State legislatures on the West Coast are intensifying their focus on private equity and management service organizations (MSOs) in healthcare, introducing new regulatory measures that could significantly reshape investment...more
The outlook for federal antitrust enforcement remains murky, at best, with uncertainty about whether the new federal HSR rules, merger guidelines, and existing enforcement actions. The forecast for state antitrust...more
2/11/2025
/ Antitrust Provisions ,
Competition ,
Department of Justice (DOJ) ,
Federal Trade Commission (FTC) ,
Hart-Scott-Rodino Act ,
Healthcare ,
Merger Controls ,
Mergers ,
Premerger Notifications ,
Private Equity ,
State and Local Government ,
State Attorneys General
On September 28, 2024, Governor Newsom vetoed Assembly Bill No. 3129 (AB 3129), which would have required private equity groups and hedge funds to obtain the Attorney General’s written consent at least 90 days prior to...more
10/2/2024
/ California ,
Governor Newsom ,
Governor Vetoes ,
Health Care Providers ,
Healthcare ,
Investment ,
Legislative Agendas ,
New Legislation ,
Private Equity ,
Regulatory Agenda ,
Regulatory Requirements
CMS recently published the First Annual Evaluation Report (the “Report”) highlighting its most significant observations in the first year following implementation of the Kidney Care Choices Model (the “KCC Model”). By way of...more
After its passage in the California Senate on August 31, 2024, Assembly Bill No. 3129 (AB 3129) is now headed to Governor Newsom’s desk.
As discussed in depth in our previous blog series on AB 3129, the legislation would...more
9/9/2024
/ Acquisitions ,
California ,
Governor Newsom ,
Health Care Providers ,
Healthcare Facilities ,
Healthcare Reform ,
Investors ,
Legislative Agendas ,
Mergers ,
New Legislation ,
Private Equity ,
State and Local Government ,
State Legislatures
California’s Office of Health Care Affordability (OHCA) has officially approved amendments (“Amendments”) to the cost and market impact review (CMIR) regulations, effective August 22, 2024. Most significantly, these...more
On July 18, 2024, the Massachusetts Senate passed S. 2871, An Act Enhancing the Health Care Market Review Process (the Bill), to increase oversight of healthcare transactions involving private equity firms, real estate...more
Only two months after California’s cost and market impact review (CMIR) regime began to require notice of certain healthcare-related transactions, the Office of Health Care Affordability (OHCA) has already proposed several...more
Parties involved in or considering health care transactions in California have been focused on navigating the new rules set by California’s Office of Health Care Affordability (OHCA), and newly proposed legislation could...more
4/19/2024
/ Antitrust Division ,
California ,
Healthcare Reform ,
Hedge Funds ,
Legislative Agendas ,
New Rules ,
Prior Written Authorization ,
Private Equity ,
Private Equity Firms ,
Private Equity Funds ,
State Attorneys General
At long last, the cost and market impact review (CMIR) regulations promulgated by the California Office of Health Care Affordability (OHCA) have been approved by the California Office of Administrative Law (OAL). The final...more
In its December Hospital Flash Report, Kaufman Hall identified and reviewed the continued, negative impact of COVID-19 on hospital operating margins. After a dramatic drop in hospital margins during the height of the pandemic...more
On Thursday, April 8, 2021, the Center for Medicare and Medicaid Innovation (the “Innovation Center”) announced its final list of 53 organizations set to participate in the Global and Professional Direct Contracting (“GPDC”)...more
On March 10, 2021, President Biden signed into law the American Rescue Plan Act of 2021 (the “Act”). This $1.9 trillion COVID-19 relief package not only includes a whole host of healthcare-related provisions, but, along with...more
3/29/2021
/ Affordable Care Act ,
American Rescue Plan Act of 2021 ,
Biden Administration ,
California v Texas ,
COBRA ,
Coronavirus/COVID-19 ,
Enrollment ,
Medicaid ,
New Legislation ,
Relief Measures ,
SCOTUS ,
Subsidies ,
Tax Cuts and Jobs Act ,
Trump Administration
On December 28, 2020, the Consolidated Appropriations Act, 2021 (“Appropriations Act”) was passed into law. The Appropriations Act included the No Surprises Act (“Act”), which seeks to protect patients from surprise medical...more
1/4/2021
/ American Medical Association ,
Consolidated Appropriations Act (CAA) ,
Coronavirus/COVID-19 ,
Health Care Providers ,
New Legislation ,
Out of Network Provider ,
Physicians ,
Public Health Emergency ,
Relief Measures ,
Surprise Medical Bills ,
Trump Administration
On December 3, 2020, Centers for Medicare & Medicaid Services (“CMS”) announced key details concerning a new value-based reimbursement and patient care model – the Geographic Direct Contracting Model (the “Model” or “Geo”)....more
On November 10, 2020, the U.S. Supreme Court heard oral arguments for California v. Texas, a case that will potentially decide the fate of the Patient Protection and Affordable Care Act (“ACA”).
As discussed in prior...more
On October 6, 2020, the US Supreme Court (the “Court”) heard arguments on an Employee Retirement Income Security Act (“ERISA”) case that has the potential to curtail the rights of states to regulate their individual...more
The death of Supreme Court Justice Ruth Bader Ginsburg, and alongside it the high probability of a conservative successor to the open seat she left behind, is likely to shift the Court substantially to the right. Among the...more
On May 18, 2020, California Senate Bill 977 (“SB-977”) was passed out of the California Senate Health Committee and is now scheduled for its first hearing before the Senate Appropriations Committee on June 1, 2020. SB-977...more
In 2012, the U.S. Supreme Court in NFIB v. Sebelius struck down a provision in the Patient Protection and Affordable Care Act (the “ACA”) which, for all intents and purposes, made the expansion of the Medicaid program...more
On March 17, 2020, the Centers for Medicare & Medicaid Services (“CMS”) issued a memorandum to provide information to organizations that participate in the Programs of All-Inclusive Care for the Elderly (“PACE”) program in...more
January 30th, 2020 marked a dramatic change in Medicaid funding, as the Trump Administration and Centers for Medicare & Medicaid Services (“CMS”) showcased a plan, called the “Healthy Adult Opportunity,” that would permit...more
On December 18th, 2019, the Fifth Circuit Court of Appeals released a long-awaited decision on a significant challenge to the Affordable Care Act (“ACA”), affirming a lower-court ruling that we discussed in a previous post....more
12/24/2019
/ Affordable Care Act ,
Appeals ,
Constitutional Challenges ,
Health Insurance ,
Healthcare Reform ,
Individual Mandate ,
Remand ,
Repeal ,
Severability Doctrine ,
Tax Cuts and Jobs Act ,
Texas v US
December 18, 2019, the United States Court of Appeals for the Fifth Circuit reached its widely anticipated decision in Texas vs. Azar, ruling that the Affordable Care Act’s (ACA) individual mandate is unconstitutional as a...more
On April 21, 2019, the Center for Medicare and Medicaid Innovation (“CMMI”) announced the CMS Primary Cares Initiative – a voluntary, risk-based initiative to transform the Medicare program’s reimbursement of primary care...more
12/2/2019
/ Alternative Payment Models (APM) ,
Applications ,
Centers for Medicare & Medicaid Services (CMS) ,
CMMI ,
Fee-for-Service ,
Health Care Providers ,
Healthcare ,
Healthcare Reform ,
Hospitals ,
Letters of Intent ,
Medicaid ,
Medicare ,
Physicians ,
Value-Based Care