Articles and Blogs

NATIONAL How to avoid the legal risks of telemedicine HHS OCR Clarifies When Health Plans Can Share PHI Under HIPAA Brigham and Women’s, Emory and more join radiology AI pilot program Hospital groups argue CMS wage index proposal flawed How 4 health IT leaders balance strategy with execution: key thoughts from Ed Marx, Dr.... READ MORE

In a previous article, we reported on CMS’s implementation of new billing edits that will Return to Provider any hospital UB-04 claims that identify a service location that is not an exact match to a Medicare-enrolled location identified in Provider Enrollment, Chain and Ownership System (“PECOS”). As previously reported, those edits were scheduled to be... READ MORE

On June 27, 2019, the last day of its 2018 term, the U.S. Supreme Court issued its third opinion in recent years addressing “the circumstances under which a police officer may administer a warrantless blood alcohol concentration (“BAC”) test to a motorist who appears to have been driving under the influence of alcohol.” Mitchell... READ MORE

NATIONAL Lawsuit sheds light on Amazon’s pharmacy strategy CMS’ first health informatics chief out after 4 months on the job Deals by UnitedHealth, other health giants draw antitrust scrutiny in D.C. Supreme Court to hear insurers’ bid for $12 billion in Obamacare money FDA must guard against bias in AI, focus on patient outcomes... READ MORE

NATIONAL HHS expands health reimbursement coverage 9 hospital, health system construction projects worth $300M or more May healthcare data breaches: More than 2 million patients affected Dual Payment Model for Long Term Care Hospitals Could Boost Hospice Use Uber Health will provide injured workers with transportation to medical appointments These Are The Top Children’s... READ MORE

Energy and Commerce Examines Surprise Medical Billing On June 12, the House Energy and Commerce health subcommittee held a legislative hearing on surprise medical bills as Congress continues tackling the issue on how best to resolve payment disputes between providers and health plans. There is broad agreement to pass legislation addressing surprise medical bills,... READ MORE

NATIONAL How CMS’ New Value-Based Bundled Payment Method Affects Healthcare Providers The Uber of prescription drugs: Web startups raise concerns about access to Rx medicine Cybersecurity lawsuit against Allscripts tossed by judge AMA’s president-elect is Texas allergist, immunologist Dr. Susan Bailey CMS plans to release list of 400 troubled nursing homes following Senate report... READ MORE

While much focus was given to the individual and corporate tax reductions provided in the Tax Cuts and Jobs Act of 2017 (“TCJA”), the TCJA also stirred up a great deal of interest among investors with the designation of qualified opportunity zones (“Opportunity Zones”). The Opportunity Zone additions to the Internal Revenue Code allow... READ MORE

On Monday, June 3, the United States District Court for the Southern District of Florida (the “Court”) ruled that the Food and Drug Administration (“FDA”) has the authority to regulate certain stem cell-based treatments offered by U.S. Stem Cell Clinic, LLC (the “Clinic”) and U.S. Stem Cell, Inc. After the Clinic failed to heed... READ MORE

The Centers for Medicare & Medicaid Services (“CMS”) recently made several announcements regarding graduate medical education (“GME”). This article discusses three matters that are particularly significant for teaching hospitals, teaching physicians and other GME stakeholders. First, CMS issued its inpatient prospective payment system (“IPPS”) proposed rule (“Proposed Rule”) for fiscal year 2020 and announced... READ MORE