Articles and Blogs

NATIONAL Worldwide ambulance market to reach $48.9B by 2025 MedPAC votes to nix MIPS CMS proposes expanding MRI coverage for patients with implantable cardiac devices Exploring the Bundled Payments for Care Improvement Advanced Model Amazon is hiring a health privacy expert for ‘new initiative’ CMS releases guidance for Medicaid work requirements: 5 things to know…Read More

The Department of Health and Human Services Office of Inspector General (“OIG”) recently issued Advisory Opinion 17-09, which approved an arrangement between a hospital and physician group in which neurosurgeons and the hospital implemented a cost-savings program where the hospital agreed to share a percentage of its cost savings resulting from the program (“Proposed Arrangement”)….Read More

CMS recently released a series of Frequently Asked Questions (“FAQs”) on its website providing some much needed guidance to hospitals. Among other things, CMS will allow hospitals that submitted attestations and mid-build certifications last February to get full payment under the Outpatient Prospective Payment System (“OPPS”) for dates of service on or after January 1,…Read More

Annually, the Federal Communications Commission (“FCC”) provides $400 million in funding to health care providers who serve rural populations through its Rural Health Care Program (“RHC Program”). The RHC Program is aimed at improving and reducing the cost of communications services that are used in providing health care services to residents of the rural United…Read More

In an opinion loaded with linguistic hooks, the United States District Court for the Middle District of Florida recently reinforced the Supreme Court’s holding in Escobar, enthusiastically highlighting the importance of materiality and scienter in FCA cases. Background In U.S. ex rel. Ruckh v. Salus Rehabilitation, LLC, et al., Relators were successful in a qui…Read More

NATIONAL 4 Physician Compensation Factors to Watch Divided on health care, Congress backs medical research CMS opens data submission site for 2017 MACRA reporting CMS: Medicare adds 124 ACOs for 2018 10 of the most interesting healthcare transactions of 2017 AMA: Physicians generate $2.3T in economic activity 2018 Trends: Micro-Hospitals to Gain Popularity Hospitals Nationally…Read More

CMS Allows States to Establish Medicaid Work Requirements On January 11, CMS issued new guidance that will allow states to establish work requirements for certain Medicaid recipients for the first time in the program’s history. Through a letter to State Medicaid Directors, CMS outlined criteria for the types of employment proposals targeting able-bodied, working-age Medicaid…Read More

Fresh off the 75th Annual Golden Globes Awards, which took place on January 7, mainstream and social media alike are abuzz with Oprah Winfrey’s historic acceptance of the Cecil B. DeMille Award. Winfrey, the first black woman to receive the prestigious award, brought the crowd to its feet on several occasions during her emotional acceptance speech…Read More

1) Health Insurance Mega-Mergers Crash to Earth and Other Antitrust Updates Dashed Mergers In the area of antitrust law, 2017 saw the resolution of two health insurance mega-mergers. On January 23, 2017, the U.S. District Court for the District of Columbia (“U.S. District Court, D.C.”) ruled in favor of the U.S. Department of Justice (“DOJ”)…Read More

The Centers for Medicare & Medicaid Services (“CMS”) announced its long-awaited “BPCI Advanced” model on January 9. The model – which is voluntary – will initially include 29 inpatient clinical episodes and 3 outpatient clinical episodes (a list of the 32 clinical episodes can be found here). BPCI Advanced Participants must elect to be accountable…Read More