Category Archives: Reform

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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.… Continue reading this entry

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 … Continue reading this entry

Rand Corporation Issues Report on U.S. Blood System

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“A robust, sustainable blood system is a crucial component of every health care system.”  That is how Rand Corporation’s recently issued comprehensive report entitled “Toward a Sustainable Blood Supply in the United States” (the “Report”) begins.  Issued as a result of research sponsored by the U.S. Department of Health and Human Services (“HHS”), the Report … Continue reading this entry

Obamacare in the Cross Hairs — but Procedural Hurdles Loom

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President-elect Trump and congressional Republicans have promised to “repeal and replace” the Affordable Care Act (ACA), but there is deep division regarding which provisions will be rescinded and around the details of the replacement and the length of any transition period.… Continue reading this entry

Hawai’i Receives Approval for the First State Innovation (Section 1332) Waiver

Regulations
The federal Department of Health and Human Services and Department of Treasury (the Departments) agreed that certain small employer health insurance coverage provisions of the Affordable Care Act (ACA) would be waived for the state of Hawai’i, beginning with January 1, 2017. The waiver was authorized pursuant to Section 1332 of the ACA, which allows … Continue reading this entry

New Presidency Will Compel Action in Key Areas of Health Care in 2017

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As we enter the final stretch of the U.S. presidential election, health care remains one of the most contested issues with great potential for change, particularly to existing insurance and patient care systems. Compounding matters is the opening of enrollment season for exchange plans, which places the already hotly debated Affordable Care Act (ACA) at … Continue reading this entry

IRS Denies Exempt Status for Non-MSSP Accountable Care Organizations

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In April, the IRS released a private letter ruling denying section 501(c)(3) status to an accountable care organization (“ACO”) that contracted with third-party payers outside of the Medicare Shared Savings Program (“MSSP”). I.R.S. Priv. Ltr. Rul. 2016-15-022 (Jan. 15, 2016). The ACO was formed by a non-profit, tax-exempt health system to coordinate a clinically integrated … Continue reading this entry

Additional Opioid Policy Changes Announced: What You Need to Know

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Despite the July 4 holiday, the past week featured significant regulatory and legislative action addressing the use of opioids and pain management. The changes are in keeping with the Government-wide push to better understand and reduce opioid drug abuse. We discuss here the week’s two most notable developments. Updating the HCAHPS Hospital Survey and Value-Based Purchasing … Continue reading this entry

“Site Neutrality” for Off-Campus Outpatient Departments: Proposed Rule is Worse than You Expected!

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Please note, Cheryl Storey, CPA with Moss Adams LLP is also a co-author of this post. CMS issued its Outpatient Prospective Payment System (“OPPS”) Proposed Rule for 2017 (the “Proposed Rule”) on July 6, 2016. The Proposed Rule will  be published in the Federal Register on July 14, 2016. One highly-anticipated section of the Proposed Rule … Continue reading this entry

Injunction Enjoining Enforcement of HHS Attestation Rule Affirmed

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The Court of Appeals for the District of Columbia affirmed the District Court’s decision in Central United Life v. Burwell on July 1, 2016. This decision is very significant for those assessing the future strength of, and compliance framework for, the fixed indemnity market. Central United Life v. Burwell enjoined the U.S. Department of Health … Continue reading this entry

DOJ and North Carolina Challenge Anti-Steering and Tiering Provisions in Managed Care Contracts

CMS Releases Medicare Part B Supplier Billing and Payment Data
The Department of Justice’s antitrust division (the “DOJ”)and the State of North Carolina (“NC”) jointly sued, on June 9, 2016, Carolinas HealthCare System (“CHS”), the largest healthcare system in North Carolina, over anti-steering restrictions in its managed care contracts that the DOJ believes limits competition. In its complaint, the DOJ and NC claim that CHS used its … Continue reading this entry

Shining a Brighter Light on Massachusetts Public Records - HB 4333

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If, as Justice Louis Brandeis famously said, “sunlight is said to be the best of disinfectants,” Massachusetts public records have just received a substantial splash of bleach. On June 3, 2016, Governor Charlie Baker signed into law the first update to Massachusetts’s public records law since 1973.  The law, as amended, will change how Massachusetts … Continue reading this entry

California’s End of Life Option Act: Key Requirements and Considerations

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On June 9, 2016, California’s End of Life Option Act (the “Act”) will go into effect.  The Act authorizes an adult who is suffering from a terminal disease and meets other qualifications to request an aid-in-dying drug that may be prescribed for the purpose of ending his or her life.  California is the fifth state … Continue reading this entry

