Value-Based Contracting: Is It Right For Your Practice?
Strategic Restructuring for the Future, Succeeding in Value-Based Care: How Hospices Can Collaborate Through Network Models
How to Respond to Payor Audits Without Panicking
Value-based health care: the role of payors
Leading health authorities have increasingly emphasized how non-medical factors such as socioeconomic status, education, employment, housing, food security, and community support have an outsized impact on health outcomes. By...more
ACI’s Advanced Forum on Managed Care Disputes and Litigation offers an unparalleled learning experience, specifically designed for the MCO legal community. Attend and develop winning legal strategies and business best...more
On February 23, 2024, CMS published a final rule updating the regulatory requirements of the Medicaid disproportionate share hospital (DSH) program in response to the Consolidated Appropriations Act (CAA) of 2021. The final...more
On January 10, 2024, the United States Court of Appeals for the Ninth Circuit published an opinion in the matter of South Coast Specialty Surgery Center, Inc., v. Blue Cross of California, which resolidified the Ninth...more
The emergence of joint ventures between health systems and payors is quickly reshaping the healthcare sector as we know it—presenting both new complexities and fresh opportunities for the changemakers involved....more
In a decision important to health care payors and providers alike, a California Court of Appeal, in AToN Center, Inc. v. United Healthcare Insurance Company, et al., 93 Cal.App.5th 1214 (2023), agreed with a lower court...more
Although 340B-participating covered entities likely don’t need the reminder, numerous manufacturers continue to significantly restrict 340B pricing available via traditional “bill to/ship to” contract pharmacy models, with...more
On the #HealthLawHotSpot this week, host Ericka Adler is joined by special guest Janie Tremlett from CWH Advisors, for an exploration of whether physicians should add value-based contracting to their practices. Ericka and...more
Below we outline what you need to know from the recently proposed regulations if you are a health care entity evaluating a transaction in California that is expected to close on or after April 1, 2024. Since the...more
Although the No Surprises Act was signed into law almost three years ago and has been in effect for the past year and a half, there have been numerous delays in implementation and execution due to the complexity of elements...more
During this session, Partner Jeremy Earl moderated a panel that collected insights on how specialists can participate in value-based care and the unique challenges specialists face in maximizing value-based care...more
Co-Location and the Provider-Based Rules – No News is…Good News? On July 15, the Centers for Medicare & Medicaid Services ("CMS") released the 2023 Outpatient Prospective Payment System proposed rule (“OPPS Proposed...more
WHAT YOU NEED TO KNOW IN A MINUTE OR LESS - Many Florida hospital-based pathology groups have long-standing provider agreements contracts with Cigna. These contracts – specifically the contractually agreed-upon reimbursement...more
The end of 2021 brings positive indications of the continued acceptance of telehealth as an important clinical care approach post public health emergency (“PHE”). The Centers for Medicare and Medicaid Services (“CMS”), like...more
Please join us as Christopher Kutner, a partner in the Health Services Practice Group, and Ashley Algazi, an Associate in the Health Services Practice Group, discuss the following topics: - Framework and regulatory review...more
The 340B Program has gained national attention over the last decade, in part due to the opportunities it provides to generate revenue for participating entities without risk of significant enforcement penalties for...more
Today, Husch Blackwell’s Meg Pekarske is joined by the newest member of our Hospice & Palliative care team, Noreen Vergara, where they discuss different ways hospices can come together to succeed in the value-based care...more
In this week’s episode, Roetzel attorneys Ericka Adler and Christina Kuta are joined by Elizabeth Hylton, Regional Director, American Academy of Professional Coders-Audit Services Group, to discuss how to “keep calm and carry...more
In this week’s episode, Richard Church interviews Stephen Bittinger about current trends and points of concern in the areas of health care reimbursement and integrity audit activity. The presenters discuss increases in...more
As we continue our three-part webinar series, McDermott’s litigation and healthcare lawyers will focus on how payors can actively prepare for possible enforcement and litigation stemming from recent and potential changes to...more
As the lines between payors and providers continue to blur, the market is awash with payor-provider joint ventures, and McDermott is at the forefront of structuring and negotiating these strategic transactions. Health...more
Strategies for Complying with Price Transparency and Surprise Billing Laws - State legislatures and the federal government have been busy the past 12 months churning out laws that impose new disclosure and billing obligations...more
What will the post-pandemic world look like? What risks and challenges will it raise and how to navigate the new litigation landscape? These are the most relevant questions amid the pandemic. To respond to them and provide...more
In response to the unprecedented Coronavirus pandemic, the government has released a flurry of legislation and funding measures that are enacted and supplemented on a daily basis across health, employment, tax and other...more
In this week’s episode, Gary Qualls discusses the recent Louisiana federal district court decision in Crescent City Surgical Centre vs. United Healthcare of Louisiana, in which the court found that an out-of-network...more