News & Analysis as of

Health Care Providers

News from Second & State

It was an action-packed week at the Capitol as the House of Representatives and Senate were in session. On Monday, the House Education Committee reported out a bipartisan package of bills based on the recommendations of...more

Telemedicine Reimbursement and Regulation: an Overview for Providers

by Snell & Wilmer on

The advent of telemedicine supplies a unique and convenient gateway for patients and providers to connect. The benefits of telemedicine range from increased access to care for patients, to increased efficiency and lower...more

OFCCP Clarifies Methodology for Contractor Audit Selection

by Littler on

On April 18, 2018, in another step signaling increased transparency for federal contractors, OFCCP issued a release describing its methodology for selecting and scheduling federal contractors for audit in 2018. ...more

New California Bill Attempts to Set Standard Pricing for Healthcare Services and Procedures

by King & Spalding on

Assembly Bill 3087 seeks to establish a nine-person commission tasked with imposing set prices for specific services and procedures provided by hospitals and other healthcare providers in California. Medi-Cal, Medicare, and...more

Alabama CON Report

I. Certificate of Need Program - A. AL2018-008, Eastchase Operations, LLC d/b/a The Crossings at Eastchase, Montgomery, AL: Proposes to construct and operate thirty-two (32) Specialty Care Assisted Living Facility...more

Key Takeaways from Final 2019 Payment Notice Rule

by King & Spalding on

Last week, CMS issued a final rule which aims to relax certain Affordable Care Act (ACA) health plan regulations, found at 45 C.F.R. Parts 147, 153, 154, 155, 157, and 158, while increasing marketplace competition. In...more

Health Care Providers Beware: Consumer Finance Regulations Apply Medical Debt Collection

by Baker Donelson on

While the prosecution of consumer banks and other lenders is the type of federal regulation that typically makes the headlines, many of the same debt collection regulations also apply to the collection of medical debts....more

Will the dismantlement of Obamacare affect healthcare restructuring?

by Epiq on

Bankruptcy filings among hospitals and medical centers more than tripled in 2017, according to data compiled by Bloomberg. While there are many factors contributing to this financial volatility, the political battle over The...more

Health Care Enforcement Quarterly Roundup - April 2018

by McDermott Will & Emery on

Over the past 18 months, we have closely monitored the Trump administration’s approach to health care enforcement issues, with a particular focus on whether prosecution of the False Claims Act (FCA) remains a priority under...more

Massachusetts Federal Judge Approves Settlement to Expand Dialysis Company’s Compliance Department

by King & Spalding on

On April 10, 2018, U.S. District Judge Allison D. Burroughs preliminarily approved a settlement requiring American Renal Associates Holdings, Inc. (ARAH) to expand its compliance department in response to a shareholder...more

Medicare Advantage to Address Social Determinants of Health: An Important Step for Value-Based Care

On April 4, 2018, the Centers for Medicare & Medicaid Services (“CMS”) finalized guidance and policies for the Medicare Advantage program that will expand the supplemental benefits afforded to beneficiaries to include items...more

National Right to Try Act Passes U.S. House

by Thompson Coburn LLP on

The concept of a “Right to Try” has been spreading through the U.S. over the last four years, beginning with the first passing of such laws in Colorado in 2014. Most recently, President Trump has echoed support for a federal...more

California: Proposed Legislation Regulating Health Care Rates for Payors and Providers

by Foley & Lardner LLP on

An ambitious California proposal to regulate health care rates and curb long-term health care spending was unveiled last week in Assembly Bill 3087 (Proposed Legislation). The key concept in the Proposed Legislation is the...more

HHS Warns Healthcare Organizations About SamSam Ransomware

The health care industry continues to get hammered by SamSam ransomware attacks, to the point that the Department of Health and Human Services Healthcare Cybersecurity and Communications Integration Center (HCCIC) has issued...more

CMS Announces New Initiatives For Innovating Patient Care

by Fox Rothschild LLP on

Last month, CMS Administrator Seema Verma announced several initiatives to innovate the delivery of patient care at the ground level. In collaboration with the Trump Administration and other federal agencies, CMS is taking...more

FDA Announces “Unique” Restriction on Approved Medical Device

by Arnall Golden Gregory LLP on

On April 9, 2018, the Food and Drug Administration announced an additional “unique type of restriction” on the sale and distribution of an approved medical device. FDA issued an order requiring healthcare providers and...more

The Shifting Landscape of Organ Allocation for Transplantation

by Jones Day on

Recent policy changes and the prospect of new organ sources have markedly altered the landscape for organ transplantation. In particular, new allocation policies for lung and liver transplants, and advances in gene-editing...more

Scrutiny Increases on Healthcare Providers in Central Florida

In the past month, the U.S. Attorney's Office for the Middle District of Florida--the primary federal law enforcement authority in Central Florida--has announced a series of healthcare-fraud related developments. These...more

Pennsylvania case reminds Ohio hospitals of the importance of adhering to provisions of peer review statute

by Bricker & Eckler LLP on

A recent Pennsylvania Supreme Court decision, Reginelli v. Boggs, 0 WAP 2016, 21 WAP 2016, 23 WAP 2016 (Pa. Mar. 27, 2018), has been raising a number of questions regarding the strength of a state peer review privilege based...more

K&L Gates Triage: Ride Sharing and Health Care Regulatory Considerations

by K&L Gates LLP on

Transportation is often cited as one of the top barriers to health care for individuals in the United States. To reduce this burden and increase access to care, many health care providers are now partnering with ride-sharing...more

CMS to Use Enforcement Discretion to Help States Comply with the Medicaid Home Health Final Rule

by Arnall Golden Gregory LLP on

On April 5, 2018, the Centers for Medicare & Medicaid Services (CMS) issued an Informational Bulletin regarding compliance with the Medicaid Home Health Final Rule (the “Medicaid HH Final Rule”). The Medicaid HH Final Rule...more

Federal Telehealth Policies Summary

by Holland & Knight LLP on

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

China Announces New Initiatives to Level the Playing Field for Innovative and Generic Drugs

by Ropes & Gray LLP on

China’s Government will launch several incentives to enhance accessibility of innovative drugs, especially imported oncology drugs. The State Council, China’s cabinet, has decided not to apply any tariff on imported drugs,...more

Fifth Circuit Decision is Rare Victory Permitting District Court to Enjoin Recoupment Before Provider Exhausts Administrative...

The all-too-common story of a healthcare company declaring bankruptcy in the face of aggressive Medicare recoupment actions before the company even has a hearing before an Administrative Law Judge (ALJ) may get a new ending –...more

Employment Performance Review Excluded from Peer Review Confidentiality

by Tucker Arensberg, P.C. on

The Pennsylvania Supreme Court ruled, on March 27, 2018, in Regenelli v. Boggs, Monogahela Valley Hospital and UPMC/ERMI that physician performance reviews of an ER physician, who was provided by ERMI to Mon Valley Hospital,...more

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