Articles and Blogs

NATIONAL Feds boast $2.4B in healthcare fraud judgments, settlements GAO Finds Several Medicare Beneficiary Data Vulnerabilities Feds, 30 states claim McKesson illegally repackaged cancer drugs to maximize profits Fitch identifies biggest issues facing nonprofit hospitals The Disappearing Doctor: How Mega-Mergers Are Changing the Business of Medical Care How to Ramp Up Physician Engagement at Your…Read More

A critical element in any claim for retaliation under the False Claims Act is an adverse employment action. Most commonly, FCA retaliation claims rest on an employee’s involuntary termination due to lawful actions taken by the employee in reporting or opposing the submission of false claims to the government. In certain cases, an employee can…Read More

NATIONAL Healthcare analytics market will be worth nearly $54 billion by 2025, report says A small but growing movement of doctors that don’t accept insurance and charge a monthly fee could be a model for big employers like Amazon and JPMorgan Walmart, Not Amazon, May Turn Out To Be The Real Health Care Disruptor OIG:…Read More

The Federal Policy for the Protection of Human Subjects (the “Common Rule”) regulates the conduct of human subject research supported by federal agencies. On January 19, 2017, the Department of Health and Human Services (“HHS”), as well as 15 other federal agencies and departments that are subject to the Common Rule, published significant changes to the…Read More

NATIONAL What are the biggest challenges for telemedicine programs? Still no word on whether CMS will approve lifetime Medicaid limits Alere Pays $33.2M to Settle False Claims Act Allegations Nurses continue to push for safe staffing in DC Hospitals embrace interoperability: As data exchange matures, leaders find ways to use it to their advantage Apple’s…Read More

We recently released an alert about the expiration of exception processes for the Medicare therapy caps as of January 1, 2018. Since that article, the Bipartisan Budget Act of 2018 was signed into law and includes a permanent fix to the therapy caps effective back to January 1, 2018. Therapy providers should review the changes…Read More

Major Spending Bill Passes Congress Congress passed a major $1.3 trillion spending bill this week, which keeps the government funded through September. The bill passed the House 256-167 and the Senate 65-32. In both bodies, the measure received the support of a majority of members from each party. In the Senate, unanimous consent was needed…Read More

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