DOL’s Increased Salary Test: What Health Care Employers Need to Know

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As detailed here in our Labor & Employment blog, the Department of Labor recently announced significant increases to its minimum salary threshold to be considered exempt from the overtime requirements under the Fair Labor Standards Act (FLSA).  Health care employers — both in the non-profit and for-profit sector — will be impacted profoundly because many managers … Continue reading this entry

House of Representatives v. Burwell: Another Blow to Obamacare

Obama Announces Affordable Care Act Enrollment Crosses the 8 Million Mark
Federal Judge Rosemary Collyer’s May 12, 2016 ruling in House of Representatives v. Burwell, found that the Obama administration (the “Administration”) has been improperly funding an Obamacare subsidy program. House of Representatives v. Burwell involves two sections of The Patient Protection and Affordable Care Act (the “ACA”): Sections 1401 and 1402. Section 1401 provides tax … Continue reading this entry

FCA Penalties Slated to Nearly Double This Year

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A little known federal agency, the Railroad Retirement Board (“Board”), which administers retirement-survivor and unemployment-sickness benefit programs for railroad workers, published an interim final rule on May 2, 2016 raising the amounts of penalties “under the Board’s jurisdiction.” Among these are the penalties authorized by the Federal False Claims Act (“FCA”).  The Board proposes increasing the … Continue reading this entry

OCR Releases Updated HIPAA Audit Protocol and Business Associate Listing Template

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The Office of Civil Rights (OCR) recently updated the audit protocol that it will be using to assess Covered Entities’ and Business Associate’s compliance with the Health Insurance Portability and Accountability Act (HIPAA) privacy, security, and breach notification rules. OCR also released a template that Covered Entities and Business Associates may use to keep track of … Continue reading this entry

CMS Announces Latest Alternative Payment Model - Comprehensive Primary Care Plus

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Continuing in its efforts to promote alternative payment models, on April 11, 2016, CMS announced the Comprehensive Primary Care Plus (CPC+) model. CMS hopes to implement CPC+ in up to 20 regions, accommodating up to 5,000 practices, which would potentially encompass more than 20,000 doctors and clinicians and the 25 million people they serve. The … Continue reading this entry

State Efforts to Combat Drug Price Increases

Obama Announces Affordable Care Act Enrollment Crosses the 8 Million Mark
Growth in health care costs has long been a source of political and administrative tension for public health agencies across the country. More and more, health officials, legislators, patient advocacy groups, and third-party payors blame budgetary constraints and patient dissatisfaction and poor outcomes on high prices for once affordable medications. The issue of drug pricing … Continue reading this entry

Part 2: Shelf Registration Extended Offering Period

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This is the second post of a two-part series, you can view the first post here. Our first post in this series examined the regulatory and contractual considerations for municipal securities issuers and conduit borrowers using shelf registration. Now we examine the equally important considerations for implementation.… Continue reading this entry

Shelf Registration Extended Offering Period: Ready for the Municipal Marketplace?

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This is the first post of a two-part series. Recently, a significant municipal issuer entered the market with its first sale under a $1 billion borrowing program that will use an offering statement style novel to the municipal market. For years, issuers of traditional corporate securities have used shelf registration for their securities. Shelf registration … Continue reading this entry

Recent EHR Meaningful Use Program Updates

American Hospital Association Recommends Revisions to Medicare ACO Models
As we enter the sixth year of the Medicare and Medicaid Electronic Health Records Incentive Programs (commonly referred to as the “Meaningful Use Programs”), the Centers for Medicare & Medicaid Services (CMS) continues to make adjustments to the Meaningful Use Programs to better accommodate providers and suppliers. Two recent updates are described below.… Continue reading this entry

The Who, What, and When for the CMS Final 60-Day Rule

Four years after the issuance of the Proposed Rule and six years after the authorizing statute, CMS has published the much-awaited Final Rule regarding reporting and returning of Medicare Part A and B overpayments (the “Final Rule”). 81 Fed. Reg. 7654-7684 (Feb. 12, 2016).  Since the inception of section 6402(a) of the Affordable Care Act … Continue reading this entry

FDA Unveils Action Plan to Combat Opioid Abuse

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The U.S. Food and Drug Administration (“FDA”) recently announced a “far-reaching action plan” to evaluate and improve the agency’s prescription opioid policies. The announcement came amidst public criticism and mounting political pressure on the FDA to address the country’s “opioid abuse epidemic,” including a hold placed by Senate Democrat Edward J. Markey on President Obama’s … Continue reading this entry