Articles and Blogs

NATIONAL AHA calls outpatient payment rate in final rule ‘insufficient’ given cost pressures AMA scrutinizes lack of competition, consumer harms in Medicare Advantage plans CMS bumps ASC payments to 3.8 percent in final rule CMS gives nursing homes a longer leash on staff COVID-19 vaccination requirements CMS locks in court-ordered 340B drug payment rates... READ MORE

In October 2021, the Texas Medical Association (“TMA”) sued the Departments of Health and Human Services (“HHS”), Labor and Treasury and the Office of Personnel Management (collectively, the “Departments”) challenging an Interim Final Rule which required certified independent dispute resolution (“IDR”) entities to employ a presumption in favor of the qualifying payment amount (“QPA”)... READ MORE

The Centers for Medicare & Medicaid Services (“CMS”) has retooled guidance it armed surveyors with regarding how to survey skilled nursing facilities for compliance with the CMS staff vaccine requirements. The revisions address condition-level and actual harm determinations to ensure that deficiency citations recognize good faith efforts by providers. On October 26, 2022, CMS... READ MORE

Parties to litigation are often dismayed by its costs. Attorney fees alone can motivate the payment of handsome settlements even in meritless cases, and litigation costs tend to make traditional litigation unavailable, impracticable or uneconomical as a tool for individuals and organizations if substantial funds are not available or if the dispute is not... READ MORE

Health care experts are concerned the U.S. could face a “tripledemic” this winter if cases of Covid-19, the flu and RSV all surge at the same time. Some experts are concerned that hospitals may be overwhelmed as a result of staffing shortages. After Hurricane Ian made landfall in southwest Florida, communities continue to grapple... READ MORE

Michigan voters are being asked whether to add a new section to the state constitution concerning “reproductive freedom.” Proposal 3 would initiate a new law (which can be read in full on the Secretary of State’s website) that would include the following: Proclaim that “every individual has a fundamental right to reproductive freedom, which... READ MORE

Seattle’s Fred Hutchinson Cancer Center will receive more than $700 million from the Bezos family over the next decade. The donation will be used to fund several clinical trials, new research capabilities and recruitment. Pacific Group has broken ground on the $5 billion dollar Helios Health and Wellness campus in Las Vegas. This is... READ MORE

The Second Circuit Court of Appeals emphasized, in affirming a district court’s ruling on a motion to dismiss, that a contract merely incorporating a statutory or regulatory payment provision by reference, without more, does not make all terms of the statutory and regulatory scheme material, express conditions of payment in False Claims Act cases.... READ MORE

A remarkable 90% of survey respondents reported construction delays, according to National Multifamily Housing Council’s latest quarterly construction survey, with permitting and start delays being the main culprits. A lack of availability in construction financing is also a rising concern. 76% of respondents said that they have experienced deals repriced up over the last... READ MORE

NATIONAL Biden administration extends COVID public health emergency Bain: 25% of clinicians want out of healthcare Bill would use CMS’s Five-Star system to punish consistently 1-star nursing homes How hospital CIOs, IT leaders prepared for the new information-blocking rule Moving the Needle on SDOH Data Physician shortages: Key stats to know Telemedicine regulation more... READ MORE