,
SCOTUS
The Supreme Court yesterday issued a unanimous opinion striking down the federal government’s reduction in Medicare Part B reimbursement for 340B drugs for calendar years 2018 and 2019. As background, the Centers for Medicare...more
6/16/2022
/ Centers for Medicare & Medicaid Services (CMS) ,
Health Care Providers ,
Health Insurance ,
Healthcare ,
Hospitals ,
Life Sciences ,
Medicare ,
Medicare Part B ,
Outpatient Prospective Payment System (OPPS) ,
Physician Fee Schedule ,
Prescription Drugs ,
Reimbursements ,
SCOTUS ,
Section 340B
The Big Picture -
On November 2, the Centers for Medicare & Medicaid Services (CMS) released Medicare Program; CY 2022 Payment Policies under the Physician Fee Schedule and Other Changes to Part B Payment Policies;...more
11/16/2021
/ Centers for Medicare & Medicaid Services (CMS) ,
Final Rules ,
FQHC ,
Health Care Providers ,
Healthcare ,
Healthcare Facilities ,
Healthcare Reform ,
Medicare ,
Mental Health ,
Physician Fee Schedule ,
Physicians ,
Reimbursements ,
Rural Health Care Program ,
Telehealth ,
Telemedicine
Learn How Healthcare Entities Can Access the Federal Loans Available to Support Businesses Through the Financial Challenges of COVID-19—Including the Paycheck Protection Program, Main Street Lending Program and EIDL...more
4/15/2020
/ CARES Act ,
Coronavirus/COVID-19 ,
Economic Injury Disaster Loans ,
Health Care Providers ,
Healthcare ,
Independent Contractors ,
Lending Programs ,
Loan Forgiveness ,
Paycheck Protection Program (PPP) ,
Physicians ,
Relief Measures ,
Small Business ,
Webinars
On January 8, 2015, Tennessee released a proposal to expand its Medicaid program through an amendment to its current TennCare II waiver under Section 1115 of the Social Security Act. Tennessee’s two-year proposal, called...more
Let’s Get to Work: OIG Releases 2015 Work Plan, Focusing on Long-Term Care and Health Reform -
The U.S. Department of Health and Human Services (HHS)--Office of Inspector General (OIG) released its 2015 Work Plan (Work...more
“Healthcare-Related” Calls: Ambiguity at the Intersection of HIPAA and TCPA -
Editor’s Note: The Federal Communications Commission (FCC) has established exemptions from certain requirements of the Telephone Consumer...more
11/21/2014
/ Business Associates ,
Covered Entities ,
Department of Health and Human Services (HHS) ,
Draft Guidance ,
Electronic Medical Records ,
FCC ,
Health Care Providers ,
Health Insurance Portability and Accountability Act (HIPAA) ,
Healthcare ,
Hospitals ,
PHI ,
Physicians ,
Standard of Care ,
TCPA ,
Text Messages ,
Voicemail
The Federal Communications Commission (FCC) has established exemptions from certain requirements of the Telephone Consumer Protection Act (TCPA) for health care messages regulated under the Health Insurance Portability and...more
Engaging Patients While Addressing Their Privacy Concerns: The Experience of Project HealthDesign -
Patients are using the Internet, personal health records (PHRs) and mobile applications or “apps” to collect and...more
The Five Megatrends Shaping Pharma’s Next Decade: Sustaining Success in a New Market Landscape -
Disruptive trends in the healthcare system will force companies to change their strategies. With new care models...more
Avoiding the Regulatory Land Mines of Commercial ACOs -
While providers are showing great interest in creating ACOs to participate in the Medicare Shared Savings Program (MSSP), they are showing even greater enthusiasm...more
7/23/2014
/ ACOs ,
EHR ,
Halifax Hospital ,
Health Insurance ,
Health Insurance Portability and Accountability Act (HIPAA) ,
Healthcare ,
Medicare ,
Medicare Shared Savings Program ,
Regulatory Standards ,
Reporting Requirements ,
Social Networks ,
Stark Law
Removing Regulatory Barriers to Accelerate EHR Adoption -
Recognizing the potential long-term value of EHRs for improving care and reducing costs, many hospitals considered offering physicians financial support to...more
Social and economic factors such as income, educational attainment, access to food and housing, and employment status have a profound impact on health. In fact, these nonmedical factors account for as much as 40 percent of...more
Assessing the Medicare Shared Savings Program: Diverse Participants, Diverse Results -
Rising healthcare costs and declining reimbursements have placed immense pressure on providers and health systems to manage the...more
On April 2, 2014, the New York State Office of the Medicaid Inspector General (OMIG or the Agency) released its Medicaid Work Plan (the Work Plan) for federal fiscal year 2014. OMIG’s core function is to prevent, detect, and...more
Ten Years In: Charting the Progress of Health Information Exchange in the U.S. -
HITECH: Federal Dollars Spur Adoption and Use:
The modern era of HIE-related public policy began in May 2004 with the appointment...more
Integrating Physical and Behavioral Health: Strategies for Overcoming Legal Barriers to Health Information Exchange -
A growing number of Medicaid officials believe that coordinating care across the physical and...more
2/26/2014
/ Affordable Care Act ,
CLIA ,
Data-Sharing ,
Department of Health and Human Services (HHS) ,
Eligibility ,
Federal Trade Commission (FTC) ,
Final Rules ,
Health Insurance Portability and Accountability Act (HIPAA) ,
Healthcare ,
Hospital Mergers ,
Medicaid ,
Medical Records
Trend 1: New Wave of Medicaid Expansions: Looking to the Private Market. With an eye on the economics, states that have resisted Medicaid expansion will take another look, triggering a melding of public and private coverage...more
Going Digital with Patients: Managing Potential Liability Risks of Patient-Generated Electronic Health Information -
Patients are increasingly using new electronic tools, such as personal health records and mobile...more