Articles and Blogs

Congressional Leaders Discuss Health Care Priorities Congress’ top leaders, Senate Majority Leader Mitch McConnell (R-KY) and House Speaker Nancy Pelosi (D-CA), announced they are not embracing “Medicare for All” as a priority at the American Hospital Association’s annual Washington conference. Both leaders reinforced that each chamber will pursue largely separate health care agendas in the…Read More

NATIONAL Hospitals add 13,600 jobs in March Walmart increasingly comparing physicians over cost 10 CEOs reshaping healthcare: Forbes What the HIPAA-compliant Alexa skills mean for the future of voice in healthcare PBM group says HHS drug rebate proposal would increase costs more than predicted The Best Places to Work in Health Care and Biopharma CMMI’s…Read More

Health Cost Reduction Package Slated for Summer Release Speaking on the Senate floor on Thursday, Sen. Lamar Alexander (R-TN), Chairman of the Health, Education, Labor, and Pensions (“HELP”) Committee, said he plans to move a wide-ranging legislative package through his panel seeking to curb health care costs. Sen. Alexander, along with HELP ranking member Sen….Read More

It’s no April Fools’ joke. On April 1, 2019, the Health Resources & Services Administration Office of Pharmacy Affairs (“HRSA”) unveiled a long-awaited website that gives providers participating in the 340B drug pricing program (“340B Program”) direct access to information about the maximum amounts that pharmaceutical companies may charge for certain drugs. This moves the…Read More

NATIONAL Hospital associations urge appeals court to reverse ACA ruling ‘Patient Dumping’ Still a Problem Despite Law Hospitals are largest employers in 16 states CMS finalizes nontraditional MA benefits, use of encounter data Physician Compensation Plateaued in 2018, Falling Less than 1% Feds get pressure to upgrade, expand HIPAA transactions These are the best –…Read More

In a recent case out of Kansas, the Tenth Circuit reiterated the importance of the FCA’s materiality and scienter requirements that the Supreme Court set forth in Escobar: FCA claims must satisfy materiality and knowledge requirements—both of which are rigorous and strictly enforced. A whistleblower must prove knowledge in an implied certification case—it cannot be…Read More

Conversation Shifts Back to Health Care in Washington Health care became a major discussion point for lawmakers after this week started with the Trump administration’s declaration that it supports a federal judge’s ruling that the entire Affordable Care Act (“ACA”) should be thrown out. This signals a shift in the Justice Department’s prior position that…Read More

In a previous article, we reported on new billing edits that CMS is implementing, which will Return to Provider any hospital UB-04 claims that identify a service location that is not an exact match to a Medicare-enrolled location identified in Provider Enrollment, Chain and Ownership System (“PECOS”). Those edits were scheduled to be activated starting…Read More

NATIONAL BPCI Advanced loses 252 providers, 35% of lower extremity major joint replacement participants Why hospital associations are dipping their toes into state-based Medicare ACOs 1 in 5 Catholic hospitals don’t share religious affiliation online, study finds FDA Chief Scott Gottlieb Calls for Tighter Regulations on Electronic Health Records How states are using Medicare rates…Read More

Providers are often looking for additional opportunities to engage patients and ensure compliance with treatment regimens. By implementing patient transportation programs, providers are able to help alleviate this frequent hurdle facing their patients. In addition, providers are able to increase efficiencies, avoid missed appointments and limit late arrivals by assisting patients with transportation to and…Read More