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With SGR Repealed, Replacement Policy Creates New Priorities

April 20, 2015 | Blog

On April 16, 2015, President Obama signed into law, the “Medicare Access and CHIP Reauthorization Act of 2015” (MACRA), ending annual temporary patches and massive lobbying efforts since the late 1990s to prevent significant reimbursement cuts for physicians serving Medicare beneficiaries caused by the so-called Sustainable Growth Rate (SGR) formula.
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You're Invited to a Webinar: Health Care Antitrust Trends in 2015

April 17, 2015 | Blog | By Samantha Kingsbury

Next Thursday April 23rd at 12pm EST, Mintz Levin attorneys Dionne Lomax and Steve Weiner will be presenting a webinar, moderated by Bruce Sokler, on trends in antitrust enforcement in health care.
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CMS Provides Guidance to States on Managed Care Contract Review

April 16, 2015 | Blog | By Lauren Moldawer

As states attempt to control increasing healthcare costs, many Medicaid programs are seeking approval from the Centers for Medicare & Medicaid Services (CMS) to implement Medicaid managed care programs. 
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Spring Spotlight on Food Labeling, Safety & Nutrition

April 9, 2015 | Blog | By Tara E. Dwyer

The spring of 2015 is shaping up to be a busy time in the field of food and nutrition. Issues relating to food labeling, food safety, dietary guidelines, dietary supplements, child nutrition, and nutrition education in medical schools are being examined by the FDA, Congress, the Obama administration, and some states.
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CMS Takes Initial Steps to Address Medicare & Medicaid Coverage for Biosimilars

April 9, 2015 | Blog | By Theresa Carnegie

On March 30, 2015, CMS released guidance addressing Medicare and Medicaid coverage for biosimilar drug products.  The Medicare/Medicaid coverage guidance comes on the heels of the FDA’s landmark approval of a biosimilar version of the reference cancer drug Neupogen.
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Massachusetts Announces Significant Changes to the Medical Marijuana Dispensary Program  

April 8, 2015 | Blog | By Daria Niewenhous

At today’s Massachusetts Public Health Council meeting, Department of Public Health Commissioner Monica Bharel, MD, MPH, announced sweeping changes to the Medical Marijuana Dispensary Program in Massachusetts.
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DOJ and HHS Annual Report Highlights $3.3 Billion in Settlements and Judgments in FY 2014

April 6, 2015 | Blog | By Laurence Freedman, Carrie Roll

On March 19, 2015, the Department of Justice (DOJ) and Department of Health and Human Services (HHS) issued their annual Health Care Fraud and Abuse Control (HCFAC) Program report highlighting that the HCFAC Program obtained $3.3 billion in health care fraud judgments and settlements in FY 2014.
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Upcoming HCCA Webinar: Hot Topics in Laboratory Compliance

April 6, 2015 | Blog | By Karen Lovitch

On April 8th I will be presenting in a Health Care Compliance Association webinar entitled "Hot Topics in Laboratory Compliance."
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CMS Issues Proposed Rule on Stage 3 of Meaningful Use

April 3, 2015 | Blog

On March 20, 2015, the Center for Medicare and Medicaid Services ("CMS") and the Office of the National Coordinator for Health Information Technology ("ONC") each released their much-anticipated proposed rules for Stage 3 of the Meaningful Use program and the 2015 Certification Criteria for EHR Vendors, respectively.
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3 Key Take Aways from AHLA’s Institute on Medicare and Medicaid Payment Issues

April 2, 2015 | Blog | By Bridgette Keller

Last week I attended the American Health Lawyers Association Institute on Medicare and Medicaid Payment Issues in Baltimore, Maryland. Taking a comprehensive approach to reimbursement issues, the program offered a variety of sessions ranging from Medicare and Medicaid program fundamentals to areas of highly-specific technical expertise.
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New York’s Surprise Medical Bill Law Goes into Effect

April 2, 2015 | Blog

New York’s Emergency Medical Services and Surprise Bills law went into effect yesterday, which means consumers who receive out of network (OON) emergency services will no longer have to pay more than their usual in-network obligations, regardless of the network status of the treating physician, and any disputed portions of the bill must be settled by the physician and the health plan.
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Divided Supreme Court Restricts Provider Challenges to State Medicaid Rates

April 2, 2015 | Blog

A divided Supreme Court ruled by a 5-4 margin on March 31st that providers may not sue in federal court over the adequacy of state Medicaid rates. The decision in Armstrong v. Exceptional Child Ctr., Inc. has important implications well beyond the narrow group of providers of “habilitation” services for the mentally retarded in the state of Idaho.
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Congressional Developments: SGR Repeal and CHIP Reauthorization

April 1, 2015 | Blog | By Lauren Moldawer

ML Strategies has posted its weekly Health Care Update.  This week’s Health Care Update focuses on the latest Congressional developments on the repeal of the Medicare Sustainable Growth Rate (“SGR”), commonly known as the “Doc-Fix” and the Children's Health Insurance Program (“CHIP”) reauthorization.
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Antitrust Challenge to Hospital’s Exclusive Dealing Contracts with Payors Moves Forward

March 30, 2015 | Blog | By Dionne Lomax

A small regional hospital’s antitrust suit alleging illegal exclusive dealing and attempted monopolization against its largest competitor will move forward following a district court’s denial of the defendant hospital’s motion for judgment on the pleadings.
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OIG Finds Exclusive Lab Arrangement May Violate Anti-Kickback Statute

March 26, 2015 | Blog | By Karen Lovitch

Yesterday the Office of Inspector General for the Department of Health and Human Services  (the “OIG”) issued Advisory Opinion 15-04 (“Advisory Opinion”) in which it found that an exclusive arrangement between a laboratory and a physician practice could potentially generate prohibited remuneration under the Anti-Kickback Statute.
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Mintz Attorneys to Discuss 340B Program, Overpayments and Stark Self-Disclosures at AHLA Medicare & Medicaid Institute

March 24, 2015 | Blog

This week, two of Mintz health law attorneys will speak at the American Health Lawyers Association Institute on Medicare and Medicaid Payment Issues in Baltimore, Maryland.
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$12.6 Million Sandoz ASP Reporting Settlement Raises More Questions Than It Answers

March 23, 2015 | Blog

Recently, HHS-OIG announced a first-of-its-kind settlement over pharmaceutical manufacturer reporting of Average Sales Price (ASP).  Sandoz, Inc. agreed to pay a civil monetary penalty of $12.64 million for alleged failure to submit accurate ASP data to CMS.
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Proposed Replacement of Sustainable Growth Rate Addresses Telehealth

March 20, 2015 | Blog | By Ellen Janos

On March 19th, Representative Michael C. Burgess, M.D. (R-TX) and Senate Finance Committee Chairman Orrin Hatch (R-UT) unveiled a bipartisan plan to repeal and replace the sustainable growth rate (SGR) physician payment system for physician reimbursement under Medicare.
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ML Strategies Posts Weekly Health Care Update on March 16, 2015

March 18, 2015 | Blog

ML Strategies has posted its weekly Health Care Update. This publication provides timely information on implementation of the Affordable Care Act, Congressional initiatives affecting the health care industry, and federal and state health regulatory developments.
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Mintz’s Health Care Qui Tam Update

March 17, 2015 | Blog

Mintz’s Health Care Enforcement Defense Practice has published its most recent Qui Tam Update, highlighting two qui tam cases unsealed in November and December of 2014 and giving an overview of the other 17 cases unsealed during the same time period.
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