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Health Updates

Read need-to-know updates, commentary, and analysis on Health issues written by leading professionals.

340B Hospitals File Suit in Wake of Hospital Outpatient Cuts

by Foley Hoag LLP on

On November 13, 2017, a group of hospital trade associations (the American Hospital Association, the Association of American Medical Colleges, and America’s Essential Hospitals), along with two health system providers, filed...more

CDPAP Fiscal Intermediaries Must File an Application for Authorization With DOH or Cease Operations

by FordHarrison on

On November 1, 2017, the NYS DOH issued its "Application for Fiscal Intermediary Authorization" and implementation guidelines. Significantly, DOH imposed a very short timeframe, stating: "As of November 1, 2017, all existing...more

Skilled Nursing Facilities Targeted in Government Enforcement Actions and Qui Tam Lawsuits

by Pepper Hamilton LLP on

Skilled nursing facilities (SNFs) have been the subject of multiple high-profile False Claims Act settlements in recent years, and new pronouncements and pending enforcement actions suggest that SNFs will continue to face...more

WORD OF THE DAY® – 8+2+1

by Latham & Watkins LLP on

Latham partner Robbie McLaren explains the term 8+2+1 from the Book of Jargon® – Healthcare & Life Sciences. The Book of Jargon® – Healthcare & Life Sciences is one of a series of practice area and industry-specific...more

The State AG Report Weekly Update

by Cozen O'Connor on

AG Elections- Democrat Justin Nelson Launches Campaign for Texas Attorney General- Democrat Justin Nelson declared his candidacy for Texas AG seeking to unseat incumbent Republican AG Ken Paxton, who is running for...more

De-Bunking the Opioid Litigation Epidemic

by Kelley Drye & Warren LLP on

If you type ‘opioids’ into a search engine, chances are you’ll be greeted with headlines like: “Opioid abuse is in everyone’s backyard”. The Washington Post writes: “Even this puppy wasn’t safe from America’s opioid crisis”;...more

FTC Advisory Opinion Says Hospital’s Proposed Prescription Program for Affiliated Entity Employees is Exempt from Robinson-Patman...

by Foley & Lardner LLP on

On November 7, 2017, the Federal Trade Commission (FTC) released an advisory opinion confirming that a non-profit hospital in New York may sell discounted prescription drugs to the employees of an affiliated medical practice...more

Employer Mandate Penalty Letters from the IRS Are on the Way

by Jones Day on

In the next few months, the IRS will begin sending letters notifying employers that they may owe a penalty for failing to offer health coverage under the Affordable Care Act's Employer Mandate for the 2015 calendar year. The...more

2019 Notice of Benefit and Payment Parameters

On October 27, 2017, the Department of Health and Human Services (HHS) released its annual proposed Notice of Benefit and Payment Parameters, containing proposed changes to the regulation of the individual and small group...more

New York DOH Indicates it May Issue Guidance Regarding Fiscal Intermediary Authorization Applications

by Hodgson Russ LLP on

The Department of Health has indicated that it may be issuing guidance regarding the completion of the fiscal intermediary authorization applications. The guidance is likely to take the form of a series of Frequently Asked...more

Requirements for Participation Guidance for LTC Surveyors Published

by Baker Ober Health Law on

The State Operations Manual Guidance for Long Term Care Surveyors (Appendix PP), effective November 28, 2017, has undergone substantial revision. As a result of regulatory changes, the F-tags for surveys have been renumbered....more

The Opioid Epidemic: Are We Headed Toward a Tipping Point?

by Burr & Forman on

Health care law and policy occupy a prime place in the current news cycle. Much of the attention revolves around the actions or inactions of Congress and the White House, particularly with regard to their impact on the future...more

What the DOJ’s Potential Policy Shift on Qui Tam Actions May Mean for Businesses

by Polsinelli on

In a surprise announcement, the Department of Justice (DOJ) announced that the government will move to dismiss a qui tam action brought under the False Claims Act when it determines that the case has no merit. ...more

Florida Argentum Reports That Appeals Court Strikes Down Emergency Stay in Generator Case

Florida Argentum reports that the Florida’s First District Court of Appeal issued a response to its motion filed last week and determined that an “automatic stay” of the Division of Administrative Hearings’ Final Order...more

Unreliable Expert Collapses DOJ-Led False Claims Act Case

by Holland & Knight LLP on

False Claims Act cases often turn into battles of the experts. But only rarely does that battle turn into a rout. It did last week in a case out of the Eastern District of Virginia, United States ex rel. Ribik v. HCR...more

C.D. Cal. Excludes Three Plaintiff Experts in Breast Implant Case

by Reed Smith on

It is not as if we are delighted to see efforts to resuscitate breast implant litigation, but we won’t groan when the rulings are as good as they are in Laux v. Mentor Worldwide, LLC, No. 2:16-cv-01026-ODW(AGR) (C.D. Cal....more

K&L Gates Triage: 340B Update: CMS Finalizes 340B Program Reimbursement Cut on Part B Drugs

by K&L Gates LLP on

In this episode, Richard Church and Ryan Severson discuss the recent decision by the Centers for Medicare and Medicaid Services (CMS) to substantially decrease reimbursement under the Outpatient Prospective Payment System...more

Obamacare Fight Spurs Executive Actions and Legislative Proposal

by Burr & Forman on

The last 30 days have seen efforts by both the executive and legislative branches to improve conditions in the health care insurance markets with the goal of making health insurance more accessible and affordable. Please...more

Tennessee Health Services and Facilities Report: November 2017

by Burr & Forman on

The Tennessee Health Services and Development Agency (“HSDA”) is responsible for regulating the healthcare industry in Tennessee through the Certificate of Need Program. A Certificate of Need (“CON”) is a permit for the...more

House and Senate Tax Reform Bills May End Fringe Benefits Frequently Used to Satisfy Wage Parity Act Requirements

by Hodgson Russ LLP on

On November 9, 2017, the House Ways and Means Committee approved H.R. 1, the “Tax Cuts and Jobs Act”, which is anticipated to go before the House for a vote later this week. The same day, Senate Finance Committee Chairman...more

White Collar Courier: Delivering News and Providing Guidance in White Collar Matters

by Burr & Forman on

Before joining Burr & Forman, I was a federal prosecutor for a little over a decade focusing on health care fraud and general white collar matters. In that role, I was a member of a prosecution team that secured guilty...more

How to Pay the Piper: FDA Issues New Guidances for PDUFA VI and GDUFA II

by Arnall Golden Gregory LLP on

FDA recently issued two draft guidances: Assessing User Fees Under the Prescription Drug User Fee Amendments of 2017 (PDUFA VI) and Assessing User Fees Under the Generic Drug User Fee Amendments of 2017 (GDUFA II), which...more

The Case of the Bashful Whistleblower

by Faegre Baker Daniels on

William Nash filed a whistleblower case against his former employer but wanted to remain anonymous so that his new employer wouldn’t know that he is—you guessed it–a whistleblower. William’s qui tam action alleged Medicaid...more

CMS Finalizes Medicare Physician Fee Schedule Update for 2018

by Reed Smith on

The Centers for Medicare & Medicaid Services (CMS) has published its final Medicare physician fee schedule (PFS) rule for CY 2018. In addition to updating rates for 2018, the rule includes important policy changes, including...more

CMS Finalizes Medicare OPPS, ASC Rates and Policies for CY 2018

by Reed Smith on

CMS has published a final rule updating Medicare Hospital Outpatient Prospective Payment System (OPPS) and Ambulatory Surgical Center (ASC) Payment System rates and policies for calendar year (CY) 2018. In addition to rate...more

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