On June 23, the U.S. District Court for the District of Columbia dismissed a challenge to a federal rule requiring hospitals to disclose prices they privately negotiated with insurers....more
6/26/2020
/ Affordable Care Act ,
Arbitrary and Capricious ,
Centers for Medicare & Medicaid Services (CMS) ,
Department of Health and Human Services (HHS) ,
Final Rules ,
First Amendment ,
Health Care Providers ,
Healthcare Reform ,
Hospitals ,
Price Transparency ,
Public Disclosure ,
Secretary of HHS ,
Service Charges
On April 27, the U.S. Supreme Court held that the federal government is on the hook for $12 billion it failed to pay insurers under the Affordable Care Act (ACA) risk-mitigation program known as the Risk Corridors Program. ...more
5/3/2020
/ Affordable Care Act ,
Appropriations Bill ,
Court of Federal Claims ,
Damages ,
Government Payments ,
Health Insurance ,
Insurance Industry ,
Maine Community Health Options v. United States ,
Reimbursements ,
Remand ,
Repeal ,
Reversal ,
Risk Corridors Statute ,
SCOTUS ,
Tucker Act
On November 15, the Centers for Medicare and Medicaid Services (CMS) issued a final rule requiring public disclosure of hospital charges. Along with the Departments of Health and Human Services, Labor and the Treasury, CMS...more
11/20/2019
/ Centers for Medicare & Medicaid Services (CMS) ,
Final Rules ,
Health Care Providers ,
Healthcare Reform ,
Hospitals ,
PHSA ,
Price Transparency ,
Proposed Rules ,
Public Disclosure ,
Regulatory Requirements ,
Rulemaking Process ,
Service Charges
On September 9, in a setback for AseraCare but an overall win for hospice providers, the Eleventh Circuit affirmed a Northern District of Alabama decision to grant a new trial in a False Claims Act (FCA) case against...more
9/13/2019
/ Bifurcation ,
Department of Justice (DOJ) ,
Enforcement Actions ,
Expert Witness ,
False Billing ,
False Claims Act (FCA) ,
Health Care Providers ,
Healthcare Fraud ,
Hospice ,
Insurance Fraud ,
Life Sciences ,
Medicare ,
Objective Falsity ,
Physician Medicare Reimbursements ,
Physicians ,
Professional Liability ,
Remand ,
Scienter ,
Statistical Analysis ,
Sua Sponte ,
Terminal Illness Treatments ,
Whistleblowers
1. Product Safety -
1.1 Legal Framework -
The main laws and regulations governing product safety in the United States include:
The Consumer Product Safety Act of 1972, 15 U.S.C. ยง 2051 et seq, created the Consumer...more
A group of New Jersey lawmakers recently introduced the Patient Protection Act (A5369, S3816), which would make it more difficult for doctors to transfer or refer patients to out-of-state providers or facilities....more
Increasing uncertainty and hostility surrounding the federal Affordable Care Act (ACA) have resulted in a burst of health insurance reforms at the state level. For example, Washington recently passed a law creating a public...more
On May 13, 2019, Washington Gov. Jay Inslee signed Senate Bill 5526 into law, creating the first public option health insurance product for the individual market in the United States. ...more