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CMS Proposes to Eliminate Its Medicaid Access Monitoring Standards

Last week, CMS issued a proposed rule as part of a broader Administration-wide initiative to reduce regulatory and administrative burdens. The proposed rule would absolve states from many of the requirements of a final...more

Medicaid and Non-Emergency Medical Transportation

On June 19, the House of Representatives passed the funding bill for the Department of Health and Human Services for fiscal year 2020.  CMS is funded in this annual legislation and this funding bill is often a vehicle for...more

New Employee Benefit Rules Expand Health Reimbursement Arrangement Options for Employers

On June 13, 2019, the Internal Revenue Service (IRS), Department of Labor and Department of Health and Human Services (HHS) issued a new regulation that is intended to increase the use of tax-favored health reimbursement...more

The History of Rebates in the Drug Supply Chain and HHS’ Proposed Rule to Change Safe Harbor Protection for Manufacturer Rebates

Excerpt: I. Introduction - In February of 2019, the Department of Health and Human Services’ Office of Inspector General (HHS-OIG) issued a Proposed Rule that, if adopted, would upend the current prescription drug...more

Antitrust Implications of HHS' Proposed Rule to Limit Manufacturer Rebates - March 2019

In February of 2019, the Department of Health and Human Services’ Office of Inspector General (HHS-OIG) issued a Proposed Rule that, if adopted, would upend the current prescription drug rebate system. According to HHS-OIG,...more

MA Employers Subject to New HIRD Reporting Requirement Starting Nov. 30, 2018

In 2017, Massachusetts enacted a supplemental appropriations bill providing for the creation of an employer healthcare coverage form that Massachusetts employers with six or more employees would be required to submit...more

Antitrust Implications of HHS Proposal to Limit Manufacturer Rebates

I. Introduction - In May 2018, the Department of Health and Human Services (HHS) introduced a “Blueprint” and Request for Information setting forth proposed actions and policies as a means to purportedly help lower...more

340B Hospitals File Suit in Wake of Hospital Outpatient Cuts

On November 13, 2017, a group of hospital trade associations (the American Hospital Association, the Association of American Medical Colleges, and America’s Essential Hospitals), along with two health system providers, filed...more

State and Federal Government Move to Enforce Employer Health Care Assessments

On Tuesday, November 7, 2017, the Massachusetts Executive Office of Labor and Workforce Development issued proposed regulations to implement the Employer Medical Assistance Contribution (EMAC) supplemental assessment that was...more

President Signs EO Loosening Health Care Regulations

On October 12, 2017, President Trump signed an Executive Order (EO) entitled “Promoting Healthcare Choice and Competition Across the United States.” The much-anticipated EO directs the Departments of Treasury, Labor, and...more

New Massachusetts Employer Assessment Intended to Deter MassHealth Enrollment

Since the beginning of this year’s legislative session, Governor Baker has expressed concern over the growth in enrollment in MassHealth, the state’s Medicaid program. A look at the numbers explains why. Prior to the...more

Five Provisions of New Healthcare Legislation that Affect Employee Benefit Plans

Early on Thursday morning, March 9, the Committee on Ways and Means of the U.S. House of Representatives passed legislation that would fundamentally restructure the Affordable Care Act (or, as it is sometimes colloquially...more

“Patient Protection and Affordable Care Act; Market Stabilization” Proposed Rule

On February 15, 2017 the Centers for Medicare & Medicaid Services (CMS) released a proposed rule entitled, “Patient Protection and Affordable Care Act; Market Stabilization.” Excerpt - In general, the proposed rule...more

New IRS Memo Concludes Benefits Paid by Fixed-Indemnity Health Plans May Be Taxable Income

On January 20, 2017, the Office of Chief Counsel of the Internal Revenue Service (IRS) issued a Memorandum on the tax treatment of benefits paid by fixed-indemnity health plans. In the Memorandum, the OCC concludes that...more

Summary: PAMA Final Rule

Market Based Payment for Clinical Diagnostic Laboratory Tests - Summary - On June 17, 2016 the Centers of Medicare & Medicaid Services (CMS) issued the long awaited Medicare Clinical Diagnostic Laboratory Tests...more

Medicaid Program: Covered Outpatient Drugs, Final Rule with Comment Period Summary

On January 21, 2016, the Centers for Medicare & Medicaid Services (CMS) released the final rule implementing the prescription drug rebate provisions enacted as part of the health care reform law, the Affordable Care Act...more

Supreme Court Allows Closely Held Corporations to Invoke Religious Objections Against Providing Employee Contraceptive Coverage

In a 5-4 decision, the United State Supreme Court ruled Monday in Burwell v. Hobby Lobby Stores, Inc., that closely held for-profit corporations may invoke religious objections to exclude contraceptive coverage from the...more

DC District Court Strikes Down 340B Orphan Drug Rule

On May 23, Judge Contreras of the U.S. District Court for the District of Columbia (DC District Court) ruled that the Health Resources and Services Administration (HRSA) did not have the statutory authority to promulgate its...more

Centers for Medicare & Medicaid Services Proposes Changes to Six Protected Class Rule under Medicare Part D

On December 8, 2003, the Medicare Prescription Drug, Improvement, and Modernization Act (the “MMA”) was signed into law by former President George W. Bush1. Prior to the enactment of the MMA, Medicare prescription drug...more

Foley Hoag and AdvaMed Collaborate on Industry Guidance on Retail Exemption in Final Device Tax Regulations

Foley Hoag and the Advanced Medical Technology Association (AdvaMed) collaborated on an important resource guiding manufacturers, importers, and producers of taxable medical devices through the newly released Internal Revenue...more

What Every Employer Should Know About the Affordable Care Act (ACA)

After months of uncertainty, the U.S. Supreme Court upheld the federal healthcare reform law known as the Affordable Care Act (ACA). What does this landmark law mean for employers now and in the near and distant future?...more

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