February 10, 2016 | Advisory | By Theresa Carnegie, Ellyn Sternfield, Lauren Moldawer
In late January, the Centers for Medicare & Medicaid Services (“CMS”) released the much anticipated Covered Outpatient Drugs Final Rule with Comment (the “AMP Final Rule”).
January 26, 2016 | Advisory | By Julie Cox, Stephen Weiner, Sasha Dudding
The Massachusetts Division of Insurance (DOI) recently held a two-day hearing on rate changes proposed by Massachusetts health insurance plans to be effective for the second quarter of 2016 (Q2).
November 13, 2015 | Alert | By Joanne Hawana, Eli Greenspan
On November 12th and 13th, the Food and Drug Administration hosted genome scientists from across the nation at its campus in White Oak, Maryland.
October 23, 2015 | Alert | By Julie Cox, Sasha Dudding, Stephen Weiner
Building on the momentum of early October hearings on the state’s growing health care expenditures, the Health Policy Commission (HPC), the Joint Committee on Health Care Financing, Governor Charlie Baker, and others spent the past two weeks crafting new policies for the industry and its consumers.
June 9, 2015 | Alert | By Dionne Lomax, Daria Niewenhous
On June 4, 2015, the Center for Medicare & Medicaid Services ("CMS") released the highly anticipated Final Rule ("Final Rule") updating the Medicare Shared Savings Program ("Shared Savings Program").
June 5, 2015 | Advisory | By Susan Berson, Ellyn Sternfield, Pamela Kramer, Bridgette Keller, Lauren Moldawer
On May 27, 2015, the Centers for Medicare and Medicaid Services (“CMS”) published a 653-page proposed rule affecting the thirty-nine states (plus the District of Columbia) that use managed care organizations (“MCOs”) to administer their Medicaid benefits.
May 4, 2015 | Advisory | By Dionne Lomax, Stephen Weiner, Nili Yolin
In an April 22, 2015 letter to the New York State Department of Health (DOH), the Federal Trade Commission (FTC) cautioned that part of the State’s Medicaid reform program may sanction anticompetitive behavior.
April 22, 2015 | Advisory | By Thomas Crane
In my post of April 2, Divided Supreme Court Restricts Provider Challenges to State Medicaid Rates, I wrote about the March 31st Supreme Court decision that providers may not sue in federal court over the adequacy of state Medicaid rates (See Armstrong v. Exceptional Child Ctr., Inc. (“Exceptional Child Center”).
April 21, 2015 | Advisory | By Nili Yolin
Last year New York passed legislation known as the “Emergency Medical Services and Surprise Bills” law, a much-heralded consumer protection law primarily intended to guard against surprise bills for out of network (OON) health care services.
February 13, 2015 | Alert | By Theresa Carnegie, Ryan Cuthbertson, Carrie Roll, Jonathan Talansky
On December 19, 2014, the Internal Revenue Service (“IRS”) issued a private letter ruling (the “Ruling”) allowing corporations that manage physician practices through a so-called “friendly physician” arrangement to treat the physician practices as members of the corporations’ consolidated tax group for U.S. federal income tax purposes.
On the Verge of Melt-Down: Core of ACA at Risk and Remedial Options Scant If Supreme Court Rules Against Government in King v. Burwell
January 5, 2015 | Alert | By Andrew Shin, Stephen Weiner
Important dates for the ACA:
CMS’s Proposed Changes to the MSSP Aim to Grow Two-Sided Risk Models and Modify Processes for Evaluating and Facilitating Care Coordination
December 9, 2014 | Advisory | By Daria Niewenhous
The Centers for Medicare & Medicaid Services (CMS) has published long-awaited changes to the Medicare Shared Savings Program (MSSP).
October 9, 2014 | Alert | By Theresa Carnegie, Thomas Crane, Carrie Roll, Stephanie Willis
Fridays never seem to be slow in the health care regulatory world. On Friday, October 3rd, the HHS Office of the Inspector General (OIG) issued a highly anticipated proposed rule (the Proposed Rule) that provides amendments to the Anti-Kickback Statute’s regulatory safe harbors (AKS Safe Harbors) and adds protections for increasingly common payment practices and business arrangements under the Civil Monetary Penalty Law (CMP).
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