Articles and Blogs

On November 1, the Centers for Medicare & Medicaid Services (“CMS”) surprisingly finalized a proposal to reduce reimbursement by almost 27 percent for separately payable drugs purchased at reduced prices under the 340B drug discount program (“340B Program”). Currently, all 340B-participating hospitals (“Covered Entities”) except for critical access hospitals (“CAHs”) receive Medicare OPPS payments of 6…Read More

On Thursday, November 2, 2017, Republicans in the House of Representatives released the text and summary of H.R.1, their promised tax reform bill. The short title of the bill is the “Tax Cuts and Jobs Act.” It is the first substantive shot fired in the tax reform war that the Republican leadership intends to wage to…Read More

CMS Drastically Cuts 340B Payments in 2018 OPPS/ASC Final Rule On November 1, CMS released the final rule updating the hospital Outpatient Prospective Payment System (“OPPS”) rates by 1.35 percent in CY 2018 compared to 2017. This is down from 1.75 percent in the proposed rule. In addition, CMS removed total knee replacements from the…Read More

NATIONAL Opioid crisis: Feds relax HIPAA rules so doctors can share information with family members of a patient who overdoses CMS Administrator Verma Announces “Meaningful Measures” Initiative Leapfrog releases fall 2017 hospital safety grades: 6 things to know Hospice provider to pay record-setting $75 million false claims settlement Physician data offer new insights into ACA’s…Read More

The Centers for Medicare & Medicaid Services (“CMS”) released a draft of the Interpretive Guidelines (“Draft Interpretive Guidelines”) to the final Conditions of Participation (“CoPs”) for home health agencies that CMS issued in January 2017. The CoPs are scheduled to be implemented January 13, 2018. CMS has asked for feedback on the Draft Interpretive Guidelines. The Draft Interpretive…Read More

Hatch-Brady Proposal Introduced as Alternative Market Stabilization Plan On October 24, Senate Finance chairman Orrin Hatch (R-UT) and House Ways and Means chair Kevin Brady (R-TX) proposed a bicameral agreement for ACA market stabilization. Similar to the Senate HELP Committee proposal released last week, Hatch-Brady includes two years of funding for the ACA’s cost-sharing subsidies….Read More

NATIONAL Pilot test will evaluate MACRA’s ability to reduce costs Telehealth laws expanded, updated in nearly every state House budget chairman wants to get rid of EMTALA Over 1,300 Hospitals Urge CMS to Withdraw 340B Drug Payment Cuts Regenstrief to evaluate how health information exchange impacts EDs More metropolitan areas are dominated by single insurance…Read More

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