Articles and Blogs

Senate Introduces Bipartisan Market Stabilization Legislation On October 18, Senate HELP Committee Chairman Sen. Lamar Alexander (R-TN) and Ranking Member Patty Murray (D-WA) introduced their individual market stabilization bill. The bill includes 11 Republican and 11 Democratic co-sponsors. The legislation proposes to restore funding for cost-sharing reduction payments for two years. The White House announced…Read More

NATIONAL GOP, Dem senators push health deal as Trump keeps distance Kaufman Hall: Number of hospital mergers and acquisitions this year on pace to top 2016 Alexander-Murray Healthcare Bill: 5 Fast Facts You Need to Know Trump appears to back further away from bipartisan health-care push Healthgrades: Hospital quality varies widely throughout the country National…Read More

The Fifth Circuit recently addressed pre-suit disclosure and causation requirements for FCA theories of liability in United States ex rel. King v. Solvay Pharmaceuticals Inc., 871 F.3d 318 (5th Cir. 2017). Two former employees (“Relators”) of Solvay Pharmaceuticals, Inc. filed a qui tam suit claiming that Solvay induced false Medicaid claims through a variety of…Read More

Trump Administration Announces Plans to Weaken ACA On October 12, President Trump signed an executive order to overhaul health insurance regulations. The order instructs the Departments of Treasury, Labor and Health and Human Services to expand health coverage through inexpensive, short-term health plans exempt from current Affordable Care Act (“ACA”) insurance market rules. One mechanism…Read More

NATIONAL Survey: Healthcare execs name data analytics, population health among top challenges for 2018 10 Common Physician Compensation Mistakes Most hospitals tie doctor pay to productivity; new research examines how that impacts academic medicine Trump could make waves with health-care order CMS releases star ratings for Medicare Advantage and drug plans, Kaiser earns top marks…Read More

On September 7, 2017, the Second Circuit realigned its stance on false certifications under the False Claims Act (“FCA”) in light of the Supreme Court’s decisions in Universal Health Services, Inc. v. United States ex rel. Escobar, 136 S.Ct. 1989, 195 L.Ed.2d 348 (2016). Background In the initial action, relators brought a qui tam action under…Read More

House and Senate Committees Advance CHIP Funding After Congress missed the September 30 deadline to renew funding for the Children’s Health Insurance Program (“CHIP”), both the House and Senate worked to advance bipartisan CHIP legislation this week. The Senate Finance Committee advanced a bill, known as the Keep Kids’ Insurance Dependable and Secure (“KIDS”) Act,…Read More

NATIONAL Which ASC company has grown the most in 2017? Five questions on healthcare following Price’s resignation Pence protégé seen as frontrunner to replace Price Congress moves toward funding lapsed federal children’s health insurance program 3 things to know about HHS Acting Secretary Dr. Don Wright 18 things to know about the 6 CEOs leading…Read More

On September 6, 2017, the Centers for Medicare & Medicaid Services (“CMS”) issued a Survey and Certification (“S&C”) Memo 17-44 with new guidance to State Survey Agencies pertaining to the application of the Medicare statutory definition of  “hospital” and whether a hospital is “primarily engaged” in the provision of inpatient services. CMS clarified that a hospital…Read More

On September 13, 2017, the Department of Justice (“DOJ”) announced a $4 million settlement with a New York-based hospital owner that owns and operates two hospitals in New York. The qui tam lawsuit was filed July 15, 2013, and the relator was an employed physician at one of the hospitals implicated in the lawsuit (the…Read More