Articles and Blogs

NATIONAL Best patient experience innovations at 17 health systems DaVita, Fresenius Broke Kickback Rules, Whistleblower Says CMS Finalizes Medicare Pay Increase for Rural Hospital Workers 4 major questions on HHS and FDA’s drug importation action plan New CMS Pilot Program Gives Physicians Claims Data Access HHS Designates $20 Million for New Rural Residency Programs... READ MORE

Recently, Lyft announced that its ridesharing service is now considered a covered benefit under the Arizona Medicaid program. This announcement follows implementation of new Arizona Medicaid regulations allowing ‘”rideshare”‘ companies to enroll as non-emergency medical transportation providers. Under the policy, participating Medicaid patients can request to schedule non-emergency medical transportation to ensure access to... READ MORE

Last week, a federal district court in Illinois entered judgment for Defendants in an FCA action against a self-proclaimed “one stop shop” health care referral management company, alleging anti-kickback and FCA violations for its arrangement with a care coordination organization for low-income seniors.[1] Originally filed in 2016, this case highlights how even an FCA... READ MORE

On July 29, 2019, the Centers for Medicare & Medicaid Services (“CMS”) released its proposed rule for Calendar Year (“CY”) 2020 Hospital Outpatient Prospective Payment System (“Proposed Rule”). Among many other changes, CMS proposed three key payment policy updates impacting hospital outpatient departments, including: (1) lowering the supervision standard for hospital outpatient therapeutic services... READ MORE

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