Counsel That Cares Podcast - Value-Based Care and Shifting Away from the Healthcare Fee-for-Service Model
Compliance Perspectives: Changes to the Physician Self-Referral and Anti-Kickback Rules
Value-based health care: compliance infrastructure
The Biggest Obstacle to Value-Based Care
Polsinelli Podcast - Health Care Payment Changes: From Service to Value
As the health care industry continues to evolve at a rapid pace, many family physicians are exploring innovative practice models, including concierge and direct pay care. These models have gained traction in primary care in...more
In a September 2022 brief concerning program integrity, the Health and Human Services Office of Inspector General (OIG) identified seven measures to identify providers who may present a high risk for improper Medicare...more
In what feels like an instant, telemedicine has gone from an emerging niche to a must-have. The pandemic created an opportunity for telemedicine providers to grow — rapidly — giving even more reason for venture capital and...more
In the wake of Covid-19, telehealth and telemedicine exploded as agents of change in the delivery of health care. Covid-19 forced health care providers to adapt to a “new normal” which consequently fostered a newfound...more
On July 13, the Centers for Medicare & Medicaid Services (CMS) released the annual Medicare Physician Fee Schedule (MPFS) proposed rule for calendar year (CY) 2022. The MPFS establishes fee-for-service payments for physicians...more
Since the COVID-19 public health emergency was initiated in Arkansas in March 2020, Governor Asa Hutchinson has repeatedly renewed the emergency order, maintaining the public health emergency for fourteen (14) months. ...more
On October 14, 2020, the Centers for Medicare & Medicaid Services (CMS) expanded the list of telehealth services that Medicare Fee-For-Service will pay for during the coronavirus disease 2019 (COVID-19) public health...more
The Situation: The spread of the novel coronavirus (COVID-19) pandemic has significantly impacted the delivery of health care services and increased demand for telehealth services. The Result: The pandemic has encouraged...more
As healthcare moves increasingly from fee-for-service model to one focused on outcomes and value-based payments, the traditional fraud and abuse laws, such as the Anti-Kickback Statute and the Stark Law, pose obstacles to...more
What should new and old Connecticut telemedicine and telehealth providers know about billing for Connecticut Medicaid services now that Connecticut’s Governor Ned Lamont again has expanded the ability of providers to offer...more
Editor’s Note: As the demand for telemedicine services continues to grow, states are implementing new policies related to the payment for, and provision of, care via telemedicine modalities for all patients. State Medicaid...more
Telemedicine providers can sell their services in a number of ways. Consumers, self-funded health plans, and health insurance companies are all important and growing customers for many telemedicine providers. Telemedicine...more
The integration of technology into health care delivery is exploding throughout the health industry landscape. Commentators speculating on the implications of the information revolution’s penetration of the health care...more
More good news on the telehealth reimbursement front: CMS reported its total 2015 payments for telehealth services under the Medicare program and it was a 25% increase over last year. This reflects how providers are...more
A lonely sentence at the end of New Hampshire’s new telemedicine law could mean the Granite State will join 48 other states in offering Medicaid FFS coverage of telehealth services. Interestingly, the very end of the Act...more
Accountable Care Organizations (ACOs) can share costs of telehealth and remote patient monitoring services among their hospitals, providers/suppliers, and other ACO participants, according to federal regulations under the...more
In a recent Alert, the Mintz Levin Health Law Practice and ML Strategies provided a comprehensive look at recent developments in Massachusetts health policy. In addition to a detailed report on recent Health Policy Commission...more
Senate Working Group Pressing Forward on Telehealth - As Congress focuses on bigger picture policy decisions, including broad budget negotiations and raising the debt ceiling, there are some exciting developments on the...more
On August 28, 2015, the Health Resources and Services Administration (“HRSA”) published proposed Omnibus Guidance (the “Proposed Guidance”) governing policies related to section 340B of the Public Health Service Act (“PHSA”),...more
Our fourth annual Digital Health Summit brought together a select group of investors active in the digital health, life sciences, medical device, and healthcare industries for a one-day meeting to discuss the future of...more
Nationwide, states continue to enact laws requiring commercial health plans to cover medical services provided via telemedicine to the same extent they cover medical services provided in-person. These laws are intended to...more