Articles and Blogs

NATIONAL Apple wants to gather all your medical records in the Health app 10 predictions for healthcare industry growth in 2018 Kaufman Hall: Hospital M&A jumped 13% from 2016 U.S. telehealth industry eyes Medicare for its next big check What To Watch In Health Care In 2018: Six Key Trends ‘Not a lot of... READ MORE

Due to an expiration of certain provisions in the Social Security Act, there are several changes to the Medicare therapy caps effective for dates of service on or after January 1, 2018. Hospitals and other therapy providers should review these changes to determine their impact on current operations. Therapy providers should also monitor legislation... READ MORE

Recently, the D.C. Court of Appeals held that CMS Manual instructions are general statements of policy, which have no binding effect. Although this case involved a procedural claim, the court’s decision reminds providers that solely relying on CMS Manual instructions as guidance for Medicare coverage criteria could result in potential Medicare payment compliance issues.... READ MORE

In its recent MLN Connects for January 25, 2018, the Centers for Medicare & Medicaid Services (“CMS”) issued a reminder to providers regarding appropriate change in ownership reporting. Notification Requirements All physicians, non-physician practitioners, physician practitioner organizations and non-physician practitioner organizations are required to report any changes in ownership, as well as changes in... READ MORE

NATIONAL Six things to know about CMS’ new bundled payment model The big bang is coming in health care, and it will spark the next industrial revolution Medical industry trends toward more openness after errors Hospitals’ best-laid plans upended by disaster CMS to form interagency group to review Stark Law: 4 things to know... READ MORE

NATIONAL Worldwide ambulance market to reach $48.9B by 2025 MedPAC votes to nix MIPS CMS proposes expanding MRI coverage for patients with implantable cardiac devices Exploring the Bundled Payments for Care Improvement Advanced Model Amazon is hiring a health privacy expert for ‘new initiative’ CMS releases guidance for Medicaid work requirements: 5 things to... READ MORE

The Department of Health and Human Services Office of Inspector General (“OIG”) recently issued Advisory Opinion 17-09, which approved an arrangement between a hospital and physician group in which neurosurgeons and the hospital implemented a cost-savings program where the hospital agreed to share a percentage of its cost savings resulting from the program (“Proposed... READ MORE

CMS recently released a series of Frequently Asked Questions (“FAQs”) on its website providing some much needed guidance to hospitals. Among other things, CMS will allow hospitals that submitted attestations and mid-build certifications last February to get full payment under the Outpatient Prospective Payment System (“OPPS”) for dates of service on or after January... READ MORE

NATIONAL 4 Physician Compensation Factors to Watch Divided on health care, Congress backs medical research CMS opens data submission site for 2017 MACRA reporting CMS: Medicare adds 124 ACOs for 2018 10 of the most interesting healthcare transactions of 2017 AMA: Physicians generate $2.3T in economic activity 2018 Trends: Micro-Hospitals to Gain Popularity Hospitals... READ MORE

1) Health Insurance Mega-Mergers Crash to Earth and Other Antitrust Updates Dashed Mergers In the area of antitrust law, 2017 saw the resolution of two health insurance mega-mergers. On January 23, 2017, the U.S. District Court for the District of Columbia (“U.S. District Court, D.C.”) ruled in favor of the U.S. Department of Justice... READ MORE