California Targets Surprise Medical Bills, Follows on the Heels of New York and Florida


Governor Brown approved a new law last Friday that limits patient exposure to so-called surprise medical bills.  AB 72 caps the cost-sharing obligations of patients who unexpectedly receive care from non-contracted providers during or because of a stay at an in-network facility.  The law limits cost sharing for covered services to in-network amounts unless the patient consents in writing to receive care from a noncontracting provider.  The law passed the California legislature with broad bipartisan support.

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New Federal Telemedicine Grants Announced; Florida Not Listed


The U.S. Department of Agriculture just announced new grant funding awarded to seven telemedicine and 11 distance learning projects across 16 states to use technology to expand access to health care, substance misuse treatment, and advanced health education opportunities. The USDA’s Distance Learning and Telemedicine (DLT) program awarded more than $4.7 million this year, adding to the $240 million it has awarded to 729 DLT projects since 2009. This year’s recipients include universities, hospitals, clinics, and schools across the country. But zero dollars were awarded to Florida, and this was not the first time Floridians missed out on telemedicine grants.

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The EpiPen Controversy Signals Intensifying Scrutiny of Drug Classification Under Medicaid Rebate Program


Price increases threatening the availability of EpiPen® and EpiPen Jr® Auto-Injectors (“EpiPen”) have touched off the latest firestorm over drug pricing. Lost amid the public outcry, however, is a thorny regulatory issue: EpiPen’s classification as a generic drug for purposes of the Medicaid Drug Rebate Program (“MDRP”).  Resolution of the classification issue carries significant risk for segments of the drug industry. Continue reading this entry

The Top 10 Things you Need to Know About Voluntary Disclosures and Government Refunds


In February 2016, CMS issued the highly anticipated Final Rule on reporting and returning Medicare Part A and B overpayments. The Final Rule was meant to clear up some of the confusion among providers regarding such overpayments.

Summarized below is our Top 10 list of the things you need to know: Continue reading this entry

ONC Releases Enhanced Regulatory Requirements to Improve Transparency for Health Information Technology Products


The Office of the National Coordinator for Health Information Technology (“ONC”) has operationalized regulatory requirements to improve transparency in health information technology (“health IT”). The regulations, which were finalized in October 2015, clarified in December 2016, and effective as of January 14, 2016, apply to all health IT products and services certified to the 2014 Edition as well as the newly issued 2015 Edition standards, which include the certification criteria for Meaningful Use.

The goal of the requirements, according to the ONC, is to make developers more accountable for the cost, benefits, and limitations of their health IT. The ONC regulations include disclosure, certification, and oversight provisions to increase accountability among health IT developers. Continue reading this entry