Clinical Laboratories: Proposed Rule Implements Requirements for Reporting and Payment Based on Private Payer Rates


As required by a 2014 statute, CMS has issued proposed regulations (Proposed Rule) implementing new requirements for laboratory reporting of, and eventually basing Medicare payment on, rates for clinical laboratory services paid by private payers. When finalized, the rules will appear in 42 C.F.R. Part 414, primarily in Subpart G. Comments on the Proposed Rule are due on November 24. Continue reading this entry

Telehealth and Consumer Subscription Models


Justin Stone, executive vice president and general counsel at MDLIVE, is a guest co-author for this post. He can be reached at

Telehealth opportunities continue to grow at an exponential rate, aligning with the concurrent growth of retail and consumer-focused medicine. Capturing the retail sentiment, companies are looking to offer subscription-based models for telehealth services. While these models offer promise, companies should be aware of state law requirements, including whether or not these models would mean the company is in the “health insurance” business and subject to insurance regulations. Continue reading this entry

Recap: Health Care Investors Summit – Exploring the Impact and Opportunities from Health Care Convergence


The 2015 Health Care Investors Summit, co-hosted by Foley and Deloitte & Touche, LLP, was held on September 24. This program examined convergence in health care and the effects on investing, mergers and acquisitions, provider consolidation, partnerships, collaborations and related regulatory developments.

A robust discussion occurred between the keynotes as well as the panelists. Some key takeaways from those discussions are: Continue reading this entry

U.S. to China Health Care Arrangements: New Rules for Medical Institution and Service Advertisements


As U.S. hospitals and health care providers continue to explore China’s market for international health care business opportunities, including telemedicine, they often consider providing services or products to consumers through partnerships with Chinese medical institutions and other entities. U.S. hospitals and health care providers should know how their services or products are being advertised and promoted by their China partners, particularly in light of proposed China rules regarding medical advertisements. Being aware of and addressing these specific issues in the contractual arrangements on the front end is a prudent decision. Continue reading this entry

Precision Medicine - Even Medicare Will Pay For It!


President Barack Obama announced in his 2015 State of the Union address that he was introducing a new Precision Medicine Initiative, supported with over $200 million in the proposed 2016 federal budget. “Precision Medicine” and “Personalized Medicine” are often used as interchangeable terms. Sylvia Burwell, Secretary of the Department of Health and Human Services (HHS), referenced the common description for these terms, and the hopes and expectations for the concepts they reflect, in an HHS blog entry: Continue reading this entry