Articles and Blogs

The U.S. Department of Justice and the Office of the Inspector General of the United States Department of Health and Human Services announced this month news of a Settlement Agreement and a Corporate Integrity Agreement (the “Agreements”) with Greenway Health, LLC (“Greenway”). The Agreements include a payment by Greenway of $57.25 million. Greenway customers... READ MORE

Senate Lays Groundwork for Pricing Transparency Legislation A bipartisan group of senators continue to lay the groundwork for the introduction of pricing transparency legislation. On February 5, the senators released a letter seeking information from stakeholders as they prepare to introduce legislation that builds on draft legislation from last Congress. The effort is being... READ MORE

In a partial affirmation, the Fourth Circuit weeded out False Claims Act (“FCA”) claims made without particularity, requiring relators to “connect the dots” between the alleged false claims and government payment and highlighted the FCA’s recently amended “objective reasonableness” standard in reviewing retaliation claims. Background In 2010, the FCA was amended to include any... READ MORE

NATIONAL How to make healthcare more like Amazon? It comes down to data and payer-provider collaboration How hospitals will handle outpatient competition & disruption in 2019 White House reportedly reviewing final rule to reverse nursing home arbitration ban CMS Lifts Moratoria on Home Health After 5 Years Amazon’s PillPack secures more state licenses, could... READ MORE

S&P Global Ratings, Fitch Ratings and Moody’s Investors Service recently released their Nonprofit Healthcare 2019 Outlooks, which are largely consistent with 2018, despite changes in the health care industry over the past year. Fitch and Moody’s issued negative outlooks for the nonprofit health care sector, while S&P’s sector outlook was stable. Despite their differing... READ MORE

HHS Previews 2019 Regulatory Agenda At a symposium on Tuesday, Deputy HHS Secretary Eric Hargan and CMS Administrator Seema Verma outlined the administration’s health care strategy for 2019, which includes advancing the use of technology, adjusting payments in rural areas and testing new ways to reward high-quality care and reforms to the Stark and... READ MORE

On January 31, 2019, the Department of Health and Human Services Office of Inspector General (“OIG”) issued a proposed rule that, if finalized, would eliminate Anti-Kickback Statute (“AKS”) safe harbor protection for prescription drug rebates paid by manufacturers to pharmacy benefit managers (“PBMs”), Medicare Part D plans and Medicaid managed care organizations (“Proposed Rule”).... READ MORE

NATIONAL Why hospitals’ future will involve keeping people from showing up GAO: Advantages of Voluntary and Mandatory Bundled Payments Study: Hospitals dramatically increase ad spend following data breaches Study finds freestanding EDs charge more than urgent care centers Stephen Klasko: Hospitals of the future won’t look the same Why some nonprofit hospitals are turning... READ MORE

Once again, the Equal Employment Opportunity Commission (“EEOC”) is demonstrating its strong stance against harassment in the workplace. The EEOC recently announced a partnership with the U.S. Department of Justice, allowing for quicker action against state and local government employers in harassment allegations – keep in mind that county hospitals typically fit the definition... READ MORE

Welcome to Practical Matters! This series aims to provide an overview of trending topics in a variety of service areas. Our goal is to present current topics to spark discussion within your organization that could lead to a new approach and result in a positive impact. As we begin 2019, many health care organizations... READ MORE