News & Analysis as of

Accountable Care Organizations

Capitol Hill Healthcare Update

by BakerHostetler on

HOUSE PANEL TO QUESTION GOTTLIEB ON FDA BUDGET - Food and Drug Administration (FDA) Commissioner Scott Gottlieb will testify Tuesday before a House appropriations subcommittee on his agency’s fiscal 2019 budget – which...more

Is Your Agreement Non-Exclusive in Name Only?

by Epstein Becker & Green on

The legality of certain collaborative arrangements and contracts often rises and falls on whether the relationship between the parties involved is exclusive or non-exclusive. For example, the issue of exclusivity often...more

Continuing Resolution Creates Significant Changes to Medicare and Medicaid Policies

by Polsinelli on

The Bipartisan Budget Act of 2018, commonly referred to as the “Continuing Resolution,” was recently signed into law, creating a short-term fix to funding the federal government for six weeks while also raising the debt...more

6 Key Takeaways for Providers on BPCI-Advanced (Value-Based Medicare Payment)

by Foley & Lardner LLP on

Despite some initial difficulty in gaining momentum, the use of value-based payment methodologies will likely increase across all provider niches. This change is partly a function of cost savings driven by margin compression...more

Vermont Legislative Update 03-02-2018 - An analysis from DRM's Government & Public Affairs Team

When it returns on March 13, the Vermont Senate is expected to consider S.197, a bill that creates strict liability for damage to property and human health for the release of many harmful substance into the environment, and...more

Expanded coverage of telehealth

by Hogan Lovells on

The recently enacted Bipartisan Budget Act of 2018 expands Medicare’s coverage for telehealth services in several ways. Inclusion of these provisions, which had been part of a Senate bill called the CHRONIC Care Act, is...more

Significant Changes in Healthcare Laws Enacted Through the Bipartisan Budget Act of 2018: Stark, Civil and Criminal Penalties,...

by Dorsey & Whitney LLP on

On February 9, President Trump signed the Bipartisan Budget Act of 2018 (“BBA”) into law. The BBA funds the federal government through March 23 and included a bipartisan agreement to increase annual spending authority for a...more

Key Health Care Provisions of Bipartisan Budget Act of 2018

by Baker Donelson on

The wide-reaching Bipartisan Budget Act of 2018 (BBA), passed by Congress and signed by the President on February 9, 2018, extends and modifies dozens of health care programs, including extending funding for two years for...more

Bipartisan Budget Act of 2018 Enacts Changes to Employee Retirement and Health Benefit Plans, and Medicare

by Ballard Spahr LLP on

Following a brief shutdown of the federal government, on February 9, Congress passed and President Donald J. Trump signed into law the Bipartisan Budget Act of 2018 (Budget Act), which provides Congress until March 23 to...more

Major Advances for Telehealth in the Bipartisan Budget Act of 2018

by Baker Donelson on

On February 9, 2018, Congress passed and the President signed into law the Bipartisan Budget Act of 2018 (BBA). This wide-reaching legislation enacts major changes for telehealth policy in Medicare by incorporating policies...more

Top 5 Ways Telehealth Will Change Under the New Federal Funding Bill

by Foley & Lardner LLP on

The telemedicine industry has been abuzz upon learning that provider-friendly legislation was included in the new federal Bipartisan Budget Act of 2018, signed into law by the President on February 9, 2018. But telehealth...more

Medicare Extenders Included in House-Passed Continuing Resolution

by Baker Donelson on

On February 6, 2018, the House voted 242-182 to pass a Continuing Resolution (CR) to extend government funding until March 23, 2018 (H.R. Res 128). The CR includes provisions to extend funding for a number of Medicare...more

SAMHSA Final Rule Expands Permitted Disclosures of Substance Use Disorder Information to Subcontractors

The Substance Abuse and Mental Health Services Administration (SAMHSA) has issued a final rule (Rule) updating the Confidentiality of Substance Use Disorder Records, 42 CFR part 2 (Part 2), to expand the circumstances under...more

CMS Establishes New Rules for Medicare Shared Savings Program ACOs Impacted by Extreme/Uncontrollable Circumstances

by Reed Smith on

CMS has just put on display an interim final rule with comment period to establish special policies to assess the performance year 2017 financial and quality performance of Medicare Shared Savings Program accountable care...more

Hospitals & Physician Organizations Summary Report - November 2017

by Benesch on

Uncertainty and pressures continue to mount for healthcare providers, creating a new operating environment – Uncertainty around Medicaid and other programs, the shift to value-based care, margin pressures, the need to search...more

New Legislation Offers Major Reforms to the Physician Self-Referral Prohibition (the 'Stark Law')

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

Most First-Phase ESCOs Achieved Success

by McGuireWoods LLP on

On October 13, the Centers for Medicare & Medicaid Services (CMS) announced results from the first performance year of the Comprehensive ESRD Care (CEC) Model. The CEC Model was designed by the Center for Medicare & Medicaid...more

Health Update - October 2017

A New Look at Digital Health Business Models - Editor’s Note: The Commonwealth Fund is developing an innovative digital health advisor (DHA)—an integrated suite of digital services that would provide consumers with health...more

Integrating MassHealth Long-Term Services and Supports: Considerations for ACOs and MCOs

I. INTRODUCTION AND CONTEXT - MassHealth, Massachusetts’ Medicaid program, is the largest payer of long-term services and supports (LTSS) in the Commonwealth and administers a number of LTSS programs, some in conjunction...more

Chronic Care Legislation Approved by Senate

by Reed Smith on

The U.S. Senate has unanimously approved S. 870, the Creating High-Quality Results and Outcomes Necessary to Improve Chronic (CHRONIC) Care Act of 2017 (as amended). The bill is intended to improve care for the chronically...more

CMMI Requests Ideas to Spur Innovation and Reduce Burden

by Polsinelli on

The Center for Medicare & Medicaid Innovation (CMMI) is seeking ideas on how to better drive change and reduce regulatory burden. CMMI solicited ideas to shape the agency’s future activities through a September 2017 “request...more

OIG: “High-Performing” ACOs Point the Way for Medicare Shared Savings Program Savings

by Reed Smith on

The OIG has examined the results of the first three years of the Medicare Shared Savings Program, under which accountable care organizations (ACOs) coordinate care to reduce Medicare costs and improve quality of care. The OIG...more

Massachusetts Senators Hold Healthcare Roundtable Discussions

by Mintz Levin on

This past August, the Massachusetts Senate and the Millbank Memorial Fund Healthcare Working Group held three roundtable discussions geared towards finding solutions to rising healthcare costs and providing patients with more...more

International News: Focus on Health Care - Fall 2017

by McDermott Will & Emery on

Nationalism and Cross-Border M&A: Navigating Populist Politics in Deal Making - More than half of the G20 countries voted-in campaigns that focused on harming foreign, outside interests as a means to strengthen domestic...more

Payment Reform: Moving at the Speed of Trust

by Epstein Becker & Green on

An August 14 meta-analysis of payment reform evaluations by Len Nichols and others offers health care investors a sobering appraisal of the success to-date of a range of payment reforms initiated by the Centers for Medicare &...more

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