As this fall’s election approaches, headwinds have been brewing in DC and state legislatures for private equity health care dealmaking, many of them with bipartisan support. While a key Senate committee scrutinized patient...more
On Sept. 21, 2023, the Federal Trade Commission (FTC) sued U.S. Anesthesia Partners, Inc. (USAP) and its private equity sponsor, Welsh, Carson, Anderson & Stowe, asserting they crafted a “multi-year anticompetitive scheme” to...more
Paying the $1.3 million fine is the easy part. Complying with the CAP is a different undertaking.
On Sept. 11, 2023, the U.S. Department of Health and Human Services (HHS) Office for Civil Rights (OCR) announced an...more
9/19/2023
/ Cybersecurity ,
Data Privacy ,
Data Protection ,
Data Security ,
Department of Health and Human Services (HHS) ,
Fines ,
Health Care Providers ,
Health Insurance Portability and Accountability Act (HIPAA) ,
HIPAA Violations ,
Hospitals ,
Physicians
Health care policy and business face consequential times ahead, with Election Day Nov. 3 and a challenge to the Affordable Care Act (ACA) being heard before the Supreme Court on Nov. 10. In February 2018, two months after...more
With states and localities loosening restrictions across the country, health care businesses have returned to something closer to normal, perhaps refining the “new normal” as they adapt. Health care services previously deemed...more
As part of its ongoing effort to provide guidance on how the Paycheck Protection Program (“PPP”) is supposed to work, the Small Business Administration (“SBA”) has been issuing “Frequently Asked Questions” or “FAQs.” While...more
We are “at war” with the coronavirus, and the country has increasingly adopted a quasi-wartime crisis footing. While people are doing everything they can to save their businesses, it’s important to make sure they are setting...more
Voters have begun to receive and complete their ballots around the country as election season reaches full swing, with dramatic implications for businesses, industries and the economy as a whole. At the federal level,...more
Adoption of telehealth and alternative delivery methods is growing and could alter the health care delivery landscape, but it is still in the early stages. While there are risks that telehealth and alternative delivery...more
Despite the U.S. substantially outspending peer high-income nations with almost 18 percent of GDP dedicated to health care, on any number of statistical measurements from life expectancy to birth rates to chronic disease, the...more
The Federal Communications Commission (FCC) is launching a major revision to its Rural Health Care (“RHC”) subsidy programs. These revisions would address two main issues, the level of funding and ways to make the programs...more
Last week, bipartisan legislation was introduced in the House and Senate to make significant reforms to the Stark Law, which bars a physician from referring patients to an entity with which the physician has a financial...more
Telemedicine has the potential to disrupt the health care delivery system by providing access to care at a lower cost than face-to-face visits. Telemedicine incorporates remote communications into the provision of health care...more
While debate rages on Capitol Hill over “repeal and replace,” only limited attention has been directed toward reforming the current “fee for service” model. Indeed, both the Affordable Care Act (“ACA”) and proposals for its...more
Colorado hospitals and other licensed and certified health care facilities scored a significant victory on October 14, when the Colorado Supreme Court issued its en banc ruling in Simpson v. Cedar Springs Hospital, Inc. (2014...more
In the October 3 Federal Register (79 FR 59717), the Office of Inspector General (“OIG”) of the Department of Health and Human Services (“HHS”) published a proposed rule that would amend the safe harbor regulations to the...more
Standard & Poor’s (S&P) Rating Services recently warned the health care sector was at “a tipping point where negative forces have started to outweigh many providers’ ability to implement sufficient countermeasures.” S&P noted...more
Since the Affordable Care Act (the “ACA”) was enacted in 2010, the health care industry has been on the edge of its proverbial seat waiting to see which care delivery models are best suited to sustain all the changes: to...more
8/8/2014
/ ACOs ,
Affordable Care Act ,
Blue Cross ,
CIGNA ,
Health Care Providers ,
Healthcare ,
Healthcare Reform ,
Highmark ,
Hospital Mergers ,
Hospitals ,
Humana ,
Joint Operating Agreement ,
Joint Venture ,
United Healthcare Insurance Co. ,
WellPoint
With almost 18 percent of U.S. GDP spent on health care, experts see consolidation as fundamental to reducing costs—by integrating care coordination and delivery, and by increasing scale to drive efficiencies, including with...more
Since January 2009, the DOJ has recovered more than $13.4 billion through False Claims Act cases involving fraud against federal health care programs, and last month, Halifax Hospital Medical Center and Halifax Staffing, Inc....more
4/29/2014
/ Corporate Integrity Agreement ,
Department of Health and Human Services (HHS) ,
Department of Justice (DOJ) ,
Employment Contract ,
False Claims Act (FCA) ,
Halifax Hospital ,
Healthcare ,
Hiring & Firing ,
Medicare ,
Settlement ,
Stark Law ,
Whistleblower Awards
Drakeford v. Tuomey and U.S. vs. Bradford Regional Medical Center -
With the Affordable Care Act and market forces driving consolidation and creative transactions across the health care industry, health care...more