Tag Archives: Health Care

Health Care Policy Happenings - September 17-21, 2018

Here are some key health care policy headlines from the past week that you may have missed. Congress Legislation and Committee Activity Bloomberg: Opioids Compromise Already in the Works in Congress – Congress is working on a compromise package of bills to fight the opioid crisis and hopes to finish voting on it in the … Continue reading this entry

Health Care Policy Happenings - September 4-7

Congress is back in session after the August recess and, as expected, a flurry of activity took place.  Here are some key health care policy headlines from the past week that you may have missed.… Continue reading this entry

Health Care Policy Newsletter

Foley & Lardner LLP’s (“Foley”) Bipartisan Public Policy Team is pleased to share our “Public Policy Weekly* Health Care Newsletter” in which we compile the latest Health Care policy news and legislation. *Please note that we publish this newsletter only when Congress is in session.… Continue reading this entry

Florida’s New Law Changes Physician Responsibilities for Opioid Dispensing

controlled substances
Florida’s House Bill (HB) 21, enacted to help combat opioid abuse, contains several noteworthy changes to Florida law that impact the dispensing of opioids. Effective July 1, 2018, dispensing providers must consult Florida’s Prescription Drug Monitoring Program (PDMP) prior to dispensing controlled substances to patients, and must report any controlled substances dispensed in the PDMP … Continue reading this entry

Health Care Policy Newsletter

Policy
Foley’s Bipartisan Public Policy Team  is pleased to share our “Public Policy Health Care Newsletter” in which we compile the latest health care policy news and legislation. *Please note that we publish this newsletter only when Congress is in session.… Continue reading this entry

Health Care Policy Newsletter

Foley & Lardner LLP’s (“Foley”) Bipartisan Public Policy Team is pleased to share our “Public Policy Weekly  Health Care Newsletter” in which we compile the latest health care policy news and legislation. *Please note that we publish this newsletter only when Congress is in session.… Continue reading this entry

Health Care Policy Newsletter

Introduction Foley & Lardner LLP’s (“Foley”) Bipartisan Public Policy Team is pleased to share our second “Public Policy Weekly* Health Care Newsletter” in which we compile the latest health care policy news and legislation. Please note that we publish this newsletter only when Congress is in session.… Continue reading this entry

Two Recent Examples of Challenges To Collect “Reasonable” Charges

Two recent cases illustrate the continuing challenges providers, and in particular hospital providers, face when seeking to collect their charges when dealing with “out-of-network” patients. First Example – A Claim for Services Under an ERISA Plan In the first, a not for publication decision of the 9th Circuit, Eden Surgical Center v. Cognizant Technology Solutions … Continue reading this entry

7 Things to Know About Physician Practice Recapitalization Transactions

A tremendous amount of capital has been, and continues to be, dedicated by private equity sponsors, and private equity backed companies, toward the recapitalization of physician practices. Here are seven important high-level considerations that may impact your approach to these transactions:… Continue reading this entry

California: Proposed Legislation Regulating Health Care Rates for Payors and Providers

california
An ambitious California proposal to regulate health care rates and curb long-term health care spending was unveiled last week in Assembly Bill 3087 (Proposed Legislation).  The key concept in the Proposed Legislation is the establishment of an independent commission with the authority to set the rates paid for health care services in most commercial contexts.  … Continue reading this entry

FCA's "First to File" Bar Retains Some Teeth

Granston Memo
Health care providers are under constant threat of lawsuits brought by whistleblowers under the federal civil False Claims Act, 31 U.S.C. §§ 3729, et seq. (FCA), the statute under which the government obtains most judgements against providers. These qui tam lawsuits can be costly even where they lack any merit, and counsel for providers are … Continue reading this entry

Massachusetts Proposed Legislation to Curb Health Care Costs by Regulating Hospital Reimbursement Rates

Massachusetts
In a previous blog post, we began to dissect the new Massachusetts State Senate bill, “An Act Furthering Health Empowerment and Affordability by Leveraging Transformative Health Care,” and focused on a provision that would ban hospitals from billing payors for many common outpatient hospital services.  In this second of a multipart series, we review how … Continue reading this entry

CMS Finalizes Reimbursement Cuts for 340B Hospitals

hospital
In a striking blow to 340B hospitals, the Department of Health and Human Services, Centers for Medicare and Medicaid Services (CMS) released a final Medicare Outpatient Prospective Payment System (OPPS) rule adopting its earlier proposal to significantly reduce Medicare reimbursement for separately payable outpatient drugs purchased by hospitals under the 340B program.  The final rule … Continue reading this entry

