Articles and Blogs

NATIONAL Which innovations have executives most excited? 6 insights from healthcare leaders CMS gives telehealth a reimbursement win CMS proposes rule to overhaul Medicare ACO program Moody’s: CMS proposed changes to Medicare’s outpatient prospective payment system could hurt hospitals DOJ, HHS continue war on Medicare fraud with formation of new regional fraud strike force S….Read More

On August 6, 2018, the Department of Health and Human Services Office of Inspector General (“OIG”) published Advisory Opinion 18-07, approving an arrangement whereby a group purchasing organization (“GPO”) would serve as a purchasing agent on behalf of health care facilities under a common parent organization with the GPO (the “Proposed Arrangement”). This is the…Read More

NATIONAL CMS missed deadline to create MACRA-mandated chiropractic preauthorizations, GAO says The health-care sector is leaving tech in the dust. Some see more gains ahead. AHA urges creation of Stark Law exception for value-based payments How each state’s healthcare system ranks — 51 statistics Regent Surgical Health: 6 trends for ASCs to watch Using Big…Read More

The hope and promise of alternative dispute resolution (“ADR”) processes is that they will resolve disputes more efficiently and with less expense than litigation. But, when the parties cannot achieve a negotiated settlement and turn to arbitration, they find that standard arbitration, which allows discovery and motions, is not nearly as simple and inexpensive as…Read More

In the restaurant industry, it’s pretty common for fast food and sandwich shop operators—think Wendy’s, Chick-fil-A, Subway, etc.—to run their companies based on a franchise model. Under this model, which is somewhat analogous to a large corporation that has a main “corporate office” and satellite locations scattered around the country, the franchisor owns the brand,…Read More

On July 31, 2018, the Centers for Medicare & Medicaid Services (“CMS”) issued a final rule (CMS-1696-F) outlining Fiscal Year (“FY”) 2019 Medicare payment updates and quality program changes for skilled nursing facilities (“SNF”)(“Final Rule”). The Final Rule finalized the value-based purchasing payments that start October 1, 2018, updated several SNF Quality Reporting Program details…Read More

This Week in Washington joined the House on its August break but has provided a news update to address CMS finalizing its Hospital Inpatient Prospective Payment System final rule. On August 2, CMS finalized its Hospital Inpatient Prospective Payment System final rule for fiscal year (“FY”) 2019. The final rule updates Medicare payment policies and…Read More

On July 12, 2018, the Centers for Medicare & Medicaid Services (“CMS”) released its proposed rule for the Calendar Year (“CY”) 2019 Medicare Physician Fee Schedule (“MPFS Proposed Rule”). Among many other changes, CMS proposed to maintain payments for certain non-excepted (non-grandfathered) off-campus provider-based hospital departments (“PBDs”) at 40 percent of the Outpatient Prospective Payment System (“OPPS”)…Read More

NATIONAL CMS’ proposed outpatient payment rule for 2019: 10 things to know Add cardiologists to the list of doctors in short supply CMS proposes 2% ASC pay increase in 2019 House Subcommittee Hears Mixed Review of MACRA How Hospital CEOs Deliver Consistent Patient Experience Across An Enterprise Medicare’s Hospital Outpatient Prospective Payment System Proposed Rule:…Read More

Last month, the United States Conference of Catholic Bishops voted to approve the sixth edition of the Ethical and Religious Directives for Catholic Health Care Services (the “ERDs”). The approved revisions specifically relate to Part Six of the ERDs, which addresses “Forming New Partnerships with Health Care Organizations and Providers.” The approved revisions entail a restructuring…Read More