Articles and Blogs

Mergers and acquisitions in the health care industry involve unique challenges that are not often present when undertaking similar transactions in other industries. Because of health care’s highly regulated nature, parties may falter if a health care transaction is not reviewed and negotiated carefully with respect to the distinct concerns that health care entails.... READ MORE

NATIONAL How total joints’ outpatient migration could affect value-based pay Federal court says HHS can’t limit fees for 3rd-party access to patient records Private equity pushes into healthcare: 8 latest deals Patient groups push back against Medicaid block grants States ranked by ER visit rate How Social Media Helped an Accountable Care Organization Save... READ MORE

The Hart-Scott-Rodino Antitrust Improvements Act of 1976 (“HSR”), as amended, requires all persons contemplating certain mergers or acquisitions that meet or exceed the jurisdictional thresholds (shown below) to file notification with the Federal Trade Commission (“FTC”) and Department of Justice (“DOJ”) Antitrust Division and to wait a period of time before consummating the transaction.... READ MORE

NATIONAL Pete Stark, congressman who reshaped health care, dies at 88 Hospital group fights drug shortages by making needed meds Epic CEO Judy Faulkner asks hospitals to oppose HHS’ interoperability rule 4 health systems that dropped the dual-CEO model Health Catalyst becomes 1st healthcare member of Partnership on AI Joint replacement bundled payments losing... READ MORE

On January 21, 2020, the Supreme Court denied a motion to expedite consideration of a petition for certiorari in a case directly challenging the constitutionality of the Affordable Care Act (“ACA”).[1] Given the Supreme Court’s decision, it is likely that the fate of Obamacare will not be decided until sometime after the 2020 presidential... READ MORE

NATIONAL DoJ Recovered $2.6B from Healthcare Fraud Cases in 2019 297%: The average difference between highest, lowest outpatient charges, study says SCOTUS declines expedited review of ACA case Uber Health plans to double in size this year Forbes names ‘Best Employers for Diversity’: 14 hospitals, health systems in top 100 Surgeries are being postponed... READ MORE

On January 10, 2020, the Federal Trade Commission (“FTC”) and Antitrust Division of the U.S. Department of Justice (“DOJ”) (collectively, the “Federal Antitrust Enforcers”) proposed their first new vertical merger guidelines (the “Draft Vertical Merger Guidelines”) in 36 years. The Draft Vertical Merger Guidelines, which will supersede and replace the 1984 DOJ “Non-Horizontal Merger... READ MORE

On January 8, 2020, the Centers for Medicare & Medicaid Services (“CMS”) released an Informational Bulletin titled “Best Practices for Avoiding 340B Duplicate Discounts in Medicaid” (“Bulletin”). The Bulletin outlines best practices that CMS encourages state Medicaid agencies to consider to avoid the situation where a manufacturer provides both a Medicaid drug rebate and... READ MORE

NATIONAL Could Patient Privacy Awareness Drive Health IT Innovation in 2020? How tech will transform the healthcare workplace by 2050: 3 predictions Physicians will keep fighting on these 6 key issues in 2020 How healthcare will change in 2020 Health Plans Struggle with HIPAA Compliance, Unprepared for Audit AHA files another challenge to CMS... READ MORE

Under the Protecting Access to Medicare Act (“PAMA”), certain laboratories must report private payor data to the Centers for Medicare & Medicaid Services (“CMS”). This data is in turn used by CMS to establish a single, national Clinical Laboratory Fee Schedule. For a more detailed discussion on PAMA and the types of laboratories that... READ MORE