Measures of success: How value-based pricing may change the pharmaceutical industry
The Biggest Obstacle to Value-Based Care
The Office of Inspector General (OIG) and the Centers for Medicare & Medicaid Services (CMS) jointly published final rules that expand upon and modify regulatory safe harbors and exceptions to the Anti-Kickback Statute and...more
As highlighted in a May 2020 Milbank Memorial Fund white paper titled, “How Payment Reform Could Enable Primary Care to Respond to COVID-19,” the COVID-19 public health emergency has driven transformation in the provision of...more
Insurance payments for healthcare services and supplies are frequently based on projections of future costs, often measured against a baseline calculated on past costs. However, COVID-19 and its attendant changes to the...more
The case is instructive because these fees must be a “condition of sale” to be dutiable. Therefore, it is critical for importers to review the specific circumstances of their import transactions before including or excluding...more
In the waning hours of the 2019 session, the Washington Legislature narrowly passed SB 5993, which increases the tax on petroleum that primarily funds the state’s contaminated site cleanup program, protects the funds from...more
On February 14, 2019, Judge Lane of the Bankruptcy Court for the SDNY issued an opinion in Republic Airways Holdings Inc. addressing whether the liquidated damages provisions in certain aircraft “true leases” under Article 2A...more
Retirement plan providers need to look at their fees and determine what work they are doing for their retirement plan clients because like me, they may try to break down their plan expenses into a day rate and try to figure...more
Fee objections happen often, but they are not always what they seem. Next time a prospect objects to your firm’s fees, think about the following questions: Is it real? Is it time? Is there something else? Is that all?...more
Hogan Lovells partner Alice Valder Curran teams up with Robert Spurr of Novartis to outline the challenges and share potential solutions to consider when entering into value-based pricing arrangements. Adoption of...more
On November 16, 2015 the Centers for Medicare and Medicaid Services (CMS) published the final Medicare Physician Fee Schedule (Final MPFS).1 The Final MPFS addresses changes to the physician fee schedule and related policies,...more
Our fourth annual Digital Health Summit brought together a select group of investors active in the digital health, life sciences, medical device, and healthcare industries for a one-day meeting to discuss the future of...more
CMS has proposed significant changes in the Medicare physician self-referral (typically referred to as the “Stark Law”) regulations, including new compensation exceptions and several clarifications and refinements of existing...more
In the proposed Medicare Physician Fee schedule (PFS) update for 2016, CMS announces a number of new policies, making changes to several of the quality reporting initiatives that are associated with PFS payment, and begins...more
In this video, Foley Partner Lawrence Vernaglia discusses the biggest obstacle to realizing a value-based system of health care, and what realistically can be done in the industry by taking "measured steps."...more