News & Analysis as of

Health Insurance Healthcare Office of the Inspector General

Health Care E-Note - January 2017

by Burr & Forman on

On October 4, 2016, The Centers for Medicare and Medicaid Services ("CMS") released the final rules regarding the requirements of participation for skilled nursing facilities. One of the most significant changes to the...more

HHS OIG Finalizes New Exclusion Rules as Administration Exits

by Hogan Lovells on

With just a week left before a new administration takes office, the U.S. Department of Health and Human Services (HHS) Office of Inspector General (OIG) finalized changes to the regulations authorizing OIG to exclude...more

2016 Health Care Year in Review

by Burr & Forman on

Since I began writing this year-end review in 2013, there have been some common themes – a shift to pay for quality and away from fee-for service, much of which has been brought about by the Affordable Care Act (ACA): efforts...more

Millennium Health to Pay $256 million in False Claims Act Settlement

by Polsinelli on

Millennium Health, one of the nation’s largest urine drug testing laboratories, has agreed to pay the government $256 million to resolve claims that it violated the Federal False Claims Act (“FCA”). The Settlement...more

Manatt on Health Reform: Weekly Highlights - October 2015 #3

Arizona seeks Medicaid Waiver to implement new coverage restrictions for Medicaid expansion enrollees and delivery system reform; Tennessee’s uninsured rate continues to drop; and Louisiana gubernatorial candidates line up...more

Washington Healthcare Update

by McGuireWoods LLP on

Bicameral Bill Introduced to Provide HHS Authority to Reject Proposed Insurance Rates - Before Congress left for its Columbus Day recess, Rep. Jan Schakowsky (D-IL) and Sen. Diane Feinstein (D-CA) introduced the Health...more

Manatt on Health Reform: Weekly Highlights - September 2015 #5

New study shows Marketplace premiums parallel the employer market; Montana likely to select a private insurer to administer benefits to its Medicaid expansion population; and Washington’s Exchange customers will begin paying...more

Manatt on Health Reform: Weekly Highlights - September 2015 #4

The Massachusetts Marketplace takes steps to ease consumer confusion by reducing choice among QHPs; North Carolina appears poised to pass Medicaid reform legislation; and bipartisan support is gaining for defining businesses...more

The Telehealth Top 10 for 2015

by Foley & Lardner LLP on

Telehealth continues to be an innovative alternative to traditional brick-and-mortar medicine. The number of providers offering telehealth services is rapidly increasing and states are enacting laws requiring health plans to...more

OIG Issues Advisory Opinion Regarding Pharmaceutical Manufacturers’ Program to Provide Free Limited Drugs to Beneficiaries When...

by King & Spalding on

On August 12, 2015, the Department of Health and Human Services Office of Inspector General (OIG) posted Advisory Opinion No. 15-11, finding that a program to supply a limited amount of free cancer drugs to federal health...more

Manatt on Health Reform: Weekly Highlights - August 2015 #2

Reductions in uninsured rates are greatest in states with Medicaid expansions and State-based or State Partnership Marketplaces; Kentucky finds increased use of preventive healthcare following Medicaid expansion; and,...more

2015 Florida Legislative Post-Session Report

by Carlton Fields on

Carlton Fields Jorden Burt’s Government Law and Consulting Practice Group released its 2015 Florida Legislative Post-Session Report detailing significant bills that passed during the 2015 Regular Session of the Florida...more

OIG Advisory Opinion 15-07: An Indicator of Clinical Trial Copayment Change?

by BakerHostetler on

“You scratch my back, I scratch yours” arrangements are common in business transactions. These agreements are risky in the healthcare space, however, with the potential to implicate civil and criminal sanctions. Whether...more

SGR Law Brings Changes to CMP Prohibition on Gainsharing

by K&L Gates LLP on

On April 16, President Barack Obama signed into law the “Medicare Access and CHIP Reauthorization Act of 2015,” ending a perennial struggle over the Medicare reimbursement formula for physicians. Although the law is most...more

OIG Warns Lab “Pull-Through” Arrangements May Be Illegal

by Perkins Coie on

In an important advisory opinion, the U.S. Department of Health and Human Services Office of Inspector General (OIG) gave a thumbs-down to a proposed clinical laboratory “pull-through” arrangement even though the patients in...more

Attention Seniors! Check Into a Hospital and Get $100!

by Faegre Baker Daniels on

OIG Advisory Opinion 15-03 approves a Medigap insurer’s program that, among other things, calls for (a) network hospitals to waive the deductible for Medicare enrollees, (b) the insurer to pay the hospital network a fee each...more

Challenges Physicians Can Expect in 2015

by McAfee & Taft on

Reimbursement for medical services continues to decline. Continuing uncertainty about the Affordable Care Act persists. Government regulations create burdensome paperwork, busywork, and compliance headaches. Technology costs...more

OIG Report: MCOs Cause Limited Access to Primary Care for Medicaid Enrollees!

by Williams Mullen on

With flu season well under way, access to care to primary care physicians for Medicaid recipients is (as it is always) extremely important. During flu season, in particular, emergency rooms (ERs) are full of people suffering...more

Do You Offer or Accept Copayment Coupons? OIG says YOU are Responsible for Compliance with Federal Law

In recent years, copayment coupon programs have become standard promotional practices for both large and small pharmaceutical manufacturers. Copayment coupons are typically offered to commercially insured patients in order...more

OIG Proposes Rules on Free Transportation, Hospital Gainsharing, and Other Access to Care Arrangements

by Morgan Lewis on

The proposed rule to give providers more protections to promote beneficiary access to care solicits significant industry input. On October 2, the Department of Health and Human Services (HHS) Office of Inspector...more

News from the Health Law Gurus™

Chinese Hackers Infiltrate Health System Network Affecting 4.5 Million Individuals – Community Health Systems, Inc. (“CHS”) reported this week that the information of approximately 4.5 million individuals has been affected by...more

Health Care Providers May Waive Patients' Copayment Obligations, But...

by Baker Donelson on

In a difficult economic environment, many health care providers are actively trying to increase cash flow and reduce administrative expenses. One potential way for providers to accomplish these goals is to discount their...more

OIG Advisory Opinions Provide Some Helpful Guidance

by Baker Donelson on

In spite of a slow start, the OIG has issued a number of interesting advisory opinions to date in 2013. Here are a few of the highlights. The OIG reiterated its long-standing concern about arrangements which “carve out”...more

OIG Publishes Audit of Outpatient Therapy Services Seeking Return of $3.1 Million in Reimbursements

In June 2013, the Department of Health and Human Services, Office of Investigator General (OIG) published a review of its audit of an outpatient therapy services provider. The OIG concluded that the outpatient therapy...more

OIG Updates Special Advisory Bulletin on the Effect of Exclusion from Federal Health Programs

by Baker Donelson on

On May 8, 2013, the OIG issued an update that supersedes and replaces its 1999 Special Advisory Bulletin, The Effect of Exclusion from Participation in Federal Health Care Programs. The updated bulletin continues to stress...more

25 Results
|
View per page
Page: of 1
Cybersecurity

"My best business intelligence,
in one easy email…"

Your first step to building a free, personalized, morning email brief covering pertinent authors and topics on JD Supra:
Sign up using*

Already signed up? Log in here

*By using the service, you signify your acceptance of JD Supra's Privacy Policy.
*With LinkedIn, you don't need to create a separate login to manage your free JD Supra account, and we can make suggestions based on your needs and interests. We will not post anything on LinkedIn in your name. Or, sign up using your email address.