Publications by Amy L. Mackin

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Change Healthcare Cybersecurity Incident – Legal and Operational Considerations for Affected Organizations

[03/18/24]

CMS Requests Information about Medicare Advantage Data

[03/08/24]

Medicare Advantage Plans Must Follow the Two-Midnight Rule

[11/17/23]

CMS Publishes RADV Audit Methodology and Intent to Recover Overpayments

[02/14/23]

REACHing Beyond the Direct Contracting Model: CMS Announces the New ACO REACH Model Application Period

[03/03/22]

Defining Opportunity in the Sprint to Value: CMS and OIG Finalize Value-Based Definitions in Connection with New Stark Exceptions and Anti-Kickback Safe Harbors

[01/12/21]

Holiday Surprise for Health Care Providers: Spending Package Includes Surprise Billing Fix

[12/28/20]

REMINDER: Hospital Price Transparency Requirements Begin January 1, 2021 (Now with CMS Audits)

[12/21/20]

CMS Announces Geographic Direct Contracting Model

[12/14/20]

Pulling Back the Curtain: Final Rule Requires Payors to Disclose Rates

[12/02/20]

Court Rules that Hospital Price Transparency Requirements Can Take Effect

[06/26/20]

CMS Proposes Major Overhaul to Incorporate Payer Pricing into Medicare Cost Report Data and MS-DRG System

[05/19/20]

Providers May Set Reimbursement Rates with Out-Of-Network Payors for COVID-19 Testing by Posting Rate to Website

[04/22/20]

Temporary Suspension of Medicare Sequestration and Increased DRG Payments Under the CARES Act: But What About Medicare Advantage?

[04/08/20]

The Price May Not Be Right, But It Will Be Public: CMS Finalizes Price Transparency Rule Requiring Hospitals to Publish Payer-Specific Rates

[11/18/19]

Here’s Price Transparency![1]

[09/13/19]

No Surprise Here…the Debate Continues on Surprise Billing

[08/28/19]

Paying Physicians for Quality, Value and Cost Containment: Six Steps Your Health Care Organization Can Take Right Now

[06/06/19]

Is It Fee-for-Service or Managed Care? CMS Launches Direct Contracting Models

[05/10/19]

CMS Removes Compliance Training Requirements for Downstream Providers Under Medicare Advantage and Part D

[07/05/18]

The Wave of PBM and Insurer Integration Continues as Cigna and Express Scripts Announce a Merger of Their Own

[03/16/18]

The Physician Pipeline and Counting Residents: Too Little and Too Much

[08/24/17]

Non-Network Employer Health Plans – The Struggle Continues

[07/07/17]

U.S. District Court Blocks Second Insurance Mega-Merger; Court Not Impressed with Anthem’s Plan to “Drop the Hammer” on Providers

[03/23/17]

Medical Necessity Audits: Not Just a Governmental Payor Issue

[02/20/17]

U.S. District Court Blocks $37 Billion Aetna/Humana Merger; Decision Looming in Anthem/Cigna

[01/27/17]

Discrimination in Federally Funded Health Care Programs – Part III: HHS New Regulations Regarding Equal Access for Individuals with Disability Under Section 1557 of the Affordable Care Act

[08/02/16]

Final Rule Prohibiting Discrimination in Federally Funded Health Care Programs – Part II: Equity in Communication

[06/13/16]

HHS Final Rule on Nondiscrimination in Health Programs and Activities – Part I: Sex Discrimination

[05/27/16]

"Tuomey Revisited: Key Takeaways for Health Care Attorneys," Prognosis, North Carolina Bar Association, Health Law Section, Vol. 30, No. 1, August 2013.