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CMS Finalizes The Increasing Organ Transplant Access Model

The Increasing Organ Transplant Access Model ("IOTA Model") introduces mandatory financial incentives and penalties for selected kidney transplant hospitals....more

No Surprises Act Update: Rule Governing Dispute Resolution Process Set Aside

In a win for health care providers across the nation, the U.S. District Court for the Eastern District of Texas has vacated a key regulation regarding the process for resolving payment disputes between insurers and...more

Telehealth Awareness Week: Insights on Telehealth

In support of the American Telemedicine Association's Telehealth Awareness Week (September 19-25, 2021), Jones Day's Digital Health team shared key insights on various legal topics applicable to telehealth. Jones Day's...more

New Law Eliminates 75-Year-Old Antitrust Exemption for "Business of Health Insurance"

The Development: Congress unanimously passed and before leaving office, President Trump signed into law, the Competitive Health Insurance Reform Act ("CHIRA"). CHIRA limits application of the McCarran-Ferguson Act, an...more

HHS Finalizes New AKS Safe Harbors for Patient Engagement and CMS-Sponsored Arrangements

The Situation: As health care providers transition to value-based care models, they have often been forced to rely on safe harbors under the Anti-Kickback Statute, or AKS, that were never designed with value-based payment...more

Strategies for Successful Post-COVID-19 Telehealth Payer Contract Negotiations

The Situation: The spread of the novel coronavirus (COVID-19) pandemic has significantly impacted the delivery of health care services and increased demand for telehealth services. The Result: The pandemic has encouraged...more

Health Care on the Other Side: Changing Payer-Provider Relationships in a Post-COVID-19 Landscape

Hospitals, physician practices, and other provider organizations are dealing with unprecedented challenges in the present public health emergency following the spread of the novel coronavirus (COVID-19). Providers can expect...more

A Dramatic Shift in Health Care Pricing Transparency

The Issue: On June 24, 2019, President Trump signed an executive order, which instructed the Department of Health and Human Services to publish rules requiring hospitals to publicly disclose their negotiated rates for...more

CMS Proposed Rule Would Expand Coverage of Telehealth Benefits Under Medicare Advantage

The Situation: Earlier this year, Congress passed the Bipartisan Budget Act of 2018 ("BBA"), which expands coverage for telehealth in Medicare Advantage ("MA") plans beginning in 2020. The Update: The Centers for Medicare...more

Direct Contracting 101: Collaborations Between Employers and Health Care Providers

As employers continue to encounter escalating health care costs, many are exploring the "direct contracting" option, which allows for direct service and pricing negotiations with health care providers. While the direct...more

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