News & Analysis as of

Payment Caps

Bass, Berry & Sims PLC

6 Considerations for Your Next Hospice Transaction

interdisciplinary care focused on treating symptoms to improve quality of life rather than curing disease. Investment activity in the post-acute care sector continues to grow as the market remains largely fragmented and the...more

Sheppard Mullin Richter & Hampton LLP

ACA Medicaid Expansion Weakens: Trump Administration Unveils Optional Plan for Block Grants

January 30th, 2020 marked a dramatic change in Medicaid funding, as the Trump Administration and Centers for Medicare & Medicaid Services (“CMS”) showcased a plan, called the “Healthy Adult Opportunity,” that would permit...more

Smart & Biggar

Rebate Update: Amendments to Ontario Regulations remove cap on Ordinary Commercial Term Benefits and restrictions on Private Label...

Smart & Biggar on

In November 2019, we highlighted the key proposed amendments to Regulations made under the Ontario Drug Benefit Act (ODBA) and the Drug Interchangeability and Dispensing Fee Act (DIDFA). The proposed amendments aim to reduce...more

Robinson+Cole Health Law Diagnosis

D.C. Circuit Court of Appeals Allows HHS Rule that Includes Payments Received from Third Parties in DSH Payment Cap Calculation

On August 13, 2019 the D.C. Circuit Court of Appeals (the D.C. Circuit) issued an opinion in Children’s Hospital Association of Texas v. Azar (No. 18-5135), allowing the Department of Health and Human Services (HHS) to...more

Michigan Auto Law

Will Gov. Gretchen Whitmer veto Michigan No-Fault Reform Bills?

Michigan Auto Law on

Gov. Gretchen Whitmer and Republican leadership have been in talks through the weekend. The two sides are now attempting to reach enough common ground for Gov. Whitmer to sign No-Fault Reform legislation after the No-Fault...more

Bricker Graydon LLP

Bipartisan Budget Act of 2018 repeals therapy caps: What does it mean for hospital outpatient therapy departments?

Bricker Graydon LLP on

“Therapy caps” date back to the Balanced Budget Act of 1997, which limited (or “capped”) the amount of annual per-patient therapy expenditures under Medicare Part B. However, Congress created an exceptions process in 2006,...more

Michigan Auto Law

No-Fault vs. health insurance: What’s the better choice for crash victims?

Michigan Auto Law on

Health insurance is full of landmines for unsuspecting car crash victims, who are subject to ‘auto exclusions,’ coverage limitations, managed care, HMOs and medical pre-approval requirements and ERISA liens....more

Mintz - Health Care Viewpoints

Therapy Caps: A Minibus Rider

In a recent post, we provided additional details on the structure, funding, and evaluation of the Maternal, Infant, Early Childhood, Home Visiting (MIECHV) program. In this post we will go into detail on the background and...more

King & Spalding

Hospice Requests Supreme Court Review of Medicare Hospice Annual Cap

King & Spalding on

On June 8, 2016, Southeast Arkansas Hospice, Inc. (SEARK) filed a petition for a writ of certiorari to the Supreme Court to review an Eighth Circuit decision that upheld the annual Medicare payment cap for hospice services. ...more

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