Articles and Blogs

A new report argues that Alabama’s certificate of need law is negatively impacting health care in the state. Researchers estimate that Alabama would have 52 more hospitals, the cost of care would be reduced and post-surgery complications would decrease by 5.2% but for certificate of need restrictions. New data has been published on private... READ MORE

NATIONAL $1 in Medicaid cuts costs rural areas $5: community hospital CEO Catholic health systems warn of program closures, higher premiums if Medicaid cuts pass CMS deploying more coders, ‘advanced systems’ to audit all Medicare Advantage contracts CMS shift sparks hope for high-needs ACO REACH extension CMS to crack down on Medicare Advantage overpayment... READ MORE

On April 30, 2025, the Centers for Medicare & Medicaid Services (“CMS”) released the FFY 2026 Inpatient Prospective Payment System (“IPPS”) Proposed Rule (“Proposed Rule”) to update IPPS payment rates, change DSH payments, increase uncompensated care payments and request input on ways to streamline Medicare regulations and reduce provider burden. Increase to Payment Rates... READ MORE

The Center for Medicare & Medicaid Innovation (“CMMI”) has announced a new strategy for establishing payment systems that incentivize healthier lives through a focus on three key pillars: (1) promoting evidence-based prevention; (2) empowering patients to achieve their health goals; and (3) driving choice and competition. This strategy includes several positives for providers participating... READ MORE

In the latest example of enforcement action against pharmacy benefit managers (“PBMs”), Michigan Attorney General Dana Nessel recently filed an antitrust lawsuit in federal court against Express Scripts, Inc. and Prime Therapeutics LLC, alleging the two PBMs engaged in an unlawful agreement to suppress pharmacy reimbursement rates and harm competition (the “Complaint”). The Complaint,... READ MORE

Hospitalogy recently compiled statistics tracking the top health systems along several metrics, as of January 1, 2025, including total revenue (Kaiser Permanente), patient service revenue (HCA Healthcare) and patient revenue growth (BJC Health System). Health system margins dipped below 1% for the first time in 15 months, according to a recent report. The report... READ MORE

NATIONAL 5 Stark law developments physicians can’t afford to miss 4 takeaways from RFK Jr.’s dual congressional hearings AHA makes 100 suggestions for Trump administration American Medical Association’s next CEO brings policy experience and ‘digital savvy’ California to put $3.3B toward 5,000 mental health beds Colonoscopy reimbursement cuts spell trouble for patient care CVS... READ MORE

Health care continues to drive private equity (“PE”) activity, creating opportunities for investors and traditional health care providers. Transactions in the health care space are especially complicated, layering health care regulatory and reimbursement considerations on top of a complex securities, antitrust, privacy and security framework. Hall Render’s PE team of attorneys and advisors leverage... READ MORE

President Trump unveiled his 2026 budget proposal. Key health care takeaways include: 1) The Department of Health and Human Services will receive funding to promote nutrition, physical activity and healthy lifestyles; 2) VA medical centers will receive additional funding, and veterans will be able to access care from local providers; 3) funding for National... READ MORE

NATIONAL 19 states sue to block HHS reorganization, claim overhaul is unconstitutional Bill grants hospital staff same federal protections as flight crews: 5 notes CMS lead Dr. Oz questions federal funding for Medicaid expansion CMS process undermines negotiated drug prices, 340B: AHA CMS suspends 8 MIPS improvement activities Dr. Oz talks ‘generational opportunity’ to... READ MORE