Articles and Blogs

NATIONAL Tech’s Next Big Wave: Big Data Meets Biology Hospitals Acquired 5K Independent Practices from 2015 to 2016 CMS promises more APM’s, continued flexibility, better alignment of reporting tracks for MACRA CMS official: Moving physicians into advanced APMs under MACRA a ‘top strategic goal’ Five areas of the highest physician pay in the US revealed…Read More

Senate Committee Hearing Assesses 340B Program The Senate Health, Education, Labor and Pensions (“HELP”) Committee held a hearing this week to examine the 340B drug discount program as some stakeholders have urged lawmakers to scale back its reach. HELP Committee Chairman Lamar Alexander (R-TN) said the purpose of the hearing was to learn more about…Read More

Last week, Cigna Corporation, the fifth largest health insurer in the country, and Express Scripts, the nation’s largest stand-alone pharmacy benefit manager (“PBM”), issued a statement outlining Cigna’s plans to acquire the PBM giant for $67 billion. This deal is just the latest example of a health insurer and PBM joining forces, coming just a…Read More

NATIONAL Google Unveils New Cloud Service for Health Care Nurse shortage: Healthcare organizations pull out all the stops to attract and retain experienced RNs More than 60% of healthcare orgs saw cyberattack in past year, survey finds Hospitals eye concierge medicine to lure patients, boost revenue Cigna To Spend About $52 Billion For Express Scripts…Read More

On February 15, 2018, the Centers for Medicare & Medicaid Services (“CMS”) released a long-awaited Final Decision Memo (the “Memo”) updating the National Coverage Determination for implantable automatic defibrillators (NCD 20.4), also known as Implantable Cardioverter Defibrillators (“ICDs”). CMS’s update to NCD 20.4, the guidance describing when providers may bill and receive payment from CMS…Read More

Azar Pushes Value-Based Care Approach  During the annual policy conference for the Federation of American Hospitals, Health and Human Services (“HHS”) Secretary Alex Azar laid out an agenda for a more cost-effective and transparent health care system. Azar said HHS is focused on four key priorities: giving consumers greater control over health information through interoperable…Read More

NATIONAL No-frills micro hospitals with as few as 8 rooms emerge as a new way to cut health-care costs Doctors can now call Uber for patients, ditching taxi vouchers Ocular Telehealth Battle Heats Up With New Group, Lawsuit Appeal Bracket partners with Uber Health to ease clinical trial site, patient burden A New taskforce designs…Read More

After informal communications with the Centers for Medicare & Medicaid Services (“CMS”) Central Office, it appears that edits that impact Critical Access Hospital (“CAH”) Method II claims have been overreaching. Specifically, reason codes 17713, 17714, 17716 and 17717 should not be applying to the facility charges on CAH Method II claims. These reason codes should…Read More

On February 22, 2018, U.S. Citizenship and Immigration Services (“USCIS”) published a policy memorandum clarifying existing regulatory requirements relating to H-1B petitions filed for workers who will be employed at one or more third-party worksites. Effective immediately, the new guidance aligns with President Trump’s Buy American and Hire American Executive Order and the directive to…Read More

On Tuesday, February 27, 2018, Attorney General Jeff Sessions announced the creation of the U.S. Department of Justice (“DOJ”) Prescription Interdiction & Litigation (“PIL”) Task Force in an ongoing effort to curb the country’s current prescription opioid crisis. According to DOJ’s press release, the PIL Task Force will “aggressively deploy and coordinate all available criminal…Read More