Articles and Blogs

NATIONAL CMS releases proposed physician payment rule for 2019 Pharmaceutical, biotech companies cited as biggest drivers of high healthcare costs Amazon and start-up Xealth are planning a pilot where doctors would ‘prescribe’ products to be delivered after patients leave the hospital How rural hospitals can improve revenue cycle performance by renewing focus on the... READ MORE

In State v. Mitchell, 2018 WI 84, a non-precedential decision released earlier this month, the Wisconsin Supreme Court upheld an OWI conviction based on a blood draw taken when the defendant driver was literally passed out drunk. In May 2013, Sheboygan Police received a tip about a possible drunk driver. When they caught up... READ MORE

CMS Releases 2019 Proposed Medicare’s Physician Fee Schedule  On July 12, the Centers for Medicare & Medicaid Services (“CMS”) announced numerous new policy proposals in a proposed rule to update payment policies, payment rates and quality provisions for services furnished under the Medicare Physician Fee Schedule (“PFS”) for 2019. The annual update reduces payments... READ MORE

NATIONAL CMS gives providers another week to decide whether to jump into BPCI Advanced The biggest financial pain points hospitals feel right now: Experts weigh in 340B overhaul at the top of Congress, Azar’s mind CMS Suspends $10.4B in Risk Adjustment Payments to Payers Atul Gawande starts first day as CEO of Amazon, Berkshire... READ MORE

On June 12, 2018, the Wisconsin Court of Appeals (“Court”) affirmed a decision by a Wisconsin circuit court and held that a family planning clinic with multiple locations in Wisconsin (“Provider”) was not required to repay the Wisconsin Department of Health Services (“DHS”) a total of $185,074.80 related to Medicaid fee-for-service claims submitted for... READ MORE

Governor Hickenlooper recently signed into law Senate Bill 18-082, which revised Colorado’s existing statute governing non-competition agreements to explicitly permit physicians treating a patient with a “rare disorder” to disclose the physician’s professional contact information to said patients after termination of an employment, partnership or corporate agreement between physicians, even if a non-competition agreement... READ MORE

NATIONAL Feds boast largest healthcare fraud takedown ever at $2B in false claims GAO: 340B hospitals, contract pharmacies need more oversight CMS to waive MACRA’s alternative payment model requirements for Medicare Advantage under test CMS: Doctors, hospitals received $8.4B in payments from drug companies last year AHA urges CMS to expand start dates for... READ MORE

The Centers for Medicare & Medicaid Services (“CMS”) recently enacted a Final Rule removing certain compliance training requirements previously applicable to first tier, downstream and related entities (“FDRs”) of Medicare Advantage and Part D Plan Sponsors (“Plan Sponsors”). Specifically, beginning in plan year 2019, health care providers that participate in Medicare Advantage and Part... READ MORE

Senate Seeks Solutions on Reducing Health Care Costs On June 27, the Senate Health, Education, Labor and Pensions Committee held a hearing on how to reduce health care costs, which will examine administrative costs and waste, how to improve transparency, private sector solutions and other issues. Both Chairman Lamar Alexander (R-TN) and Ranking Member... READ MORE

On June 27, 2018, the Wisconsin Supreme Court (the “Court”) upheld the constitutionality of a state statute that establishes a $750,000 cap on medical malpractice noneconomic damages as part of Wisconsin’s unique medical liability system that also guarantees payment of all of a proper claimant’s economic damages. In Mayo v. Wis. Injured Patients and... READ MORE