Articles and Blogs

A federal district court in Connecticut recently applied the Supreme Court’s favorable opinion in the Allina case (which we previously wrote about here), compelling the Secretary to adhere to notice-and-comment rulemaking of Medicare policy when it affects providers’ eligibility, benefits or payment. Additionally, CMS cannot use a preclusion statute to avoid challenges for which it did not... READ MORE

On June 14, 2019, the U.S. Department of Health and Human Services (“HHS”) published in the Federal Register a proposal to revise certain civil rights anti-discrimination regulations implementing and enforcing Section 1557 of the Affordable Care Act (“ACA”) (“Section 1557 Rule”) that HHS believes are inconsistent with pre-existing civil rights statutes and likely unlawful... READ MORE

Energy and Commerce Examines Surprise Medical Billing On June 12, the House Energy and Commerce health subcommittee held a legislative hearing on surprise medical bills as Congress continues tackling the issue on how best to resolve payment disputes between providers and health plans. There is broad agreement to pass legislation addressing surprise medical bills,... READ MORE

HELP Committee Leaders Release Draft Bill Targeting Health Care Priorities Senate Health, Education, Labor, and Pensions (“HELP”) committee leaders Sens. Lamar Alexander (R-TN) and Patty Murray (D-WA) released a wide-ranging draft bill addressing health care issues such as surprise medical billing, prescription drug costs and urgent public health concerns. The proposal is separated into... READ MORE

Lawmakers Seriously Pursuing “Surprise Medical Bill” Fix Continuing the bipartisan interest in addressing the issue of surprise medical billing, also known as balance billing, a group of bipartisan senators led by Sens. Bill Cassidy (R-LA) and Maggie Hassan (D-NH) introduced legislation on Thursday. The legislation states that providers would be prohibited from balance billing... READ MORE

Addressing “Surprise” Medical Bills High Priority for Administration and Congress Yesterday, President Trump held an address at the White House where he emphasized that Congress should act to “hold insurance companies and hospitals totally accountable” for surprise medical bills. A surprise medical bill, more commonly known as balance billing, occurs when patients, through no... READ MORE

Congressional Leaders Discuss Health Care Priorities Congress’ top leaders, Senate Majority Leader Mitch McConnell (R-KY) and House Speaker Nancy Pelosi (D-CA), announced they are not embracing “Medicare for All” as a priority at the American Hospital Association’s annual Washington conference. Both leaders reinforced that each chamber will pursue largely separate health care agendas in... READ MORE

Health Cost Reduction Package Slated for Summer Release Speaking on the Senate floor on Thursday, Sen. Lamar Alexander (R-TN), Chairman of the Health, Education, Labor, and Pensions (“HELP”) Committee, said he plans to move a wide-ranging legislative package through his panel seeking to curb health care costs. Sen. Alexander, along with HELP ranking member... READ MORE

It’s no April Fools’ joke. On April 1, 2019, the Health Resources & Services Administration Office of Pharmacy Affairs (“HRSA”) unveiled a long-awaited website that gives providers participating in the 340B drug pricing program (“340B Program”) direct access to information about the maximum amounts that pharmaceutical companies may charge for certain drugs. This moves... READ MORE

Conversation Shifts Back to Health Care in Washington Health care became a major discussion point for lawmakers after this week started with the Trump administration’s declaration that it supports a federal judge’s ruling that the entire Affordable Care Act (“ACA”) should be thrown out. This signals a shift in the Justice Department’s prior position... READ MORE