News & Analysis as of

Medicare Healthcare

CMS announces new voluntary episode-payment program: BPCI Advanced

by Thompson Coburn LLP on

On Jan. 9, 2018, the Centers for Medicare and Medicaid Services (CMS) announced a new voluntary episode-payment program, Bundled Payments for Care Improvement Advanced (BPCI Advanced). Following on the success of the initial...more

‘Twas the Season to Contract? A Year-End Review of Network Negotiations and Billing Disputes

As 2017 drew to a close, some health plans and healthcare providers across the country were still busy trying to finalize contracts for in-network services for 2018 and beyond. A number of negotiations made the headlines in...more

ML Strategies – 2018 Health Care Preview

Happy New Year!?! 2017 was an eventful year for health care, and now we can all sit back and relax with very little concern that major health policy will be on the table in 2018. Right? Why must Speaker Ryan ruin our...more

Electronic Medical Records and Federal Criminal Prosecution

Electronic medical records (or “EMR”) were supposed to be a boon to the provision of healthcare. As two Boston-area physicians point out, EMR are anything but a benefit...more

Health Care Weekly Preview from ML Strategies – December 2017 #3

Republicans enter this week on target to pass a sweeping tax reform package after securing support from Senators Corker (TN) and Rubio (FL). Additionally Susan Collins (ME) applauded the “inclusion of multiple amendments,”...more

K&L Gates Triage: 2017 Updates to the OIG’s Active Work Plan Items & Related Audit Experience

by K&L Gates LLP on

In this episode, Hilary Bowman summarizes recent updates to the U.S. Department of Health & Human Services, Office of Inspector General (OIG) 2017 Work Plan. Specifically, she discusses OIG’s plans to investigate and audit...more

Alston & Bird Healthcare Week in Review

by Alston & Bird on

On November 15, 2017, the Food and Drug Administration (FDA) issued a draft guidance entitled, Assessing User Fees Under the Biosimilar User Fee Amendments of 2017. The Biosimilar User Fee Amendments of 2017 (BsUFA II)...more

Lending Against Medicare/Medicaid Receivables: A Refresher Course

by Burns & Levinson LLP on

With the failed effort to overturn the Patient Protection and Affordable Care Act (a/k/a Obamacare) this week, the expansion of Medicaid coverage in effect since that law’s passage will be around for a while. The bill to...more

Final Medicare Payment Regulations Expected for Physician Providers, Hospitals and Home Health Agencies in Fall 2017

by Baker Donelson on

The Centers for Medicare & Medicaid Services (CMS) released several annual Medicare proposed payment rules over the summer that are expected to be finalized this fall for 2018. On July 13, CMS released the proposed 2018...more

Value-based health care: the role of payors

by Ropes & Gray LLP on

Bill Knowlton, Ropes & Gray health care partner, examines the critically important role of payors in value-based health care programs. ____________ Payors are critically important to value-based health care because they're...more

K&L Gates Triage: 340B Eligibility - Hospital Covered Entities

by K&L Gates LLP on

This podcast focuses on the eligibility requirements for hospitals participating in the 340B Drug Pricing Program. Factors affecting eligibility include a hospital’s licensure status, patient population, and Medicare...more

Feb. 13 Deadline Looms for Provider-Based Departments Seeking Mid-Build Exception

by Polsinelli on

A new section of the 21st Century Cures Act provides much-needed relief for hospitals with an off-campus provider-based department (off-campus PBD) that was mid-build or under development as of November 2, 2015 (the Mid-Build...more

CMS Issues Final Rule on New Medicare and Medicaid Conditions of Participation for Home Health Agencies

by Stinson Leonard Street on

The Centers for Medicare & Medicaid Services (CMS) recently issued a final rule, 42 C.F.R. pt. 484, implementing significant changes to the conditions of participation (CoPs) that home health agencies (HHAs) must satisfy to...more

Potential Implications to the ACA Under the Incoming Republican Administration – Part IV: Pharmacies

The Affordable Care Act (ACA), as a whole, did not have a significant impact on pharmacy services per se. However, a complete repeal would likely impact certain areas of pharmacy services including the drug benefit for the...more

Jan. 31 Deadline: Off-Campus Provider-Based Relocations Requests

by Polsinelli on

For relocations that occurred between 11.2.15 and 12.31.16, providers must submit relocation requests by 1.31.2017. The CY 2017 OPPS Final Rule brought significant changes to the way Medicare reimburses hospitals for...more

The Affordable Care Act: On the Fast Track to Repeal

by Carlton Fields on

On January 20, hours after his inauguration, President Donald Trump issued an executive order directing the heads of all executive departments and agencies to “waive, defer, grant exemptions from, or delay the implementation...more

ML Strategies 2017 Outlook: Health Care

If Congress chose to do nothing other than what it absolutely has to address, it would have three very consuming legislative policy issues on its plate in 2017: the various User Fee Acts (UFAs) reauthorization, the...more

Potential Implications to the ACA Under the Incoming Republican Administration – Part II: Physicians

In contemplating the ways in which physicians may be affected by the possible repeal of the Affordable Care Act (ACA)—and certain features of any legislation that may replace it—a good place to start is with the person...more

Texas Court Enjoins Enforcement of Regulation that Would Forbid Discrimination in Healthcare on the Basis of Gender Identity and...

by FordHarrison on

As LGBTQ rights have taken center stage in political and social issues, FordHarrison has been following ground-breaking litigation related to LGBTQ rights and providing updates. In the latest decision, a federal judge in...more

Tennessee Health Services and Facilities Report: January 2017 Newsletter

by Burr & Forman on

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

Birmingham Medical News: End in Sight for Medicare ALJ Backlog?

by Burr & Forman on

As providers who are currently undergoing a Medicare claims appeal know, there is a lengthy delay to having an appeal actually heard by an Administrative Law Judge (“ALJ”). Some estimates indicate that it will currently take...more

The New “Price” of U.S. Health Care: The Future of Value-based Reimbursement Under President-elect Trump and Tom Price

by Carlton Fields on

The total U.S. health care expenditure was $3.2 trillion in 2015, and is projected to grow to nearly $5.6 trillion by 2025. As our nation’s cost of care rises, both Democrats and Republicans recognize the overwhelming need to...more

The AHA’s Letter to Santa Claus

The American Hospital Association, after having been “nice” all year, penned its letter to Santa Claus with its wish list for Christmas. Its four page letter (actually addressed to President-Elect Donald Trump at 1717...more

The Future of the ACA Week 4: The Ryan Plan, “A Better Way”

The recent Republican election victories appear to ensure that the Affordable Care Act’s (ACA) days are numbered. But with nearly a fifth of the U.S. economy, and the health care coverage for some tens of millions of U.S....more

Healthcare Law Update: December 2016

by Holland & Knight LLP on

Prompt Payment Discounts Not an Anti-Kickback Statute Violation - In United States of Am. et al. ex rel. Ruscher v. Omnicare, No. 15-20629, 2016 WL 6407128 (5th Cir. Oct. 28, 2016), the court of appeals affirmed summary...more

1,082 Results
|
View per page
Page: of 44
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.