Articles and Blogs

On January 31, 2019, the Department of Health and Human Services Office of Inspector General (“OIG”) issued a proposed rule that, if finalized, would eliminate Anti-Kickback Statute (“AKS”) safe harbor protection for prescription drug rebates paid by manufacturers to pharmacy benefit managers (“PBMs”), Medicare Part D plans and Medicaid managed care organizations (“Proposed Rule”).... READ MORE

NATIONAL Why hospitals’ future will involve keeping people from showing up GAO: Advantages of Voluntary and Mandatory Bundled Payments Study: Hospitals dramatically increase ad spend following data breaches Study finds freestanding EDs charge more than urgent care centers Stephen Klasko: Hospitals of the future won’t look the same Why some nonprofit hospitals are turning... READ MORE

The Oregon State Legislature is considering a bill that bases the determination of tax-exemption for hospital property on the relationship between hospital executives’ compensation and the amount of charity care provided by the hospital. While a number of other states have passed legislation that threatens a hospital’s property tax-exempt status where a hospital fails... READ MORE

NATIONAL GAO’s latest report on patient matching: It’s still not easy Fostering a culture of innovation: 5 CIOs share insights Research: Physician Burnout is a Public Health Crisis; Improving EHR Usability is Critical New drug shortages rose 27% in 2018 Telehealth and the law: What hospital executives should know about kickback and false claims... READ MORE

January 1, 2019 marked the start of a new data collection period for laboratories pursuant to the Medicare Clinical Diagnostic Laboratory Tests Payment System Final Rule (“CLFS Rule”).¹ The CLFS Rule establishes the Centers for Medicare & Medicaid Services’s (“CMS’s”) new private payor-based rate-setting system for clinical diagnostic laboratory tests (“CDLTs”) paid under the... READ MORE

NATIONAL Medicaid gets new acting director Healthcare leaders on communicating effectively with other C-suite executives Hospitals are turning to telehealth to manage scarce physician resources ACOs want deadline extended for CMS’s Pathways to Success applications Intermountain Healthcare-led generic drug venture CivicaRx garners new members including NYU Langone, Memorial Hermann, Oschner Telemedicine Licensure Compact is... READ MORE

NATIONAL Prescription Drug Spending Higher at 340B Hospitals, Study Finds Medicaid chief out after 3 months: 3 things to know How artificial intelligence will shape the physician toolkit in 2019 Health care experts call new federally-required hospital price listings ‘not very consumer-friendly’ HHS releases voluntary cybersecurity guidance DOJ Recovers $2.5B in Healthcare Fraud, False... READ MORE

On December 27, 2018, a federal judge ruled in favor of hospital associations and hospitals challenging the reduction in reimbursement for drugs purchased at a discount under the 340B Program established in the 2018 Outpatient Prospective Payment System final rule (“2018 OPPS Rule”). Judge Rudolph Contreras of the United States District Court in Washington,... READ MORE

Master Trust Indentures or “MTIs” have historically been implemented by hospitals and health systems as a way to pool the credit of multiple entities (the members of the “obligated group”) and create a “master trust” consisting of revenues or other assets pledged by the obligated group members under the MTI. An MTI allows the... READ MORE

The Department of Justice (“DOJ”) reported it collected more than $2.8 billion in False Claims Act (“FCA”) settlements and verdicts in 2018.¹ This is significantly down from the record $5.69 billion recovered in 2014 and from the $3.6 billion – $4.7 billion in 2015 through 2017. This can primarily be explained by the absence... READ MORE