Foley Named ACC Outstanding Committee Sponsor of the Year

For the second year in a row, Foley & Lardner LLP was named the Outstanding Committee Sponsor of the Year Award by the Association of Corporate Counsel (ACC) for Foley’s work on behalf of the ACC’s national Health Law Committee. Attorneys Alan Einhorn and Jana Anderson, Foley’s liaisons to the Health Law Committee, were presented … Continue reading this entry

Mandatory Cardiac Episode Payment Program: CMS Proposes Cancellation

hospital
Also Changes Required Participation in the CJR Model   On August 15, 2017, the Centers for Medicare and Medicaid Services (CMS) issued a proposed rule (Proposed Rule) that, if finalized, would (1) reduce the number of Metropolitan Statistical Areas (MSAs) in which there is mandatory participation in the Comprehensive Care Joint Replacement model (CJR) from … Continue reading this entry

Medicare Claims Appeals: D.C. Circuit Reverses and Remands in Case Seeking Relief From Processing Delays

hospital
Summary of AHA v. Price, 2017 U.S. App. LEXIS 14887 (D.C. Cir. Aug. 11, 2017)   On August 11, 2017, the D.C. Circuit reversed the district court and held that the district court abused its discretion by ordering the Secretary of HHS to clear the backlog of administrative appeals of denied Medicare reimbursement claims within … Continue reading this entry

Alaska’s Telemedicine Business Registry: What You Need to Know

telemedicine business registry
Alaska’s Department of Commerce, Community, and Economic Development has finalized new regulations to create a special Telemedicine Business Registry for health care providers delivering telemedicine services in the Frontier State. The regulations in Title 12, Chapter 02 of the Alaska Administrative Code were effective on April 28, 2017 and implement provisions of Alaska SB 74 … Continue reading this entry

Lessons Learned from 2017 OCR HIPAA Enforcement Actions

So far 2017 is proving to be an active year for Health Insurance Portability and Accountability Act (HIPAA) enforcement. This comes on the heels of 2016, which saw an unprecedented level of enforcement actions, with 13 total settlements and nearly a 300 percent increase in total collected fines over 2015. To date in 2017, nine … Continue reading this entry

New Jersey’s Telemedicine Law: What Providers Need to Know

new jersey telemedicine
New Jersey has a new telemedicine law, recently signed by Governor Chris Christie. The law cements the validity of telehealth services in the Garden State, establishes telemedicine practice standards, and imposes telehealth coverage requirements for New Jersey Medicaid, Medicaid managed care, commercial health plans, and other State-funded health insurance. After a year of debate in … Continue reading this entry

OIG to Audit Medicare Telehealth Services: What You Need to Know

medicare telehealth
For what may be the first time, the Office of Inspector General (OIG) at the Department of Health & Human Services (HHS) recently announced a new project to review Medicare payments for telehealth services. Accordingly, providers who bill the Medicare program for telehealth services may expect to have those claims reviewed to confirm the patient … Continue reading this entry

Opioid Crisis Initiating New State Gift Ban Laws

pharmaceutical
The Maine legislature passed with broad bipartisan approval L.D. 911, An Act to Prohibit Certain Gifts to Health Care Practitioners. The legislation prohibits gifts to practitioners who are licensed to prescribe and administer drugs by manufacturers, wholesalers, or agents of manufacturers or wholesalers of prescription drugs.… Continue reading this entry

Eight Things to Know About the New Federal Substance Use Disorder Privacy Rule

A final rule published on January 18 implements the first major revisions to the federal regulations governing the confidentiality of substance-use disorder patient records (Part 2) since 1987. It finalizes a proposal from last February to modernize the regulations in light of the significant changes in the health care delivery system. On the same day, … Continue reading this entry

OIG Rings in the New Year With New Anti-Kickback Statute Safe Harbors

Just in time for the New Year, the Office of Inspector General (OIG) of the U.S. Department of Health and Human Services issued final regulations (Final Regulations) that revised two existing Anti-Kickback Statute safe harbors, added two regulatory safe harbors to complement existing statutory safe harbors, and created an entirely new safe harbor regarding local … Continue reading this entry

Florida Board of Medicine Hearing on Telemedicine and Medical Marijuana

The Florida Board of Medicine will hold a public hearing on February 3, 2017 to discuss its proposed amendment to Florida’s telemedicine practice rules.  The proposed amendment, published December 8, 2016, is intended to clarify that physicians may not order medical cannabis or low-THC cannabis via telemedicine.… Continue reading this entry