Seven Key Questions in Understanding the Current Regulatory State of HCT/Ps

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Despite regulations, litigation, and significant draft guidance, the future of regulation of HCT/Ps remains up in the air.  Learn what you need to know quickly with these seven questions and answers.

What do I Need to Know?

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Payor/Provider Convergence: Joint Venture Health Plans

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Background

Health Plans and health care providers are getting into each other’s business.  This payor/provider convergence has taken different forms.  Health systems have ventured into the health insurance business by acquiring or starting their own health plans and by establishing joint ventures with payors, to jointly own and operate a health plan.  Health plans have also moved into the health care provider business by acquiring hospitals, surgery centers, medical groups, and other providers.  This blog post examines one aspect of this Payor/Provider Convergence – payor/provider joint ventures to operate health plans.

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Key Takeaways From FHA’s Health Law Summit

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Foley recently co-hosted the Florida Hospital Association’s (FHA) 2017 Health Law Summit, which brought together more than 40 in-house attorneys and compliance officers from FHA member hospitals to discuss the current state and future direction of the health care industry.

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House Committees Reveal Draft of Bill to Modify and Repeal Portions of the Affordable Care Act

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On Monday, two House committees with oversight over health care and taxation, Energy and Commerce and Ways and Means, released draft reconciliation bills designed to repeal and alter significant portions of the Patient Protection and Affordable Care Act (PPACA).  These long-awaited draft bills, collectively entitled the American Health Care Act (AHCA), would make significant modifications to the health insurance markets and to the operation of state Medicaid programs, and would also repeal or delay several taxes imposed by PPACA.

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New Attorney General Issues Guidance on Corporate Compliance Programs

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The US Department of Justice (DOJ) Fraud Section has published new guidance for corporate entities on corporate compliance programs.  The guidance, titled, “Evaluation of Corporate Compliance Programs” (Compliance Program Evaluation)  provides companies – and their compliance teams – with key insights into how government regulators will assess efforts taken to develop, implement and evaluate the program.  The Compliance Program Evaluation provides the first DOJ guidance issued under Attorney General Jeff Sessions and the new administration and should signal that DOJ will continue to adhere to the principles set forth in the United States Attorney’s Manual and other publications in its assessment of corporate compliance programs.

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