Tricia Beckmann on Health Care Providers

Patient Engagement Tools and Supports: Analysis of the New Anti-Kickback Statute Regulatory Safe Harbor

Providers have a new tool in their toolbox to promote population health. The Health and Human Services Office of Inspector General (OIG) has adopted a new, extremely broad safe harbor that allows certain providers to give...more

12/3/2020 / ACOs , Anti-Kickback Statute , Centers for Medicare & Medicaid Services (CMS) , Health Care Providers , Medical Devices , OIG , Pharmaceutical Industry , Pharmacy Benefit Manager (PBM) , Safe Harbors

The CARES Act: Relief for Health Care Providers

The $2 trillion Coronavirus Aid, Relief, and Economic Security (CARES) Act, signed into law on March 27, 2020, contains significant relief to assist health care providers faced with the double burden of an onslaught of...more

4/8/2020 / CARES Act , Coronavirus/COVID-19 , Department of Health and Human Services (HHS) , Health Care Providers , Relief Measures

Is There a ‘Z’ in SDOH? New Government Report on Social Determinants of Health

Over the last five years, clinicians, health plans and policymakers have ramped up their focus on the social determinants of health (SDOH). SDOH are non-medical factors (food security, housing security, reliable access to...more

1/29/2020 / Centers for Medicare & Medicaid Services (CMS) , Fee-for-Service , Health Care Providers , Medicare , Physicians

Executive Order on Health Care Prescribes Change Ahead for Providers and Insurers

President Trump signed an Executive Order (EO) aimed at improving health care price and quality transparency. While it requires few immediate changes, it foreshadows future requirements for health care providers and health...more

6/26/2019 / Department of Health and Human Services (HHS) , Executive Orders , Health Care Providers , Prescription Drugs , Trump Administration

The Pronounced Importance of an Unpronounceable Acronym: New Guidance on SSBCI in Medicare Advantage

On April 24, Centers for Medicare and Medicaid Services (CMS) issued a memo to Medicare Advantage (MA) plan sponsors detailing the scope of Special Supplemental Benefits for the Chronically Ill (SSBCI). Established by the...more

4/26/2019 / Centers for Medicare & Medicaid Services (CMS) , Health Care Providers , Medicare , Medicare Advantage

CMS Announces Primary Cares Initiative: New Direction or New Messaging?

On April 22, The Center for Medicare and Medicaid Innovation (the Innovation Center) at the Centers for Medicare and Medicaid Services (CMS) announced a new Primary Cares Initiative, with two new payment models aimed at...more

4/24/2019 / Alternative Payment Models (APM) , Centers for Medicare & Medicaid Services (CMS) , Health Care Providers , Value-Based Care

Medicare Advantage Plan Adoption of New Flex Benefits in 2019

Medicare Advantage, the private plan option in the Medicare program, is growing rapidly. Currently, 22 million people choose Medicare Advantage — more than one third of people with Medicare — and that number is expected to...more

1/25/2019 / Centers for Medicare & Medicaid Services (CMS) , Health Care Providers , Medicare , Medicare Advantage

‘Text Me Your Symptoms’: CMS Proposes Expanding Coverage for Digital Health Services

In what can only be described as “out of the box” thinking, the Centers for Medicare and Medicaid Services (CMS) is proposing to pay physicians for virtual check-ins, and for asynchronous interactions with patients in which...more

7/30/2018 / Centers for Medicare & Medicaid Services (CMS) , Health Care Providers , Medicare , Physician Fee Schedule , Physicians , Telehealth

A Cautious First Step From a Bold Administration: Proposed Rule on Clinician Quality-based Payments Incorporates Some, But Not...

On June 30, the Centers for Medicare & Medicaid Services (CMS) published a proposed rule covering the second and future years of the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) Quality Payment Program. The...more

7/3/2017 / Alternative Payment Models (APM) , Centers for Medicare & Medicaid Services (CMS) , Health Care Providers , Medicare Access and CHIP Reauthorization (MACRA) , MedPAC , MIPS

An Unsettling Settlement: Health Plan to Pay $32 Million to Settle Coding and Provider Network Misrepresentation Charge

On May 30, the Department of Justice (DOJ) announced that it reached a settlement with commonly-owned Freedom Health Inc. and Optimum Healthcare, Inc. (Freedom Health) — two Tampa, Florida, managed care plans — to settle...more

6/6/2017 / Centers for Medicare & Medicaid Services (CMS) , Department of Justice (DOJ) , False Claims Act (FCA) , Health Care Providers , Medicare Advantage

Tricia Beckmann

Faegre Drinker Biddle & Reath LLP

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