Articles and Blogs

With the advent of the Patient Protection and Affordable Care Act (“ACA”), we are entering a new era of clinical integration and coordinated care.  The government is interested in actively facilitating better care for patients, better health for populations and lower health care costs.  To achieve this three part objective, CMS is championing the Medicare…Read More

Background The Hart-Scott-Rodino Antitrust Improvements Act of 1976, as amended (“HSR Act”), requires all persons contemplating certain mergers or acquisitions that meet or exceed the jurisdictional thresholds (shown below) to file notification with the Federal Trade Commission and Department of Justice Antitrust Division and to wait a period of time before consummating the transaction. Each…Read More

The Centers for Medicare & Medicaid Services (CMS) has issued a proposed rule that enacts a provision of the Patient Protection and Affordable Care Act (PPACA) that seeks to make Medicaid reimbursement for medications more transparent and more closely aligned with what pharmacies pay for the drugs.  In a press release, CMS states the rule…Read More

The Department of Justice (DOJ) has recommended to the Supreme Court of the United States (SCOTUS) that only the provisions of the Patient Protection and Affordable Care Act (PPACA) that require insurers to accept everyone regardless of health status and to apply “community rates” be overturned if the Justices rule that the law’s mandate is…Read More

The Centers for Medicare & Medicaid Services (CMS) released updated guidance on Section 6501 of the Patient Protection and Affordable Care Act (PPACA) that requires state Medicaid agencies to terminate the participation of any individual or entity if such individual or entity is terminated under Medicare or any other state Medicaid plan.  

This installment of Hall Render’s Health Law Broadcast series on health care reform is designed to provide you with the insight, analysis and practical suggestions with respect to the various reform initiatives that will affect your organization.   Amicus Curiae Briefs In a seven-day period ending January 13, the United States Supreme Court received over two dozen…Read More

The operational and financial role of health information technology (“HIT”) is rapidly increasing.  The provision of HIT services and products is generally governed by lengthy and complex agreements.  Unless you are directly and actively involved in the negotiation process for each product or service, reviewing, understanding and evaluating these agreements can be a daunting task. …Read More

This week, the Centers for Medicare & Medicaid Services (CMS) updated Section 40.1 of Publication 100-1, the Medicare General Information, Eligibility and Entitlement Manual, to reflect Section 3108 of the Patient Protection and Affordable Care Act (PPACA).  This update permits physician assistants to perform the initial certifications and recertifications of a beneficiary’s need for skilled nursing…Read More

CMS’s most recent monthly report for the EHR Incentive Program shows rapid growth in the number of Eligible Hospitals and Eligible Providers registered for the program and receiving payments under the programs.  In December, Medicare payment tripled with $89 million in payments to Eligible Professionals and $374 million in payments to Eligible Hospitals and CAHs.   Total Medicare payments for…Read More

So-called “superbugs”, those bacteria strains that have developed resistance to antibiotics, have long generated high levels of concern for hospitals and long-term care facilities.  These infections are difficult to treat, and often generate serious complications for individuals with already impaired immune systems.  The Wall Street Journal (WSJ) today published a note detailing efforts by researchers to…Read More