Articles and Blogs

This week, CMS released the 2020 Medicare Hospital Outpatient Prospective Payment System (“OPPS”) and Ambulatory Surgical Center Payment System Proposed Rule (“Proposed Rule”). Among a host of other items, CMS announced its intent to continue paying Average Sales Price (“ASP”) minus 22.5 percent for most drugs acquired under the 340B drug discount program (“340B... READ MORE

NATIONAL Will telehealth help keep rural LTC residents healthy after discharge? Study aims to find out What Do We Know About Prices And Hospital Quality? Independent Physicians Feel The Pressure As Hospital-Owned Practices Continue To Grow Trump meets with pharma execs: 4 things to know HHS grant seeks to draw resident physicians to rural... READ MORE

NATIONAL More mega-mergers in Q2 drive healthcare mergers and acquisitions activity to near-historic levels Mounting battle between Amazon’s PillPack and Surescripts over access to patient data Outmigration of cardiology — Logistical challenges for ASCs + how hospitals are bracing for volume loss 2 payment models incentivizing cost-effective joint replacements Noteworthy CMS announcements, actions in... READ MORE

Effective July 1, 2019, The Joint Commission (“TJC”) implemented new and revised requirements regarding suicide prevention for all TJC-accredited hospitals and behavioral health entities. The seven new and revised requirements, part of TJC’s elements of performance (“EPs”) under National Patient Safety Goal (“NPSG”) 15.01.01, are designed to improve quality and safety of care for... READ MORE

On July 10, 2019, CMS issued proposed rulemaking titled Medicare Program; Specialty Care Models to Improve Quality of Care and Reduce Expenditures. The rule proposes to implement two new mandatory Medicare payment models – the Radiation Oncology Model and the End-Stage Renal Disease (“ESRD”) Treatment Choices Model. Comments on this proposed rule are due... READ MORE

NATIONAL Mandatory bundled radiation oncology demo seeks to upend payment Premera Reaches $10M Settlement with 30 States Over 2014 Data Breach Study: Doctor burnout costs health care system $4.6 billion a year Uber, Lyft see $15B opportunity in healthcare: 4 things to know Hospital execs turning to EHRs, patient portals to improve patient experience... READ MORE

On June 26, 2019, Florida Governor Ron DeSantis signed into law a bill dramatically limiting substantial portions of Florida’s Certificate of Need (“CON”) program. The new law takes effect in two phases. Effective July 1, 2019, general hospitals, comprehensive rehabilitation and “tertiary”[i] health services, such as pediatric cardiac catheterization, pediatric open-heart surgery and neonatal... READ MORE

Thanks to a final rule issued by the Centers for Medicare & Medicaid Services (“CMS”) this spring, Medicare Advantage (“MA”) plans will now be able to offer additional telehealth benefits to enrollees starting in 2020. Historically, MA plans have been able to offer more telehealth services compared to Original Medicare as part of their... READ MORE

NATIONAL Readmissions penalty doing little to slow the spinning of hospitals’ revolving doors Joint replacement penalties for rehospitalizations may have hit their limit 3 things to know about physician salary The Impact of a Hospital Post-Acute Care Program on Value-Based Care 10 health systems with strong finances What Telemedicine’s Growth Rate Means for the... READ MORE

For-profit businesses are generally organized and operated to maximize shareholder value. For this reason, for-profit organizations have inherent limitations in pursuing goals or purposes that conflict with increasing the bottom line for shareholders. While for-profit companies have traditionally had these limitations, in recent years, many for-profit organizations have been presented with a new legal... READ MORE